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Neuropathic pain is one of the most frequently stated complications after spinal cord injury. In post-spinal cord injury, the decrease of gamma aminobutyric acid synthesis within the distal spinal cord is one of the main causes of neuropathic pain. The predominant research question of this study was whether exercise training may promote the expression of glutamic acid decarboxylase-65 and glutamic acid decarboxylase-67, which are key enzymes of gamma aminobutyric acid synthesis, within the distal spinal cord through tropomyosin-related kinase B signaling, as its synthesis assists to relieve neuropathic pain after spinal cord injury. Animal experiment was conducted, and all rats were allocated into five groups: Sham group, SCI/PBS group, SCI-TT/PBS group, SCI/tropomyosin-related kinase B-IgG group, and SCI-TT/tropomyosin-related kinase B-IgG group, and then T10 contusion SCI model was performed as well as the tropomyosin-related kinase B-IgG was used to block the tropomyosin-related kinase B activation. Mechanical withdrawal thresholds and thermal withdrawal latencies were used for assessing pain-related behaviors. Western blot analysis was used to detect the expression of brain-derived neurotrophic factor, tropomyosin-related kinase B, CREB, p-REB, glutamic acid decarboxylase-65, and glutamic acid decarboxylase-67 within the distal spinal cord. Immunohistochemistry was used to analyze the distribution of CREB, p-CREB, glutamic acid decarboxylase-65, and glutamic acid decarboxylase-67 within the distal spinal cord dorsal horn. The results showed that exercise training could significantly mitigate the mechanical allodynia and thermal hyperalgesia in post-spinal cord injury and increase the synthesis of brain-derived neurotrophic factor, tropomyosin-related kinase B, CREB, p-CREB, glutamic acid decarboxylase-65, and glutamic acid decarboxylase-67 within the distal spinal cord. After the tropomyosin-related kinase B signaling was blocked, the analgesic effect of exercise training was inhibited, and in the SCI-TT/tropomyosin-related kinase B-IgG group, the synthesis of CREB, p-CREB, glutamic acid decarboxylase-65, and glutamic acid decarboxylase-67 within the distal spinal cord were also significantly reduced compared with the SCI-TT/PBS group. This study shows that exercise training may increase the glutamic acid decarboxylase-65 and glutamic acid decarboxylase-67 expression within the spinal cord dorsal horn through the tropomyosin-related kinase B signaling, and this mechanism may play a vital role in relieving the neuropathic pain of rats caused by incomplete SCI.

Background and Purpose: Contemporary approaches to the treatment of cerebral palsy (CP) advocate a task-specific approach that emphasizes repetition and practice of specific tasks. Recent studies suggest that body-weight-supported treadmill training (BWSTT) programs may be beneficial in clinical settings. The purposes of this case series were to explore the outcomes and feasibility of a home-based BWSTT program for three children with CP., Case Description: Three children with CP at Gross Motor Function Classification System (GMFCS) Levels III or IV participated in this case series. Examination included the Functional Assessment Questionnaire (FAQ), the 10-meter walk test, the Gross Motor Function Measure (GMFM-66), and the Pediatric Evaluation of Disability Inventory-Computer Adaptive Test (PEDI-CAT). A harness system was used to conduct the BWSTT program over an 8-12 week period., Outcomes: All of the families reported enjoying the BWSTT program and found the harness easy to use. Participant 2 increased from a 2 to a 4 on the FAQ, while Participant 3 increased from a 6 to a 7., Discussion: Two of the participants demonstrated post-intervention improvements in functional mobility. In addition to mobility outcomes, future research should explore the potential health benefits of a home-based BWSTT program.

Objective: To provide an overview of, and evaluate the current evidence on, locomotor training approaches for gait rehabilitation in individuals with incomplete spinal cord injury to identify the most effective therapies., Data Sources: The following electronic databases were searched systematically from first date of publication until May 2013: Allied and Complementary Medicine Database, Cumulative Index to Nursing and Allied Health Literature, Cochrane Database of Systematic Reviews, MEDLINE, Physiotherapy Evidence Database, and PubMed. References of relevant clinical trials and systematic reviews were also hand searched., Study Selection: Only randomized controlled trials evaluating locomotor therapies after incomplete spinal cord injury in an adult population were included. Full-text versions of all relevant articles were selected and evaluated by both authors., Data Extraction: Eligible studies were identified, and methodologic quality was assessed with the Physiotherapy Evidence Database scale. Articles scoring <4 points on the scale were excluded. Sample population, interventions, outcome measures, and findings were evaluated with regard to walking capacity, velocity, duration, and quality of gait., Data Synthesis: Data were analyzed by systematic comparison of findings. Eight articles were included in this review. Five compared body-weight-supported treadmill training (BWSTT) or robotic-assisted BWSTT with conventional gait training in acute/subacute subjects (≤1y postinjury). The remaining studies each compared 3 or 4 different locomotor interventions in chronic participants (>1y postinjury). Sample sizes were small, and study designs differed considerably impeding comparison. Only minor differences in outcomes measures were found between groups. Gait parameters improved slightly more after BWSTT and robotic gait training for acute participants. For chronic participants, improvements were greater after BWSTT with functional electrical stimulation and overground training with functional electrical stimulation/body-weight support compared with BWSTT with manual assistance, robotic gait training, or conventional physiotherapy., Conclusions: Evidence on the effectiveness of locomotor therapy is limited. All approaches show some potential for improvement of ambulatory function without superiority of 1 approach over another. More research on this topic is required., (Copyright © 2013 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.)