The role of motor network reorganization during rehabilitation

There are roughly 282,000 individuals living with spinal cord injury in the United States alone (National Spinal Cord Injury Statistical Center, Birmingham, AL, USA). Spinal cord injury often results in permanent functional impairments with only a limited capacity for spontaneous recovery. For the return of motor function, such as locomotion or hand and arm dexterity, rehabilitative training is the principal means to maximize the endogenous recovery of the central nervous system. The extent of rehabilitation-mediated motor recovery is likely dependent upon the extent of spared spinal cord tissue. However, the mechanisms supporting that recovery are not well understood. The primary focus of spinal cord injury research has been on inducing axonal growth and regeneration, with a lesser emphasis on how motor networks incorporate the changes induced by injury. An understanding of the role for motor learning mechanisms after spinal cord injury will provide means to maximize the functional recovery mediated by rehabilitation, stem cell treatments, regenerative therapies, or other interventions aimed at inducing plasticity of the neural circuits underlying motor function.