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Therapeutic Relevance of Motor Imagery in Motor Rehabilitation after Spinal Cord Injury (pp. 203-218) $100.00
Authors:  (Franck Di Rienzo, Aymeric Guillot, Gilles Rode, Christian Collet, Performance Motrice Mentale et du Matériel, Université Claude Bernard Lyon, Institut Universitaire de France, Paris, France, and others)
Abstract:
A large body of research demonstrated that motor imagery (the mental representation of an
action without its actual execution) shares common neural substrates with motor planning and
motor execution. In this chapter, we review current issues regarding motor imagery use in
motor rehabilitation after spinal cord injury, with a special focus on cervical cord lesions
eliciting quadriplegia. Firstly, we review the outcome of spinal cord injury on central
reorganizations, due to neuroplasticity. Then, we discuss theoretical and practical rationale for
motor imagery use as a therapeutic tool in the management of motor rehabilitation. Functional
equivalence between imagined and executed actions makes mental training relevant to
stimulate the neural networks mediating motor control, and a potential tool in the induction of
central reorganizations. Issues regarding motor imagery capacities in spinal cord injured
patients due to the effect of de-efferentation and de-afferentation on brain motor functions will
thus be considered. While neuroimaging studies report that motor imagery is likely to favor
functional recovery after spinal cord injury, only few studies addressed this issue in applied
experimental designs. Here, we report two pioneer studies supporting the therapeutic
relevance of motor imagery after cervical cord injury. Firstly, motor imagery practice might
improve motor planning of grasp actions after C6-C7 injury, by promoting motor learning of
the tenodesis grasp. Secondly, after tendon transfer following C5-C6 injury, motor imagery
practice might favor the central reorganizations required for central integration of new
muscular function. Both studies promote the impact of mental practice on cerebral plasticity
resulting in motor improvements. Tough further studies including larger group of patients are
necessary to confirm these findings, motor imagery is a promising technique to help
functional recovery after spinal cord injuries. 


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Therapeutic Relevance of Motor Imagery in Motor Rehabilitation after Spinal Cord Injury (pp. 203-218)