Journal of Neurology and Neurorehabilitation Research

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Commentary - Journal of Neurology and Neurorehabilitation Research (2025) Volume 10, Issue 4

Multimodal Neurorehabilitation Approaches for Motor and Cognitive Recovery After Spinal Cord Injury

Fatoumata Diallo*

Department of Neurophysiology, Cheikh Anta Diop University, Senegal.

*Corresponding Author:
Fatoumata Diallo
Department of Neurophysiology
Cheikh Anta Diop University, Senegal
E-mail: f.diallo@ucad.sn

Received: 03-Oct-2025, Manuscript No. JNNR-25-171950; Editor assigned: 04-Oct-2025, PreQC No. JNNR-25-171950(PQ); Reviewed: 18-Oct-2025, QC No JNNR-25-171950; Revised: 21-Oct-2025, Manuscript No. JNNR-25-171950(R); Published: 28-Oct-2025, DOI:10.35841/ aajnnr -10.4.278

Citation: Diallo F. Multimodal neurorehabilitation approaches for motor and cognitive recovery after spinal cord injury. J Neurol Neurorehab Res. 2025;10(4):278.

Introduction

Spinal cord injury (SCI) results in profound motor, sensory, and cognitive impairments, presenting substantial challenges to rehabilitation. Recovery depends on the activation of spared neural pathways, neuroplastic reorganization, and patient engagement. Multimodal neurorehabilitation strategies, which integrate physical therapy, cognitive exercises, neuromodulation, and emerging technologies, have shown promise in enhancing functional outcomes. Understanding how these interventions interact to promote adaptive network remodeling is critical for designing effective rehabilitation programs [1].

Motor recovery relies on the recruitment and strengthening of residual corticospinal and propriospinal circuits. Repetitive task-specific exercises, robotic-assisted gait training, and functional electrical stimulation promote synaptic potentiation, cortical map reorganization, and compensatory network activation. Electrophysiological studies indicate that consistent activation of motor pathways enhances connectivity between cortical and spinal circuits, facilitating voluntary movement even in patients with chronic SCI. These interventions exploit the principles of activity-dependent plasticity to improve mobility and functional independence [2].

Cognitive deficits, including attention, memory, and executive function impairments, often accompany SCI and influence rehabilitation outcomes. Cognitive training programs, virtual reality (VR)–based tasks, and neurofeedback approaches stimulate cortical networks, reinforcing synaptic efficiency and improving cognitive performance. Integrating cognitive and motor rehabilitation enhances overall network plasticity, enabling patients to perform complex activities of daily living that require coordinated motor-cognitive processing. VR platforms also increase patient motivation and engagement, supporting adherence to therapy programs [3].

Neuromodulatory techniques, such as transcranial direct current stimulation (tDCS) and epidural spinal stimulation, further augment rehabilitation outcomes. By modulating cortical and spinal excitability, these interventions enhance the effects of task-specific training and facilitate functional reorganization. Pharmacological support targeting inhibitory neurotransmission and neurotrophic signaling may complement physical and cognitive therapy by promoting synaptic plasticity. Multidisciplinary integration of these modalities maximizes functional recovery and accelerates patient progress [4].

Despite advances, variability in injury severity, lesion location, and patient responsiveness remains a challenge. Personalized rehabilitation plans, guided by neuroimaging and electrophysiological monitoring, are essential to optimize outcomes. Long-term studies evaluating functional improvements and quality of life are necessary to validate multimodal approaches. Collaboration among neurologists, therapists, neurophysiologists, and psychologists ensures that interventions are evidence-based, patient-centered, and effective [5].

Conclusion

Multimodal neurorehabilitation targeting motor and cognitive domains after spinal cord injury promotes adaptive neuroplasticity and functional recovery. By combining task-specific training, cognitive exercises, neuromodulation, and technological innovations, individualized programs can optimize mobility, cognition, and quality of life. Integrative, evidence-based approaches are essential for achieving meaningful long-term rehabilitation outcomes.

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