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Neurorehabilitation & Bioengineering

The Miami Project has a long history of utilizing novel rehabilitation strategies to enhance motor and sensory function in people living with SCI. Robotic walking machines such as the Locomat and other rehabilitation strategies have been used for years to help promote endogenous reparative strategies that might be important in SCI subjects. Combining locomotor training protocols, electrical stimulation, and vibration approaches are providing encouraging clinical findings that can be applied to the general

SCI population. An exciting new direction includes the use of brain-computer interface technology that allows functional connections between the brain and spinal cord to be introduced by novel engineering technologies. In the near future, Miami Project scientists will be utilizing these neurorehabilitation approaches and neuroengineering systems that will allow paralyzed individuals to voluntarily move their hands or legs. These neurorehabilitation strategies combined with the biological approaches, including Schwann cell transplantation that have already been described, represent a path to promoting significant clinical recovery in persons living with SCI and overall improvement of their quality of life. With the successful implantation of cells or growth-promoting factors, enhanced axonal regeneration coupled with these innovative rehabilitation tools could help modify and enhance axonal growth to appropriate targets that could lead to enhanced function.

Many people with SCI are living with the terrible situation of pain resulting from spinal damage. Miami Project researchers were some of the first to uncover the high frequency of neuropathic pain in the subject population and begin to investigate mechanisms underlying this important consequence of SCI. Today we know that more than 50% of people living with SCI have some form of neuropathic pain that in many cases is not successfully treated. In response to this need, researchers have uncovered cellular and molecular mechanism that may participate in this pathogenesis and also tested various treatment strategies including cell and drug treatments. Our faculty are involved in clinical trials to test new pain reducing agents that provide significant relief in many subjects. Established surgical approaches including deep brain stimulation are showing promise in treating both sensory and motor deficits after injury. Regarding another quality of life issue, important studies are clarifying the mechanisms underlying fertility problems in men with SCI. Based on recent findings, a clinical study is now moving forward to test a new treatment strategy that could provide hope for hundreds of couples trying to have children.