Cutaneomuscular Spinal Reflex Activity as a Biomarker of Motor Dysfunction and Neurorehabilitation After Incomplete Spinal Cord Injury

Cutaneomuscular afferent information is essential for voluntary motor tasks such as gait and balance. After spinal cord injury (SCI) changes in sensorimotor activity are involved in recovery of limited motor function. Here we present a review of clinical neurophysiological measures that quantify sensorimotor dysfunction and which have the potential to benchmark the therapeutic effect of cutaneous stimulation during SCI neurorehabilitation. Specifically we will show that long-latency cutaneous reflex and cutaneomuscular conditioned H-reflex techniques can quantify spinal neuronal activity and the presence of either adaptive or maladaptive motor control mechanisms after incomplete SCI. In conclusion, the development of neurorehabilitation programs in combination with cutaneomuscular stimulation protocols is a viable strategy not only to promote motor recovery but to prevent maladaptive neuroplasticity such as spasticity after SCI.