4.7 Review

Invasive and Non-Invasive Approaches of Electrical Stimulation to Improve Physical Functioning after Spinal Cord Injury

Journal

JOURNAL OF CLINICAL MEDICINE
Volume 10, Issue 22, Pages -

Publisher

MDPI
DOI: 10.3390/jcm10225356

Keywords

rehabilitation; exercise; neurological; spinal cord injuries; paraplegia; tetraplegia

Funding

  1. DoD-CDMRP clinical trial program [W81XWH-20-1-0845 (SC190107 CDMRP W91ZSQ)]
  2. Department of Veteran Affairs-SPiRE Program [B3456-P]
  3. National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR) [HHS-2021-ACL-NIDILRR-SIMS-004]

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This review summarizes the latest evidence on the invasive and non-invasive uses of electrical stimulation therapies for spinal cord injury patients, focusing on neuromuscular and functional electrical stimulation activities. The review also discusses recommendations for optimizing stimulation parameters and the use of stimulation to enhance daily living activities such as reaching, grasping, standing, and walking.
This review of literature provides the latest evidence involving invasive and non-invasive uses of electrical stimulation therapies that assist in restoring functional abilities and the enhancement of quality of life in those with spinal cord injuries. The review includes neuromuscular electrical stimulation and functional electrical stimulation activities that promote improved body composition changes and increased muscular strength, which have been shown to improve abilities in activities of daily living. Recommendations for optimizing electrical stimulation parameters are also reported. Electrical stimulation is also used to enhance the skills of reaching, grasping, standing, and walking, among other activities of daily living. Additionally, we report on the use of invasive and non-invasive neuromodulation techniques targeting improved mobility, including standing, postural control, and assisted walking. We attempt to summarize the effects of epidural stimulation on cardiovascular performance and provide a mechanistic explanation to the current research findings. Future trends such as the combination of epidural stimulation and exoskeletal-assisted walking are also discussed.

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