title: Activity-Based Restorative Therapies after Spinal Cord Injury: Inter-institutional conceptions and perceptions.
abstract: This manuscript is a review of the theoretical and clinical concepts provided during an inter-institutional training program on Activity-Based Restorative Therapies (ABRT) and the perceptions of those in attendance. ABRT is a relatively recent high volume and intensity approach toward the restoration of neurological deficits and decreasing the risk of secondary conditions associated with paralysis after spinal cord injury (SCI). ABRT is guided by the principle of neuroplasticity and the belief that even those with chronic SCI can benefit from repeated activation of the spinal cord pathways located both above and below the level of injury. ABRT can be defined as repetitive-task specific training using weight-bearing and external facilitation of neuromuscular activation. The five key components of ABRT are weight-bearing activities, functional electrical stimulation, task-specific practice, massed practice and locomotor training which includes body weight supported treadmill walking and water treadmill training. The various components of ABRT have been shown to improve functional mobility, and reverse negative body composition changes after SCI leading to the reduction of cardiovascular and other metabolic disease risk factors. The consensus of those who received the ABRT training was that ABRT has much potential for enhancement of recovery of those with SCI. Although various institutions have their own strengths and challenges, each institution was able to initiate a modified ABRT program.
authors.affiliation: University of Southern Mississippi, College of Health, Human Performance and Recreation, Hattiesburg, MS 39406, USA.
authors.forename: David R
authors.initials: DR
authors.lastname: Dolbow
authors.affiliation: Hunter Holmes McGuire VA Medical Center, Spinal Cord Injury and Disorders Center, Richmond, VA 23224, USA. ; Virginia Commonwealth University, School of Medicine, Richmond, VA 23298, USA.
authors.forename: Ashraf S
authors.initials: AS
authors.lastname: Gorgey
authors.affiliation: Kennedy Krieger Institute, International Center for Spinal Cord Injury, Baltimore MD 21205, USA. ; Johns Hopkins University School of Medicine, Baltimore MD 21205, USA.
authors.forename: Albert C
authors.initials: AC
authors.lastname: Recio
authors.affiliation: VA Puget Sound Health Care System, Seattle, WA 98108, USA.
authors.forename: Steven A
authors.initials: SA
authors.lastname: Stiens
authors.affiliation: VA Boston Healthcare System, Physical Medicine and Rehabilitation, West Roxbury, MA 02132, USA.
authors.forename: Amanda C
authors.initials: AC
authors.lastname: Curry
authors.affiliation: Kennedy Krieger Institute, International Center for Spinal Cord Injury, Baltimore MD 21205, USA. ; Johns Hopkins University School of Medicine, Baltimore MD 21205, USA.
authors.forename: Cristina L
authors.initials: CL
authors.lastname: Sadowsky
authors.affiliation: Penn State Hershey Medical Center and Health System, Hershey, PA 17033, USA. ; Penn State College of Medicine, Hershey, PA 17033.
authors.forename: David R
authors.initials: DR
authors.lastname: Gater
authors.affiliation: Kennedy Krieger Institute, International Center for Spinal Cord Injury, Baltimore MD 21205, USA.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Martin
authors.affiliation: Kennedy Krieger Institute, International Center for Spinal Cord Injury, Baltimore MD 21205, USA. ; Johns Hopkins University School of Medicine, Baltimore MD 21205, USA.
authors.forename: John W
authors.initials: JW
authors.lastname: McDonald
keywords: Activity-based Restorative Therapies; Locomotor Training; Massed practice; Neuroplasticity; Task-specific Practice