scholarly journals Transcutaneous spinal cord stimulation and motor responses in individuals with spinal cord injury: A methodological review

PLoS ONE ◽  
2021 ◽  
Vol 16 (11) ◽  
pp. e0260166
Author(s):  
Clare Taylor ◽  
Conor McHugh ◽  
David Mockler ◽  
Conor Minogue ◽  
Richard B. Reilly ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Spinal Cord Stimulation ◽  
Outcome Measurement ◽  
Electrophysiological Recording ◽  
Electrical Characteristics ◽  
Motor Responses ◽  
Cord Injury ◽  
Transcutaneous Spinal Cord Stimulation

Background Transcutaneous spinal cord stimulation (tSCS) is a non-invasive modality in which electrodes can stimulate spinal circuitries and facilitate a motor response. This review aimed to evaluate the methodology of studies using tSCS to generate motor activity in persons with spinal cord injury (SCI) and to appraise the quality of included trials. Methods A systematic search for studies published until May 2021 was made of the following databases: EMBASE, Medline (Ovid) and Web of Science. Two reviewers independently screened the studies, extracted the data, and evaluated the quality of included trials. The electrical characteristics of stimulation were summarised to allow for comparison across studies. In addition, the surface electromyography (EMG) recording methods were evaluated. Results A total of 3753 articles were initially screened, of which 25 met the criteria for inclusion. Studies were divided into those using tSCS for neurophysiological investigations of reflex responses (n = 9) and therapeutic investigations of motor recovery (n = 16). The overall quality of evidence was deemed to be poor-to-fair (10.5 ± 4.9) based on the Downs and Black Quality Checklist criteria. The electrical characteristics were collated to establish the dosage range across stimulation trials. The methods employed by included studies relating to stimulation parameters and outcome measurement varied extensively, although some trends are beginning to appear in relation to electrode configuration and EMG outcomes. Conclusion This review outlines the parameters currently employed for tSCS of the cervicothoracic and thoracolumbar regions to produce motor responses. However, to establish standardised procedures for neurophysiological assessments and therapeutic investigations of tSCS, further high-quality investigations are required, ideally utilizing consistent electrophysiological recording methods, and reporting common characteristics of the electrical stimulation administered.

Transcutaneous Spinal Cord Stimulation Improves Quality of Life for People With Incomplete Spinal Cord Injury

2021 ◽  
Vol 75 (Supplement_2) ◽  
pp. 7512515369p1-7512515369p1
Author(s):  
Rebecca Martin
Keyword(s):  
Quality Of Life ◽  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Spinal Cord Stimulation ◽  
Neural Circuits ◽  
Bladder Function ◽  
Incomplete Spinal Cord Injury ◽  
Cord Injury ◽  
Transcutaneous Spinal Cord Stimulation

Abstract Date Presented Accepted for AOTA INSPIRE 2021 but unable to be presented due to online event limitations. Transcutaneous spinal cord stimulation (TSCS) is a novel mechanism to excite spinal neural circuits and unmask latent voluntary function. This research presentation will discuss outcomes associated with an 8-week trial combining TSCS with therapy. Participants improved in walking function, bowel and bladder function, and sensation with commensurate improvements in quality of life. TSCS is a feasible, meaningful intervention for patients with incomplete spinal cord injury. Primary Author and Speaker: Rebecca Martin

scholarly journals Modification of spasticity by transcutaneous spinal cord stimulation in individuals with incomplete spinal cord injury

2013 ◽  
Vol 37 (2) ◽  
pp. 202-211 ◽  
Author(s):  
Ursula S. Hofstoetter ◽  
William B. McKay ◽  
Keith E. Tansey ◽  
Winfried Mayr ◽  
Helmut Kern ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Spinal Cord Stimulation ◽  
Incomplete Spinal Cord Injury ◽  
Cord Injury ◽  
Transcutaneous Spinal Cord Stimulation

scholarly journals Feasibility and utility of transcutaneous spinal cord stimulation combined with walking-based therapy for people with motor incomplete spinal cord injury

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Liza V. McHugh ◽  
Ashley A. Miller ◽  
Kristan A. Leech ◽  
Cynthia Salorio ◽  
Rebecca H. Martin
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Adverse Events ◽  
Spinal Cord Stimulation ◽  
Walking Speed ◽  
Minimal Detectable Change ◽  
Walk Test ◽  
Incomplete Spinal Cord Injury ◽  
Cord Injury ◽  
Transcutaneous Spinal Cord Stimulation

Abstract Study design Prospective case series. Objectives To evaluate the feasibility and preliminary efficacy of combining transcutaneous spinal cord stimulation (TSCS) with walking-based physical therapy. Setting Hospital-based outpatient center in Maryland, United States. Methods Ten individuals with chronic (>1 year) motor incomplete spinal cord injury (iSCI) completed 23 sessions of 2-h therapy over 8 weeks. TSCS was delivered for the first 30 min of each session using a clinically available device with adjustable current. To assess feasibility of the intervention, we tracked pain, adverse events, and participant retention. Preliminary efficacy was assessed by evaluating changes in walking speed, endurance, and quality following the intervention with select functional outcome measures (10-m walk test (10MWT), 6-min walk test (6MWT), timed up and go, and walking index for spinal cord injury II). Results We found that the combined intervention was feasible in an outpatient clinical setting. Participants tolerated the TSCS well, with no reports of significant adverse events or other issues (e.g., skin irritation or pain that disrupted training). None of the participants elected to discontinue the study. Participants also showed significant improvements in each measure of walking function following the intervention. Changes in walking speed, as measured by the 10MWT (0.56 ± 0.29 m/s to 0.72 ± 0.36 m/s), exceeded the minimal clinically important difference for individuals with iSCI. Changes in walking quality and endurance, as measured by the 6MWT (149.88 ± 99.87 m to 194.53 ± 106.56 m), exceeded the minimal detectable change for individuals with iSCI. Conclusions These results indicate that TSCS is clinically feasible and may be useful as an adjunct to walking-based therapy for adults with iSCI.

scholarly journals Transcutaneous Spinal Cord Stimulation and Motor Rehabilitation in Spinal Cord Injury: A Systematic Review

2019 ◽  
Vol 34 (1) ◽  
pp. 3-12 ◽  
Author(s):  
Alvaro Megía García ◽  
Diego Serrano-Muñoz ◽  
Julian Taylor ◽  
Juan Avendaño-Coy ◽  
Julio Gómez-Soriano
Keyword(s):  
Systematic Review ◽  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Electrical Stimulation ◽  
Lower Limb ◽  
Spinal Cord Stimulation ◽  
Voluntary Movement ◽  
Muscle Activation ◽  
Cord Injury ◽  
Transcutaneous Spinal Cord Stimulation

Background. Epidural spinal electrical stimulation at the lumbar spinal level evokes rhythmic muscle activation of lower-limb antagonists, attributed to the central pattern generator. However, the efficacy of noninvasive spinal stimulation for the activation of lower-limb muscles is not yet clear. This review aimed to analyze the feasibility and efficacy of noninvasive transcutaneous spinal cord stimulation (tSCS) on motor function in individuals with spinal cord injury. Methods. A search for tSCS studies was made of the following databases: PubMed; Cochrane Registry; and Physiotherapy Evidence Database (PEDro). In addition, an inverse manual search of the references cited by the identified articles was carried out. The keywords transcutaneous, non-invasive, electrical stimulation, spinal cord stimulation [Mesh term], and spinal cord injury were used. Results. A total of 352 articles were initially screened, of which 13 studies met the inclusion criteria for systematic review. The total participant sample comprised 55 persons with spinal cord injury. All studies with tSCS provided evidence of induced muscle activation in the lower and upper limbs, and applied stimulation at the level of the T11-T12 and C4-C7 interspinous space, respectively. All studies reported an increase in motor response measured by recording surface electromyography, voluntary movement, muscle strength, or function. Conclusions. Although this review highlights tSCS as a feasible therapeutic neuromodulatory strategy to enhance voluntary movement, muscle strength, and function in patients with chronic spinal cord injury, the clinical impact and efficacy of electrode location and current intensity need to be characterized in statistically powered and controlled clinical trials.

Transcutaneous Spinal Cord Stimulation Induces Temporary Attenuation of Spasticity in Individuals with Spinal Cord Injury

2020 ◽  
Vol 37 (3) ◽  
pp. 481-493 ◽  
Author(s):  
Ursula S. Hofstoetter ◽  
Brigitta Freundl ◽  
Simon M. Danner ◽  
Matthias J. Krenn ◽  
Winfried Mayr ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Spinal Cord Stimulation ◽  
Cord Injury ◽  
Transcutaneous Spinal Cord Stimulation
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