Neurorehabilitation: Strategies of Lower Extremities Restoration

Treatment of acute spinal cord injury (SCI) comprises two major therapeutic concepts, which aim for either restoration or compensation. Both strategies aim to reach the highest level of quality of life, mainly reflected by independence and participation in social activities. Restoration in this context means to recover sensorimotor function, which has been impaired or abolished by an incomplete spinal cord or cauda equine lesion. Therefore, only in patients with spared sensorimotor axon pathways restorative strategies can be successfully employed. In contrast, compensation means to replace irreversibly lost function through an alternative strategy, e.g., wheelchair mobility will substitute for the mobility achieved through walking. A number of excellent textbooks describe compensatory strategies in SCI rehabilitation in detail. This chapter will focus on therapies to promote recovery of walking function.