Motor recovery after activity-based training with spinal cord epidural stimulation in a chronic motor complete paraplegic

This study investigates the recovery of motor function in an individual with chronic, motor complete spinal cord injury (SCI) using activity-based training and spinal cord epidural stimulation (scES). It details the progressive recovery of voluntary leg movement and standing without scES after 3.7 years of activity-based interventions. The research highlights the ongoing neural adaptations that allowed the participant to progress from no volitional muscle activation to task-specific activation patterns and movement generation during volitional attempts without scES. The study also observed the re-emergence of muscle activation patterns sufficient for standing with independent knee and hip extension. The findings suggest that the human nervous system has a remarkable recovery potential even after chronic, clinically motor complete SCI. Activity-based training with scES can promote significant improvements in motor control and functional abilities.

• 1
  After activity-based training with scES, the participant showed progressive recovery of volitional leg movements and standing without scES.
• 2
  Volitional attempts to perform hip flexion and knee extension showed a refined, task-specific activation pattern with decreased co-activation of antagonists and distant muscles.
• 3
  The participant regained the ability to stand independently with full body weight bearing and independent knee and hip extension without external assistance.