Sensory Information Modulates Voluntary Movement in an Individual with a Clinically Motor- and Sensory-Complete Spinal Cord Injury: A Case Report

Journal of Clinical Medicine, 2023 · DOI: 10.3390/jcm12216875 · Published: October 31, 2023

Spinal Cord Injury Neurology Neurorehabilitation

Simple Explanation

Following a complete spinal cord injury, regaining motor function is often considered unlikely, leading rehabilitation to focus on compensatory strategies rather than functional restoration. This case study challenges this notion by demonstrating that an individual with a clinically motor- and sensory-complete spinal cord injury was able to perform voluntary movements when placed in a sensory-rich environment. The individual could perform movements like push-ups, trunk extensions, and leg presses, but only when provided with appropriate sensory information to the spinal circuitry.

Study Duration

Not specified

Participants

Single 31-year-old male with C3 AIS-A SCI

Evidence Level

Level 4, Case Report

Key Findings

1
An individual with a C3 AIS-A SCI was able to perform voluntary movements with both upper and lower extremities when positioned in a sensory-rich environment.
2
The individual could intentionally perform push-ups, trunk extensions, and leg presses only when appropriate sensory information was available to the spinal circuitry.
3
Appropriate sensory input, load, and kinematics were crucial for the successful execution of voluntary movements.

Research Summary

This case report details the ability of an individual with a chronic motor-complete SCI to generate and modulate motor output through voluntary movement, highlighting the role of sensory information in this process. The individual, classified as C3 AIS-A, demonstrated the ability to perform push-ups, trunk extensions, and knee extensions when placed in a sensory-rich environment with appropriate mechanical advantage. The findings suggest that intense, task-specific, and sensory-appropriate rehabilitation can promote neuroplasticity below the level of injury, leading to improved functional recovery even in individuals with motor-complete SCI.

Practical Implications

Rehabilitation Strategies

Greater attention and opportunities should be provided to individuals with AIS-A SCIs through rehabilitation services, focusing on task-specific and sensory-appropriate training.

Insurance Coverage

Insurance providers should consider the potential for functional recovery in individuals with motor-complete SCIs and provide greater access to activity-based services.

Neuromodulation Advancements

With the advancement of neuromodulation and positive outcomes obtained with epidural stimulation, greater attention and opportunities should be provided to individuals with AIS-A.

Study Limitations

1
Single case study limits generalizability.
2
Long-term functional outcomes and translation to independent living not fully assessed.
3
The role of spasticity in motor recovery remains unclear.

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