MOTOR REHABILITATION OF SPINAL CORD INJURY BY COMBINED APPLICATION OF ROBOTIC EXOSKELETON, SPINAL CORD STIMULATION AND CORTICAL MODULATION

SPINAL CORD INJURY IS ONE OF THE MOST COMMON CAUSES THAT AFFECT THE CONTROL OF MOVEMENT FOR AN INDEPENDENT LIFE AND WITH NEGATIVE SEQUELAE SUCH AS THE DETERIORATION OF OTHER BIOLOGICAL FUNCTIONS, SOCIAL AND LABOR EXCLUSION. THERE IS NO CURE FOR SCI AND DESPITE REHABILITATION BASED ON INTENSIVE TREATMENTS, REHABILITATIVE ROBOTS OR PHARMACOLOGICAL TREATMENTS, THE MAJORITY OF PATIENTS WITH INCOMPLETE SPINAL CORD INJURIES HAVE INSUFFICIENT MOTOR RECOVERY. SPINAL CORD INJURIES RESULT IN THE LOSS OF TRANSMISSION OF DESCENDING AND ASCENDING SENSORIMOTOR INFORMATION BETWEEN THE BRAIN AND THE PERIPHERY OF THE MUSCULOSKELETAL SYSTEM. THE OBJECTIVE OF THE PROJECT IS TO VERIFY IF THERE IS A SIGNIFICANT SYNERGISTIC EFFECT THROUGH THE CONTROLLED COMBINATION OF TRANSCUTANEOUS MEDULLARY STIMULATION AND SUPERFICIAL DIRECT BRAIN STIMULATION, SYNCHRONIZED IN A CONTROLLED MANNER WITH ROBOTIC EXOSKELETONS OF GAIT REHABILITATION IN PATIENTS WITH INCOMPLETE SPINAL CORD INJURIES. THE PROJECT WILL VALIDATE THE CONCEPT OF HYBRID INTERVENTION OF SPINAL NEUROPROSTHETICS AND ROBOTIC EXOSKELETONS, IN COMBINATION WITH BRAIN STIMULATION FOR GAIT REHABILITATION: - SELECTIVE STIMULATION TECHNIQUES OF RELEVANT SPINAL NETWORKS INVOLVED IN SPINAL EXCITABILITY ASSOCIATED WITH INDUCED MUSCULAR RECRUITMENT WILL BE STUDIED. - THROUGH THE CHARACTERIZATION OF BRAIN AND SPINAL RESPONSES IN THE MOTOR NEURON FIRING PROPERTIES AND THE EFFECT OF THESE CHANGES ON THE EXCITABILITY OF THE CORTICO-SPINAL TRACT, THERE WILL BE A SYNERGISTIC TREATMENT OF THREE THERAPEUTIC INTERVENTIONS FOR MOTOR AND NERVE RECOVERY. THE FUNCTION OF THE MARCH - USING A MODEL BASED ON THE NEUROMUSCULAR AND MECHANICAL RESPONSE, IT WILL BE DETERMINED IF THE CONTROLLED COMBINATION OF SPINAL AND CEREBRAL STIMULATION IN SYNERGY WITH A ROBOTIC EXOSKELETON IS BENEFICIAL FOR THE MOTOR RECOVERY OF THE LOWER EXTREMITIES.