Multi-Site Spinal Cord Transcutaneous Stimulation Facilitates Upper Limb Sensory and Motor Recovery in Severe Cervical Spinal Cord Injury: A Case Study

J. Clin. Med., 2023 · DOI: 10.3390/jcm12134416 · Published: June 30, 2023

Spinal Cord Injury Neurology Rehabilitation

Simple Explanation

This study explores a new way to help people with severe spinal cord injuries regain arm and hand function. It combines skin-surface electrical stimulation of the spinal cord with exercises. Researchers thought that stimulating different points on the spinal cord, along with exercise, could help the spinal cord better process signals needed for movement and feeling. A man with a severe spinal cord injury showed some improvement in muscle activation and sensation in his arms and hands after this treatment, suggesting it could be a promising approach.

Study Duration

14 weeks

Participants

A 53-year-old male (C2, AIS A, 8 years post-injury)

Evidence Level

Level 4: Case Study

Key Findings

1
Multi-site scTS combined with ABRT improved activation of previously paralyzed upper extremity muscles.
2
The participant experienced sensory improvements over the dorsal and volar aspects of the hand following the intervention.
3
Altered spinal cord excitability, as indicated by changes in MMR amplitudes, was observed post-training.

Research Summary

This case study investigates the effectiveness of multi-site spinal cord transcutaneous stimulation (scTS) combined with activity-based recovery training (ABRT) for upper limb recovery in a patient with severe cervical spinal cord injury (SCI). The multimodal approach involved scTS targeting various spinal segments combined with ABRT, hypothesizing that it would improve the integration of neural information for sensory and motor recovery. Results showed improved muscle activation and sensory improvements; however, visually appreciable functional recovery was not observed.

Practical Implications

Extending Therapeutic Potential

The study suggests that multi-site scTS combined with ABRT may be a therapeutic option for individuals with severe cervical SCI, expanding the potential applications of scTS.

Guiding Rehabilitation Programs

The findings can inform the development of neuromodulation and rehabilitation programs for individuals with debilitating motor and sensory dysfunctions post cervical SCI.

Future Research Directions

Further research with larger sample sizes is needed to explore the potential of scTS in restoring upper extremity function following cervical SCI more comprehensively.

Study Limitations

1
The data presented are only from one participant, and the ﬁndings may not be directly generalizable.
2
The therapists involved in the ABRT and functional assessments were not blinded.
3
The individual effect of lumbosacral scTS on truncal control was not comprehensively assessed.

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