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CHAPTER 1 Spinal cord injury is a devastating condition of the spinal cord resulting from traumatic or non-traumatic causes. Traumatic causes include spinal injury from motor accidents, falls, violence and sports, while non-traumatic causes include spinal injury from vascular disorders, spinal canal stenosis, cancer and infectious conditions. By the end of last decade, there were more than 10,000 people living with this disease in Australia, with approximately 1 new case every day (Cripps, 2009; Norton, 2010). These patients, more than 80% being males, suffer from temporary and/or permanent loss of sensory, motor, and/or autonomic function. Having the highest incidence in the 15-24 age group, most patients require lifetime care and support leading to a nation-wide ongoing cost of A$500 million per year (Norton, 2010). The severity of the symptoms largely depends on the extent of the injury as well as the spinal level involved. The extent of injury determines how much function remains. Patients with complete spinal cord injury lose all function below the level of the injury while patients with incomplete spinal cord injury still have some function remaining below the level of the injury. The spinal, or neurological level of the injury, determines the sections of the body that are affected. With the highest incidence of cervical spinal cord injury, almost 60% of the patients suffer from quadriplegia, either incomplete or complete (Norton, 2010). Quadriplegia is characterised by loss of sensorimotor function in all four limbs. Patients with lower level injuries, such as thoracic, lumbar or sacral regions, suffer from complete or incomplete paraplegia which is identified as loss of sensorimotor function in lower limbs which may include the trunk. The loss of autonomic control to the viscera also result in potentially life-threatening complications, such as autonomic dysreflexia. Unfortunately, recovery in spinal cord injured patients is limited due to the complexity of the disease, poor spontaneous recovery, and lack of effective treatments. Patients are usually managed with pharmaceuticals to reduce inflammation and muscle spasticity. Medicinal intervention is commonly combined with physical therapy to help regain muscle strength. Functional electrical stimulation is also used to orchestrate muscle contractions during rehabilitation (Ho et al., 2014). New therapies such as stem cell (Doulames and Plant, 2016), injectable hydrogels (Tukmachev et al., 2016), and photobiomodulation (Hu et al., 2016) for example, are also under investigation and development. The current chapter will provide a general review of the literature on spinal cord injury resulting from trauma (Section 1.1) and a potential treatment, referred to as photobiomodulation (Section 1.2). Lastly, the aim of the project and the structure of this thesis are summarised (Section 1.3). 1.1 Spinal cord injury The current section will provide a basic understanding of spinal cord injury including its pathophysiology (Section 1.1.1) and common treatment approaches (Section 1.1.2). 2PDF Image | Effects of Red Light Treatment on Spinal Cord Injury
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