Inducing Neural Plasticity in the Spinal Cord with Motor Point Stimulation to Improve Standing Balance
Bibliographic record
Abstract
Individuals with incomplete spinal cord injury (iSCI) experience an increased rate of falls due to decreased sensorimotor function. In particular, a lack of standing balance in individuals with iSCI worsens walking features and exposes them to falls. The main objective of this work was to 1) determine how the shank muscle function is altered after iSCI and how this may affect standing balance (Studies 1 and 2), and 2) investigate ways to strengthen the residual connections within the spinal cord (Studies 3, 4 and 5). Studies 1 and 2 looked at the control of the plantarflexor muscles, along with the co-ordination between the tibialis anterior and the plantarflexors during quiet standing by comparing between able-bodied individuals and individuals with iSCI. Individuals with iSCI showed an increased postural sway that was associated with an altered control strategy for the medial gastrocnemius and increased co-contractions between the tibialis anterior and plantarflexor muscles. Studies 3 and 4 examined the idea of paired associative stimulation to induce neural plasticity within the corticospinal and spinal reflex pathways, with able-bodied participants. The corticospinal excitability of the soleus was increased using transcranial magnetic stimulation and motor point stimulation, however, using peripheral nerve stimulation and motor point stimulation did not change the H-Reflex excitability. Lastly, Study 5 investigated changes to the corticospinal excitability of the soleus and tibialis anterior after a single session of functional electrical stimulation (FES) therapy for standing balance in able-bodied individuals and individuals with iSCI. After a single session of FES therapy, the soleus corticospinal excitability in both groups increased. Also, the changes in the soleus corticospinal excitability were related to both standing balance ability and level of injury in individuals with iSCI. In conclusion, the findings of this work suggest that the co-ordination of shank muscle activity after iSCI is altered and significantly impacts standing balance ability. Further, methods of inducing neural plasticity seem promising as the corticospinal excitability to the calf muscles can be positively changed which may lead to improved sensorimotor function. Thus, these insights may enhance the recovery of sensorimotor function, leading to improved standing balance and decreased falls after iSCI.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".