Activity-based rehabilitation in the form of overground or body weight-supported treadmill (BWST) locomotor step training has become the most widely accepted therapy translated from preclinical animal research to spinal cord injury (SCI) patients. However, locomotor training does not provide the level of functional locomotor recovery that animal models are interpreted to promise because preclinical studies have used complete spinal cord transections that do not sufficiently mimic the clinical presentation. Furthermore, animal models do not include the same standard of care, immobilization with stretch/range-ofmotion manual therapies, SCI patients receive. Therefore, we have developed an experimental animal model that includes aspects of acute patient care, immobilization and manual therapy interventions, applied daily throughout the 8 weeks following incomplete low thoracic contusion SCI in adult rats. We hypothesize that laboratory animals with clinically relevant incomplete contusion SCI achieve maximal locomotor recovery while moving about in their cages, "auto-training," within the first few weeks post-injury. Our results show that when immobilization and/or manual therapy interventions are applied the animals suffer severe short-term loss of locomotor function that significantly limits potential for long-term recovery even weeks after the interventions end. Our studies suggest that immobilization and widely practiced manual therapies may be maladaptive for functional locomotor recovery after clinically relevant incomplete SCI.
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Gain and loss of functional locomotor recovery following contusive spinal cord injury in the adult rat.