With medical advances, more people survive spinal cord injury (SCI) than before. These medical breakthroughs have prolonged the lives of individuals, but the majority of them live with a disability, decreasing their quality of life. Such injuries are devastating for individuals and their families, and tremendous social and economical costs are associated with the care of these individuals for the remainder of their lives. It is thus urgent to appropriately address the cause of these impairments, improve rehabilitation approaches and enable individuals to fully enjoy their lives. Due to the variability of gait deficits observed in SCI patients, designing appropriate treatment is difficult almost impossible because, from a clinical point of view, each individual with SCI has different deficits.
However knowledge gained from animal studies and my recent work in individuals with SCI suggest that this variability stems from the intrinsic organization of pathways coming from the brain to the spinal cord. Notably, we have demonstrated that in spite of intensive rehabilitation, functional gait could not be achieved when SCI partially interrupted pathways related to balance control. However, our knowledge on balance control mechanism is lacking since very few studies investigated balance control mechanisms after SCI.
Thus in this project we will combine state-of-the-art assessment techniques in neurophysiology and in magnetic resonance imaging with current clinical assessment to further understand 1) mechanisms of balance control after SCI and 2) neuronal structures that, if impaired, will lead to balance deficits in patients. These results will constitute a basis for refining and tailoring rehabilitation protocols to each individual, based on the characteristics of their injury. Understanding how functional deficits come about is the key to develop more effective treatment strategies, decrease disability and improve quality of life.