Treadmill Training Improves Functional Recovery After Injection of Adipose-Derived Stromal Vascular Fraction in Rats With a Spinal Cord Injury

Abstract

Spinal cord injuries (SCI) are a major health concern, resulting in substantial functional deficits, including motor and sensory impairments around and below the affected area. Despite continuous efforts, current spinal cord repair strategies have shown limited therapeutic success. The adipose-derived stromal vascular fraction (SVF) is a heterogeneous cell population with trophic, angiogenic, and immunomodulatory properties that has previously been shown to improve functional recovery after experimental SCI. The present study investigated whether treadmill rehabilitation could enhance the therapeutic effects of autologous SVF transplantation following severe thoracic SCI. Thirty-six male Sprague Dawley rats were divided into four groups: NaCl (sodium chloride) (spinal cord contusion with NaCl injection), SVF (contusion with SVF autograft), NaCl-T (contusion with NaCl injection and treadmill training), and SVF-T (contusion with SVF autograft and treadmill training). Behavioral recovery was assessed weekly over 12 weeks using the BBB locomotor score and ladder climbing test, while gait and electrophysiological analyses were performed at the study endpoint. The combined treatment produced greater improvements in locomotor performance than either SVF transplantation or treadmill training alone, as demonstrated by higher BBB and ladder climbing scores together with improved gait parameters. Electrophysiological analyses further showed that SVF treatment restored rate-dependent depression of the H-reflex, reflecting improved spinal sensorimotor inhibitory function. Collectively, these findings demonstrate that treadmill rehabilitation potentiates the functional benefits of autologous SVF transplantation and supports the combination of cell therapy and rehabilitation as a promising strategy to enhance functional recovery after traumatic SCI.