Journal
PHYSICAL THERAPY
Volume 102, Issue 1, Pages -Publisher
OXFORD UNIV PRESS INC
DOI: 10.1093/ptj/pzab228
Keywords
Autonomic Function; Chronic Cervical Spinal Cord Injury; Locomotor Training; Noninvasive Electrical Spinal Stimulation
Categories
Funding
- Center for Neurotechnology
- National Science Foundation-Engineering Research Center [EEC-1028725]
- Washington State Spinal Cord Injury Consortium
- Christopher and Dana Reeve Foundation
- University of Washington Institute for Neuroengineering grant from the Washington Research Foundation
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This study aimed to investigate the effects of transcutaneous spinal cord stimulation combined with intensive training in individuals with chronic spinal cord injury. The results showed that this intervention significantly improved walking ability, balance, sensation, and bowel function in the participants. It suggests that noninvasive spinal cord stimulation could promote recovery of locomotor and autonomic functions in people with chronic incomplete cervical SCI.
Objective This study investigated the effect of cervical and lumbar transcutaneous spinal cord stimulation (tSCS) combined with intensive training to improve walking and autonomic function after chronic spinal cord injury (SCI). Methods Two 64-year-old men with chronic motor incomplete cervical SCI participated in this single-subject design study. They each underwent 2 months of intensive locomotor training and 2 months of multisite cervical and lumbosacral tSCS paired with intensive locomotor training. Results The improvement in 6-Minute Walk Test distance after 2 months of tSCS with intensive training was threefold greater than after locomotor training alone. Both participants improved balance ability measured by the Berg Balance Scale and increased their ability to engage in daily home exercises. Gait analysis demonstrated increased step length for each individual. Both participants experienced improved sensation and bowel function, and 1 participant eliminated the need for intermittent catheterization after the stimulation phase of the study. Conclusion These results suggest that noninvasive spinal cord stimulation might promote recovery of locomotor and autonomic functions beyond traditional gait training in people with chronic incomplete cervical SCI. Impact Multisite transcutaneous spinal stimulation may induce neuroplasticity of the spinal networks and confer functional benefits following chronic cervical SCI.
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