When the second half of the 20th century began, neuroscience seemed more a marketing buzzword than a term describing a new discipline—one that recognized that complex neural tissues and their functions could be understood only when the walls among biochemists, physiologists, anatomists, and others disappeared. Although frictions remain among the disciplines associated with neuroscience (especially when molecular biology is discussed), neuroscience offers all of us a lesson about the benefits of intellectual collaboration. When researchers work together, the impossible suddenly becomes possible, and there is less fear of heresy. As a result, we make room for new kinds of questions and the creative application of research methods, ones limited not by the training of individuals but by teams and financial resources.
Since the founding of the Society for Neuroscience in 1970, the growth of knowledge about the nervous system has been remarkable. Ideas once thought to be inviolate now fall before new experimental paradigms. These paradigms provide insights that no one could have imagined when giants like Sherrington and his laboratory of future Nobel Laureates toiled to make their own equipment and seek evidence for the assumptions we now take for granted. Their brilliance laid the groundwork for what is occurring now.
Today there are many physical therapists who are neuroscientists contributing to the breaking down of walls. These therapists also are helping to draw attention to important clinical questions. They work in all aspects of neuroscience, though we most often hear about those who focus on issues related to motor control.
This month, Physical Therapy begins its special series on spinal cord injury, in which therapists and non-physical therapists alike will address not only the basic sciences that are associated with spinal cord injury but the strategies for assisting people with spinal cord injury in clinical settings. First, I want to recognize the efforts of those who served as guest editors and nurtured this series: Rebecca Craik, PT, PhD, FAPTA, Neil Spielholz, PT, PhD, and Stuart Binder-Macleod, PT, PhD.
Plasticity and repair in the spinal cord was thought to be impossible not too long ago. Now there is no question that the nervous system, given the right environment, can exhibit some of the same plasticity in the spinal cord that we imagined might only be possible in the brain. Does that mean a cure for spinal cord injury is just over the horizon? Although many of us now believe a cure is possible, we doubt whether it will happen soon. But then again, how many of us would have predicted what we now know?
As this series continues over the next few months, you will find out about new developments both in our knowledge and in the way we manage our patients with spinal cord injury. There are some things that you will not see in this series, however. You won't see a discussion of what the new discoveries mean in psychosocial terms for those who have spinal cord injuries, and you won't see a discussion of whether the beliefs of such people as Christopher Reeve represent denial or realistic hope. Although this is a legitimate question that leads to the kind of dialogue that has too often been missing between health care practitioners and the people they work with, we have purposely omitted it from this series.
You also won't see a discussion about whether too much emphasis is being placed on eliminating attributes that people with disabilities have come to accept and whether too little emphasis is being placed on providing the resources and the respect that people with disabilities deserve. This view—which is being heard more and more often today—is held by people whom many of us may consider to be militant members of the disability community. (We must be wary, however, because the term “militant” often is used to dismiss ideas not because we determine that they lack merit but because we disparage the messenger.) Again, this is a topic we have purposely omitted. In this series, we have chosen to focus on new knowledge and to save discussions of the other issues for a time and place when they can be considered in a broader context.
For 2001, the Journal is planning a series that will focus on the disability movement and the people who lead that movement. Our hope is that the series will complement the current spinal cord injury series and provide a bridge between practitioners and people with disabilities who feel that they have not been included in the decision-making process in the health care and rehabilitation environments.
As we read, let's consider the more global context of our new knowledge. Our work with persons with severe physical disabilities is often the most dramatic—and least heralded—of our tasks. From that perspective, this series should prepare us not only for better clinical practice but for new discussions about our continued commitment to service and the very nature of what we do.
- Physical Therapy
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