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.