ABSTRACT
Effective interventions to rehabilitate patients with neurological impairments and disabilities depend upon the ability of clinicians to drive adaptations within the spared nodes of neural networks. For the important skill of walking, studies in lower vertebrates and mammals, as well as in humans, are defining the interactions among interconnected neuronal assemblies, their neurotransmitters, ion channels, and genes, the effects of sensory feedback on their outputs, and molecular mechanisms of activity-dependent plasticity (1,2). This chapter examines several of these interactions as they relate to the recovery of walking after hemiplegic stroke and spinal cord injury (SCI). Intrinsic mechanisms of neuronal and network plasticity such as modifications in phosphorylation states, in spines and dendrites, and other aspects of synaptic plasticity at all levels of the neuroaxis are developed in other chapters.
