Neuromodulation to guide circuit reorganization with regenerative therapies in upper extremity rehabilitation following cervical spinal cord injury

Regenerative rehabilitation combines regenerative medicine with rehabilitation strategies to help people recover function after injuries. It's particularly important for individuals with cervical spinal cord injuries (SCIs) who struggle to regain hand strength. Current clinical practices often use neuromodulation to activate spared circuits below the injury level. Combining neuromodulation with regenerative medicine strategies may unlock new possibilities for upper extremity treatment after SCI. The development of dexterous hand use has led to an expansion of the sensorimotor cortex, making it a potential drawback after cervical SCI. Understanding SCIs is crucial in comprehending the importance of regenerative rehabilitation approaches for upper limb function.

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  Regenerative rehabilitation therapies are needed to circumvent the limitations of current treatment options and promote neurite regeneration and functional recovery following SCI, especially in the chronic phase.
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  Cell-based therapies, especially neural progenitor cell transplantation combined with rehabilitation, can foster host corticospinal axon regeneration into grafts, leading to meaningful forelimb sensorimotor recovery.
• 3
  Electrical stimulation, including FES therapy and spinal cord stimulation, can promote targeted circuit reorganization and enhance the effects of cell and stem cell therapies, guiding circuit reorganization even in severe paralysis cases.