Kinematic and kinetic gait analysis to evaluate functional recovery in thoracic spinal cord injured rats
Introduction
Spinal cord injury (SCI) has a high prevalence in the entire world (Singh et al., 2014). This disease may result in permanent loss of motor, sensory, and autonomic function caused by initial mechanical lesion and secondary tissue damage. Despite advances have taken place over the past decade, recovering the capacity to walk remains a dream for most patients. Animal models are widely used in translational research for SCI in humans. The rat has become the favorite animal for testing various treatment strategies in SCI research and different lesion techniques have been developed to mimic human spinal cord lesions (Kim et al., 2017; Kozuka et al., 2016; Nicola et al., 2017).
In experimental SCI studies, one of the most used methods is the contusion technique, which produces a typical picture of secondary spinal cord damage and closely mimics the situation in humans (Beaumont et al., 2009; Iannotti et al., 2011; Koopmans et al., 2009; Ramu et al., 2007). With this model, since not all spinal tracts are disrupted, residual function persists to some degree and several motor and sensory tests have been developed in order to quantify remaining activity in the spinal cord (Jin et al., 2014; Zhao et al., 2016). An accurate evaluation of the spared and regenerating nervous tissue can be obtained by morphological methods, however, the most important factor on predicting SCI recovery is the evaluation of functional outcome, which can determine the lesion location and severity, and give information on the integrity of specific motor and sensory pathways (Basso, 2004). Rat models of contusive thoracic SCI allow the isolation and study of white matter deficits, namely spastic paralysis below the injury and sensory loss/chronic pain (Gensel et al., 2006; Wang et al., 2015). Since the most obvious functional consequence of injuries at the thoracic level is the loss of hindlimb motor function (Anderson et al., 2005) and due to the reliability and reproducibility of thoracic SCI models and behavioral tests, this kind of model has been widely used in spinal cord research (Bhimani et al., 2017; Muir and Webb, 2000).
Depending on the type of data collected, functional evaluation tests can be classified as: endpoint measures, in which a behavior is scored upon reaching a specific goal (Fagoe et al., 2016); kinematic analysis, including continuous kinematic analysis (Couto et al., 2008) and qualitative tests describing a particular movement; kinetic measurements, which quantify the amount of force produced by the hindlimbs (Howard et al., 2000); and electrophysiological measurements, which detect and measure muscle or sensory system activity (Gad et al., 2015; Keller et al., 2018).
Several methods have been developed to improve analyses of locomotion in rats after thoracic experimental SCI. Locomotion scoring systems are widely applied to evaluate motor function (Caudle et al., 2015; Morita et al., 2016). With this kind of method, it is possible to estimate spinal cord damage without compensatory behavior (Basso et al., 1995), as opposed to endpoints tests, in which the results cannot provide any information concerning how the task was performed (Whishaw et al., 1997). With advancement of new technology, such as computed gait analysis and force plate kinetics, important information about locomotion has allowed a better understanding of functional recovery after SCI (Couto et al., 2008; Howard et al., 2000).
This literature review aims to describe the advances in kinematic and kinetic assessments to evaluate locomotion in thoracic spinal cord injured rats with the goal of accelerating the translation of discoveries from the bench to the bedside and eventually to therapeutic practices that improve the quality of life in SCI patients, namely the capacity to walk.
We selected references by searching PubMed for manuscripts published in English between January 1, 1978, and August 20, 2018, using the term “rat” and assorted combinations of the following terms: “spinal cord injury” “gait analysis”, “locomotion”. “kinematics”, “kinetics”, “functional recovery”, “ground reaction forces” and “footprint analysis”. We examined the reference lists within original research and review articles for additional references. We finalized the reference list on the basis of originality and relevance to the scope of this Review. Data on kinematic and kinetic assessments to evaluate locomotion in thoracic spinal cord injured rats are summarized in Table 1.
Section snippets
Kinematic measures
Kinematic techniques include any method that describes and quantifies the movement of the whole body or body segments relative to each other and/or to an external frame of reference. In SCI research, several kinematic methods have been used to assess functional recovery including ordinal locomotor rating scales and continuous kinematic data (Basso et al., 1995; Couto et al., 2008; Osuna-Carrasco et al., 2016).
Kinetic measurements
Kinetics is the area of biomechanics concerned with forces and can be applied to rats by using force-transducing platforms that quantify forces exerted by these animals when moving over surfaces or objects (Muir and Whishaw, 1999a, b; Muir and Whishaw, 2000).
Force-transducing platforms include three-axis piezoelectric force transducers, charge amplifiers, signal conditioning boards, and a computer-based data acquisition system (Howard et al., 2000). When measuring forces during overground
Final considerations
Recovery of locomotor function after SCI underlies a complex process where many factors contribute to a gain in walking function. Kinematic methods provide important information about walking function in SCI. Despite modern equipment and advanced technology used for studies on gait analysis, the BBB scale is still the most common functional assessment method used in SCI. Locomotor rating scales may be insufficient in providing quantitative and detailed assessment of locomotion behavior in
Author disclosure statement
The authors declare that they have no competing financial interests.
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