title: Promoting Gait Recovery and Limiting Neuropathic Pain After Spinal Cord Injury.
abstract: Most persons living with a spinal cord injury experience neuropathic pain in the months following their lesion, at the moment where they receive intensive gait rehabilitation. Based on studies using animal models, it has been proposed that central sensitization in nociceptive pathways (maladaptive plasticity) and plasticity related to motor learning (adaptive plasticity) share common neural mechanisms and compete with each other. This article aims to address the discrepancy between the growing body of basic science literature supporting this hypothesis and the general belief in rehabilitation research that pain and gait rehabilitation represent two independent problems. First, the main findings from basic research showing interactions between nociception and learning in the spinal cord will be summarized, focusing both on evidence demonstrating the impact of nociception on motor learning and of motor learning on central sensitization. Then, the generalizability of these findings in animal models to humans will be discussed. Finally, the way potential interactions between nociception and motor learning are currently taken into account in clinical research in patients with spinal cord injury will be presented. To conclude, recommendations will be proposed to better integrate findings from basic research into future clinical research in persons with spinal cord injury.
authors.affiliation: 1 Centre Interdisciplinaire de Recherche en Réadaptation et Intégration Sociale, Quebec City, Quebec, Canada.|2 Laval University, Quebec City, Quebec, Canada.
authors.forename: Catherine
authors.initials: C
authors.lastname: Mercier
authors.affiliation: 1 Centre Interdisciplinaire de Recherche en Réadaptation et Intégration Sociale, Quebec City, Quebec, Canada.
authors.forename: Meyke
authors.initials: M
authors.lastname: Roosink
authors.affiliation: 1 Centre Interdisciplinaire de Recherche en Réadaptation et Intégration Sociale, Quebec City, Quebec, Canada.|2 Laval University, Quebec City, Quebec, Canada.
authors.forename: Jason
authors.initials: J
authors.lastname: Bouffard
authors.affiliation: 1 Centre Interdisciplinaire de Recherche en Réadaptation et Intégration Sociale, Quebec City, Quebec, Canada.|2 Laval University, Quebec City, Quebec, Canada.
authors.forename: Laurent J
authors.initials: LJ
authors.lastname: Bouyer
mesh_terms: D000818:Animals; D005684:Gait / Q000502:physiology; D006801:Humans; D009437:Neuralgia / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control*; D026741:Physical Therapy Modalities; D020127:Recovery of Function / Q000502:physiology; D013119:Spinal Cord Injuries / Q000150:complications / Q000503:physiopathology / Q000534:rehabilitation*
keywords: central sensitization; locomotion; motor learning; nociception; plasticity; rehabilitation