References and suggested reading

LB therapy is a classical example for the development of new therapies in medicine. In the beginning there were basic researchers working in animal research discovering spinal motor centers for locomotion in lower vertebrates. Another typical event is the fact that spinal locomotion in the cat was found 100 years ago, but no consequences were drawn for the human SCI patient. This is hard to understand since infant stepping always told us that also the human spinal cord works with such motor programs. Some 20 - 30 years ago the rules of spinal locomotion were found and it was clear that proprioceptive key inputs were important to maintain the flow of correct efferent signals which all melted into one enormous event: Walking. Among the many researchers who contributed to this knowledge some names to remember are Grillner, Lundberg, Shik, Hultborn... However, it took another amazing finding which finally ignatated the spark for the transfere into therapy for humans: The isolated spinal cord can learn, found Edgerton in Los Angeles and Rossignol in Montreal. The first attempts with paraplegics were done independently in Canada by Barbeau and our group in Germany. It was 1995 that the first and so far only controlled study involving some 150 SCI patients appeard in print. Soon LB therapy spread to hemiplegia and other diseases with motor deficits.
The references below provide original information on these aspects, additional references can be taken from the quotations. They will give a good start for those among you who want to go the roots but also additional practical knowledge.

Barbeau, H. and Blunt, R. (1991) A novel interactive locomotor approach using body weight support to retrain gate in spastic paretic subjects. In A. Wernig (Ed.), Plasticity of Motorneuronal Connections. Restorative Neurology, Vol. 5, Elsevier, Amsterdam, pp. 461?474.

Barbeau, H. and Rossignol, S. (1987) Recovery of locomotion after chronic spinalization in the adult cat. Brain Res., 412: 844?895.

Dobkin, B.H., Harkema, S.J., Requejo, P.S. and Edgerton, V.R. (1995) Modulation of locomotor?like EMG activity in subjects with complete and incomplete spinal cord injury. J. Neurorehab., 9: 183?190.

Edgerton, V.R., Roy, R. R., Hodgson, J.A., Gregor, R.J. and de Guzman, C.P. (1991) Recovery of full weight?supporting locomotion of the hindlimbs after complete thoracic spinalization of adult and neonatal cats. In A. Wernig (Ed.), Plasticity of Motoneuronal Connections. Restorative Neurology, Vol. 5, Elsevier, Amsterdam, pp. 405-418.

Eidelberg, E., Walden, J.G. and Nguyen, L.H. (1981) Locomotor control in macaque monkeys. Brain, 104, 647?663.

Gossard, J.P. and Hultborn, H. (1991) On the organization of spinal rhythm generation in locomotion. In A. Wernig (Ed.), Plasticity of Motorneuronal Connections. Restorative Neurology, Vol. 5, Elsevier, Amsterdam, pp. 385-404.

Grillner, S. (1981) Control of locomotion in bipeds, tetrapods, and fish. In J. E. Brookhart, V. B. Mountcastle, V. B. Brooks and S. R. Geiger (Eds.), Handbook of Physiology, Section 1, Vol. 2, Part 2, American Physiological Society, Bethesda, MD, pp. 1127?1236.

Harkema, S.J., Requejo, P.S., Hurley, S.L., Patel, U.K., Dobkin, B.H. and Edgerton, V.R. (1997) Human lumbosacral spinal cord interprets loading during stepping. J. Neurophysiol., 77: 797?811.

Harms, J. (1992) Screw?threaded rod system in spinal fusion surgery. Spine: State of the Art Reviews, 6: 541?575.

Hesse, S.T., Bertelt, C., Schaffrin, A., Malezik, M. and Mauritz, K.H. (1994) Restoration of gait in nonambulatory hemiparetic patients by treadmill training with partial body weight support. Arch. Phys. Med. Rehabil., 75: 1087?1093.

Jorgensen H.S., Nakayama H., Raaschou H.O. and Olson T.S.. Recovery of walking function in stroke patients: The Copenhagen stroke study. Arch Phys Med Rehabil 78, 27-32, 1995.

Kendall, H.O., Kendall, F.P. and Wadsworth, G.E. (1971) Muscles ? Testing and Function, Williams and Wilkins, Amsterdam.

Kosak MC, Reding MJ (2000). Comparison of partial body weight-supported treadmill gait training versus aggressive bracing assisted walking post stroke.. Neurorehabil Neural Repair 2000;14(1):13-19

Lovely, R.G., Gregor, R.J., Roy, R.R. and Edgerton V.R. (1986) Effects of training on the recovery of full weight?bearing stepping in the spinal adult cat. Exp. Neurol., 92: 421?435.

Maegele, M., Müller, S., Wernig, A., Edgerton, R. and Harkema, S. (2002). J Neurotrauma 19, 1217-29,.

Nilsson et al (2001). Walking training of patients with hemiparesis at an early stage after stroke: a comparison of walking training on a treadmill with body weight support and walking training on the ground. Clin Rehabil 2001 Oct;15(5):515-27.

Richards, C. L., Malouin, F., Wood?Dauphinee, S., Bouchard, J.P. and Brunet, D. (1993) Task specific physical therapy for optimization of gait recovery in acute stroke patients. Arch. Phys. Med. Rehabil, 74: 612?620.

Visintin, M. and Barbeau, H. (1989) The effects of body weight support on the locomotor pattern of spastic paretic patients. Can. J. Neurol. Sci., 16: 315?325.

Wernig, A. and Müller, S. (1991) Improvement of walking in spinal cord injured persons after treadmill training. . In A.Wernig (Ed.), Plasticity of Motoneuronal Connections. Restorative Neurology, Vol. 5, Elsevier, Amsterdam, pp. 475-486.

Wernig, A. and Müller, S. (1992) Laufband locomotion with body weight support improved walking in persons with spinal cord injuries. Paraplegia, 30: 229?238.

Wernig, A., Müller, S., Nanassy, A. and Cagol E (1995) Laufband therapy based on "rules of spinal locomotion" is effective in spinal cord injured persons. Eur. J. Neurosci., 7: 823?829.

Wernig, A., Nanassy, A. and Müller, S. (1998). Maintenance of locomotor abilities following Laufband (treadmill) therapy in para- and tetraplegic persons: follow up studies. Spinal Cord, 36: 744-749.

Wernig, A., Nanassy, A. and Müller, S. (1999). Laufband (treadmill) therapy in incomplete paraplegia and tetraplegia. J.of Neurotrauma, 16: 719-726.

Wernig, A. (2005). Letter to the Editor. Spinal Cord, in press