Locomotor Training Principles and Practice

Physical rehabilitation for walking recovery after spinal cord injury is undergoing a paradigm shift. Therapy historically has focused on compensation for sensorimotor deficits after SCI using wheelchairs and bracing to achieve mobility. With locomotor training, the aim is to promote recovery via activation of the neuromuscular system below the level of the lesion. What basic scientists have shown us as the potential of the nervous system for plasticity, to learn, even after injury is being translated into a rehabilitation strategy by taking advantage of the intrinsic biology of the central nervous system. While spinal cord injury from basic and clinical perspectives was the gateway for developing locomotor training, its application has been extended to other populations with neurologic dysfunction resulting in loss of walking or walking disability.

Dr. Susan J. Harkema PhD, Associate Professor holds the Owsley B. Frazier Rehabilitation Chair in Neurological Surgery and is the Rehabilitation Research Director of the Kentucky Spinal Cord Injury Research Center at the University of Louisville. She is the Director of Research at Frazier Rehab Institute and is Director of the NeuroRecovery Network that provides standardized activity-based therapies for individuals with spinal cord injury at seven national rehabilitation centers in the United States. Her research focuses on neural plasticity of spinal networks and recovery of function after spinal cord injury. Dr. Behrman is an Associate Professor in the Dept of Physical Therapy, College of Public Health and Health Professions at the University of Florida and a Research Health Scientist at the VA Brain Rehabilitation Research Center, Malcom Randall VA Medical Center. She also is a co-Director of the Christopher and Dana Reeve Foundation NeuroRecovery Network translating evidence for activity-based therapies into clinical practice. Her research targets developing "best practice" for walking recovery after neurologic injury using principles of activity-dependent plasticity and an understanding of the neurobiology of walking. Dr. Barbeau was part of the first group that developed the locomotor training in SCI and stroke subjects in the early 80s. He has had a significant contribution to the development of functional electrical stimulation and the drugs on the locomotor pattern in the SCI subjects.