{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T09:50:02Z","timestamp":1777888202998,"version":"3.51.4"},"reference-count":0,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2012,1,1]],"date-time":"2012-01-01T00:00:00Z","timestamp":1325376000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Pediatric Rehabilitation Medicine"],"published-print":{"date-parts":[[2012,11]]},"abstract":"<jats:p>Physical rehabilitation after spinal cord injury (SCI) in adult and\n\t\t\t pediatric populations has traditionally compensated for paralysis and weakness\n\t\t\t using wheelchairs, assistive devices, and braces to achieve seated mobility,\n\t\t\t upright standing, or bracewalking. Recent evidence indicates efficacy of\n\t\t\t activity-based therapies in adults with SCI, specifically locomotor training\n\t\t\t (LT), to activate the neuromuscular system below the injury level and improve\n\t\t\t walking and postural control by restoring pre-morbid movements. The purpose of\n\t\t\t this paper is to demonstrate the feasibility of LT, using repetitive stepping\n\t\t\t practice on a treadmill and translated to over ground and the community, to\n\t\t\t meet the unique needs and demands of pediatric, adolescent rehabilitation.\n\t\t\t Three outpatient adolescents, T5 AIS D, age 15 (primary wheelchair user), T5\n\t\t\t AIS C, age 14 (primary wheelchair user), and C2, AIS D, 14 years (primary\n\t\t\t ambulator), received a standardized protocol of LT 4\u20135 times per week for 75,\n\t\t\t 293, and 40 total sessions, respectively, across 1\u20133 episodes of care. Two\n\t\t\t adolescents became full-time ambulators, and one adolescent improved locomotor\n\t\t\t skills, kinematics, and endurance with two individuals lacking significant\n\t\t\t increases in strength to account for the benefits. Motivational strategies were\n\t\t\t developmentally specific, parental involvement critical for carryover, and\n\t\t\t musculoskeletal considerations paramount with growth and maturation. In\n\t\t\t comparison to adults, adolescents' continued musculoskeletal, cognitive, and\n\t\t\t social growth and maturation necessitate repeated episodes of therapy and\n\t\t\t bi-annual re-evaluations to identify needs and address new goals. The use of\n\t\t\t activity-based therapies, i.e. LT, represents a paradigm shift in pediatric\n\t\t\t rehabilitation towards activation of the neuromuscular system below the lesion\n\t\t\t via task-specific training and experience, minimizing compensation strategies,\n\t\t\t and targeting recovery of function achieved via use of pre-morbid movement\n\t\t\t patterns.<\/jats:p>","DOI":"10.3233\/prm-2012-00225","type":"journal-article","created":{"date-parts":[[2019,12,3]],"date-time":"2019-12-03T17:11:10Z","timestamp":1575393070000},"page":"245-259","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":13,"title":["Restorative rehabilitation entails a paradigm shift in pediatric\t\t\t incomplete spinal cord injury in adolescence: An illustrative case series"],"prefix":"10.1177","volume":"5","author":[{"given":"Andrea L.","family":"Behrman","sequence":"first","affiliation":[{"name":"Department of Neurological Surgery and Kentucky Spinal\r\t\t\t Cord Injury Research Center, University of Louisville, Kentucky, Louisville, KY, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elizabeth","family":"Watson","sequence":"additional","affiliation":[{"name":"Magee Rehabilitation Hospital, Philadelphia, PA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Guy","family":"Fried","sequence":"additional","affiliation":[{"name":"Magee Rehabilitation Hospital, Philadelphia, PA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kelly","family":"D'Urso","sequence":"additional","affiliation":[{"name":"Kessler Institute for Rehabilitation, Outpatient\r\t\t\t Department, West Orange, NJ, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Denise","family":"D'Urso","sequence":"additional","affiliation":[{"name":"Kessler Institute for Rehabilitation, West Orange, NJ, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Natalie","family":"Cavadini","sequence":"additional","affiliation":[{"name":"Kessler Institute for Rehabilitation, Outpatient\r\t\t\t Department, West Orange, NJ, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Monifa","family":"Brooks","sequence":"additional","affiliation":[{"name":"Kessler Institute for Rehabilitation, West Orange, NJ, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marcie","family":"Kern","sequence":"additional","affiliation":[{"name":"TIRR Memorial Hermann, Houston, TX, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lisa","family":"Wenzel","sequence":"additional","affiliation":[{"name":"TIRR Memorial Hermann, Houston, TX, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Heather","family":"Taylor","sequence":"additional","affiliation":[{"name":"TIRR Memorial Hermann, Houston, TX, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elizabeth","family":"Ardolino","sequence":"additional","affiliation":[{"name":"University of St. Augustine, Austin, TX, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2012,1]]},"container-title":["Journal of Pediatric Rehabilitation Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.3233\/PRM-2012-00225","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.3233\/PRM-2012-00225","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T04:38:57Z","timestamp":1777610337000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.3233\/PRM-2012-00225"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2012,1]]},"references-count":0,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2012,11]]}},"alternative-id":["10.3233\/PRM-2012-00225"],"URL":"https:\/\/doi.org\/10.3233\/prm-2012-00225","relation":{},"ISSN":["1874-5393","1875-8894"],"issn-type":[{"value":"1874-5393","type":"print"},{"value":"1875-8894","type":"electronic"}],"subject":[],"published":{"date-parts":[[2012,1]]}}}