Laboratory Summary: We live in a tremendously exciting time when neuroscientists are making momentous discoveries about the capacity of the nervous system to recover from damage if given favorable opportunities and exposed to advantageous experiences. The studies in the Neuromotor Rehabilitation Research Laboratory cross the boundaries of basic neurophysiology of the brain and spinal cord and applied neurophysiology related to neuroplasticity and motor learning. We want to understand which interventions best promote recovery of function. Some of the rehabilitation studies focus on recovery of hand and arm function, while others are aimed at walking function. In addition to the emphasis on promotion of functional movement, we are interested in understanding the changes that occur in the nervous system that make these improvements possible.
We know that the neural circuitry of the both the brain and spinal undergo detrimental changes (maladaptive neuroplasticity) after spinal cord injury. Happily, the work of my lab and others has demonstrated that there are ways to promote beneficial changes (adaptive neuroplasticity) through the use of practice and sensory input, so that the nervous system produces more functional motor output. The work of the Neuromotor Rehabilitation Research Laboratory aims to discover optimal ways to use practice and sensory input to restore hand function and walking function after injury to the spinal cord.
Studies of nervous system development have confirmed that experience (i.e., practice) is critical for the normal growth and function of the brain and spinal cord. It makes sense that following injury, practice is also necessary for optimal recovery of the brain and spinal cord. In addition to practice, sensory inputs such as electrical stimulation can have a potent effect on neural activity. Since information exchange within the nervous system relies on neural signals, which are essentially electrical impulses, electrical stimulation may represent an effective strategy for communicating with the nervous system to improve motor function.
Experiments in my lab have shown that the brain is altered by spinal cord injury, and these alterations contribute to deficits of hand function in individuals with tetraplegia. By using practice and stimulation to engage the brain, we have been able to improve functional use of the hands in individuals with tetraplegia who have minimal hand function. Further, these studies have also shown that there are changes in the brain that accompany and support these improvements in hand function.
At the level of the spinal cord, there is evidence that neural circuits are much "smarter" than we had previously thought. Like the circuits in the brain, the circuits in the spinal cord also change in response to practice and in response to electrical stimulation. These changes represent an elementary form of learning. Studies in the Neuromotor Rehabilitation Research Laboratory capitalize on this learning to promote improved walking function.
While rehabilitation is not a "cure", it offers restorative strategies that are available today, and which make use of the innate capacity of the brain and spinal cord to adapt in response to experience, practice, and sensory inputs. Ultimately, identifying optimal restorative strategies will be critical for the success of regenerative strategies as well, since regenerative strategies are likely to be optimally effective only when combined with effective rehabilitation.
Notable Accomplishments: Dr. Field-Fote is Editor-in-Chief of the Journal of Neurologic Physical Therapy. She was Chair of an NIH Study Section from 2006 - 2008.