Retraining Reflexes: Clinical Translation of Spinal Reflex Operant Conditioning

Neurotherapeutics, 2018 · DOI: https://doi.org/10.1007/s13311-018-0643-2 · Published: July 9, 2018

Simple Explanation

Neurological disorders can cause motor impairments, partly due to spinal reflex abnormalities. Measurements of these reflexes are important for understanding and managing conditions like spasticity. Retraining these reflexes through operant conditioning may improve motor skills and complement existing therapies. Operant conditioning protocols can target beneficial plasticity to key reflex pathways; they can thereby trigger wider plasticity that improves impaired motor skills, such as locomotion. This paper reviews the value of spinal reflexes and the therapeutic promise of spinal reflex operant conditioning protocols; it also considers the complex process of translating this promise into clinical reality.

Study Duration

Not specified

Participants

People and animals with neurological disorders

Evidence Level

Review

Key Findings

1
Operant conditioning of spinal reflexes can lead to improvements in locomotion in both animals and humans with incomplete spinal cord injury.
2
The beneficial effects of spinal reflex conditioning appear to persist even after the conditioning period has ended.
3
Spinal reflex conditioning is uniquely targeted; it is possible to operantly condition a specific abnormal reflex pathway and strengthen or weaken it as appropriate for an individual person’s disability.

Research Summary

Spinal reflexes, particularly the H-reflex, serve as valuable biomarkers for evaluating neurological disabilities and guiding therapeutic interventions. H-reflex operant conditioning protocols can induce beneficial plasticity at spinal sites, improving motor functions like locomotion and potentially complementing other therapies. Translating this therapeutic approach requires further clinical studies, hardware/software development, market research, a business model, reimbursement strategy, and regulatory approval.

Practical Implications

Targeted Therapy

Spinal reflex conditioning offers a uniquely targeted approach to rehabilitation, allowing for specific modification of abnormal reflex pathways.

Enhanced Rehabilitation

Combining spinal reflex conditioning with other therapies, such as locomotor training, may lead to more effective rehabilitation outcomes.

Persistent Benefits

The potential for long-lasting improvements in motor function suggests that spinal reflex conditioning could provide sustained benefits for individuals with neurological disorders.

Study Limitations

1
Current spinal reflex operant conditioning systems are complex and require extensive operator training, limiting clinical use.
2
Further clinical studies are needed to determine the effectiveness of spinal reflex conditioning for different patient populations and in combination with other therapies.
3
A cost-effective and implementable reimbursement model is necessary for the widespread adoption of spinal reflex conditioning as a clinical therapy.

Your Feedback

Was this summary helpful?

Back to Neurology