Recovery in gait and posture: a network-based approach to the assessment of rehabilitation effectiveness after spinal cord injury

Abstract

Spinal cord injury (SCI) disrupts locomotion by affecting multiple physiological domains, including spinal conduction, reflex excitability, gait kinematics, and behavioral performance. Because recovery may be reflected not only in individual readouts but also in the organization of relationships among these readouts, we assessed post-SCI rehabilitation using a multi-domain correlation-network approach. Adult female Wistar rats underwent mild thoracic contusion SCI and were assigned to an untreated (SCI) or a treadmill-trained (SCI + TMT) group. Locomotor recovery was evaluated using treadmill testing, open-field walking, and the ladder rung test. Video recordings were processed using DeepLabCut/ALMA-derived kinematic variables and were combined with behavioral scores, electrophysiological measures, and morphometric assessment. Group differences in kinematic parameters were evaluated using Mann-Whitney U tests with Benjamini-Hochberg false-discovery-rate correction, and correlation-network graphs were constructed from Spearman associations between selected electrophysiological and kinematic indicators. At 28 days post-injury (dpi), treadmill rehabilitation was associated with partial normalization of open-field stride-time metrics: median stride time recovered by 83%-84% toward the intact baseline for hind paws and by 81% for knee points relative to the SCI-intact difference, while stride-time variability normalized by 92%-100% for knee points. The hindlimb-to-forelimb stride-time ratio was closer to the intact value in SCI + TMT than in untreated SCI animals (1.03 vs. 1.25; intact: 1.00). Correlation-network analysis after multiple-comparison correction identified a limited set of associations involving bilateral H-wave amplitude, contralateral H-wave latency-hindlimb gait timing, and hindlimb/knee stride-interval indicators in the trained group. These findings suggest that treadmill rehabilitation after SCI is reflected not only in individual locomotor metrics but also in the organization of cross-domain statistical associations.

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