Open AccessMuscular, Skeletal, and Neural Adaptations Following Spinal Cord Injury
Author(s) -
Richard K. Shields
Publication year - 2002
Publication title -
the journal of orthopaedic and sports physical therapy/journal of orthopaedic and sports physical therapy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.367
H-Index - 121
eISSN - 1938-1344
pISSN - 0190-6011
DOI - 10.2519/jospt.2002.32.2.65
Subject(s) - medicine , paralysis , spinal cord injury , physical medicine and rehabilitation , spinal cord , rehabilitation , skeletal muscle , physical therapy , neuroscience , anatomy , surgery , psychology , psychiatry
Spinal cord injury is associated with adaptations to the muscular, skeletal, and spinal systems. Experimental data are lacking regarding the extent to which rehabilitative methods may influence these adaptations. An understanding of the plasticity of the muscular, skeletal, and spinal systems after paralysis may be important as new rehabilitative technologies emerge in the 21st century. Moreover, individuals injured today may become poor candidates for future scientific advancements (cure) if their neuromusculoskeletal systems are irreversibly impaired. The primary purpose of this paper is to explore the physiological properties of skeletal muscle as a result of spinal cord injury; secondarily, to consider associated changes at the skeletal and spinal levels. Muscular adaptations include a transformation to faster myosin, increased contractile speeds, shift to the right on the torque-frequency curve, increased fatigue, and enhanced doublet potentiation. These muscular adaptations may be prevented in individuals with acute paralysis and partially reversed in individuals with chronic paralysis. Moreover, the muscular changes may be coordinated with motor unit and spinal circuitry adaptations. Concurrently, skeletal adaptations, as measured by bone mineral density, show extensive loss within the first six months after paralysis. The underlying science governing neuromusculoskeletal adaptations after paralysis will help guide professionals as new rehabilitation strategies evolve in the future.