Gosuke Sato1,2, Michihiro Osumi3, Ryo Mikami4, Shu Morioka3. 1. Neurorehabilitation Research Center, Kio University, Nara, Japan. gpamjl@live.jp. 2. Department of Rehabilitation, Nara Prefecture General Medical Center, Nara, Japan. gpamjl@live.jp. 3. Neurorehabilitation Research Center, Kio University, Nara, Japan. 4. Department of Rehabilitation, Nara Prefecture General Rehabilitation Center, Nara, Japan.
Abstract
INTRODUCTION: Neuropathic pain after spinal cord injury is difficult to treat, and it is associated with abnormalities in the function of the thalamus-to-cortex neural circuitry. Aerobic exercise provides immediate improvement in neuropathic pain and is associated with abnormal resting electroencephalography (EEG) findings in patients with spinal cord injury. This study aimed to investigate whether physical therapy, including walking, can improve neuropathic pain and EEG peak alpha frequency (PAF) in the long term in a patient with cervical spinal cord injury. CASE PRESENTATION: A 50-year-old man was admitted with a cervical spinal cord insufficiency injury sustained one week prior. The residual height was C5. Neuropathic pain was observed in the fingers bilaterally. A numerical rating scale (NRS) was evaluated to measure the weekly mean and maximum intensities of pain. Resting EEG was measured, and the PAF was calculated. Each time point was evaluated in 2-week intervals from the time of admission, and the rate of change (Δ) of PAF was calculated based on the initial evaluation. Interventions included 18 weeks of standard physical therapy focusing on gait, with additional intensive gait training (4-10 weeks). The NRS scores for the mean and maximum intensities of pain decreased significantly after 6 weeks, and ΔPAF increased significantly after 4 weeks. Improvement in PAF coincided with the start of intensive gait training. DISCUSSION: PAF shifts to a high frequency during intensive gait training, suggesting the effectiveness of aerobic exercise. Furthermore, there is a close relationship between PAF, pain, and the quantification of pain changes.
INTRODUCTION: Neuropathic pain after spinal cord injury is difficult to treat, and it is associated with abnormalities in the function of the thalamus-to-cortex neural circuitry. Aerobic exercise provides immediate improvement in neuropathic pain and is associated with abnormal resting electroencephalography (EEG) findings in patients with spinal cord injury. This study aimed to investigate whether physical therapy, including walking, can improve neuropathic pain and EEG peak alpha frequency (PAF) in the long term in a patient with cervical spinal cord injury. CASE PRESENTATION: A 50-year-old man was admitted with a cervical spinal cord insufficiency injury sustained one week prior. The residual height was C5. Neuropathic pain was observed in the fingers bilaterally. A numerical rating scale (NRS) was evaluated to measure the weekly mean and maximum intensities of pain. Resting EEG was measured, and the PAF was calculated. Each time point was evaluated in 2-week intervals from the time of admission, and the rate of change (Δ) of PAF was calculated based on the initial evaluation. Interventions included 18 weeks of standard physical therapy focusing on gait, with additional intensive gait training (4-10 weeks). The NRS scores for the mean and maximum intensities of pain decreased significantly after 6 weeks, and ΔPAF increased significantly after 4 weeks. Improvement in PAF coincided with the start of intensive gait training. DISCUSSION: PAF shifts to a high frequency during intensive gait training, suggesting the effectiveness of aerobic exercise. Furthermore, there is a close relationship between PAF, pain, and the quantification of pain changes.
Authors: T N Bryce; F Biering-Sørensen; N B Finnerup; D D Cardenas; R Defrin; T Lundeberg; C Norrbrink; J S Richards; P Siddall; T Stripling; R-D Treede; S G Waxman; E Widerström-Noga; R P Yezierski; M Dijkers Journal: Spinal Cord Date: 2011-12-20 Impact factor: 2.772
Authors: Oliver Cruciger; Thomas A Schildhauer; Renate C Meindl; Martin Tegenthoff; Peter Schwenkreis; Mustafa Citak; Mirko Aach Journal: Disabil Rehabil Assist Technol Date: 2014-11-10