Neuromodulation for recovery of trunk and sitting functions following spinal cord injury: a comprehensive review of the literature

Bioelectronic Medicine, 2023 · DOI: https://doi.org/10.1186/s42234-023-00113-6 · Published: May 16, 2023

Spinal Cord Injury Neurology Rehabilitation

Simple Explanation

Spinal cord injuries (SCI) often lead to paralysis, affecting trunk stability and sitting balance, which are crucial for daily activities and preventing falls. Traditional therapies use assistive methods, but these can limit functionality. Neuromodulation techniques are emerging as alternative therapies to improve trunk and sitting functions after SCI. This review explores existing studies on these techniques and their potential for trunk recovery. The review included 21 studies with 117 participants, finding that neuromodulation significantly improved trunk stability, sitting balance, and muscle activity. However, more large-scale studies are needed to confirm these findings.

Study Duration

Not specified

Participants

117 participants with SCI

Evidence Level

Review of 21 studies

Key Findings

1
Neuromodulation techniques, including FES, ES, FNS, TSCS, and EES, have shown potential in improving trunk stability and sitting functions in individuals with SCI.
2
Neuromodulation significantly improved reaching ability, restored trunk stability and seated posture, increased sitting balance, as well as elevated activity of trunk and back muscles.
3
FES and TSCS techniques appear more suitable for clinical practice, with FES beneficial for incomplete SCI and TSCS effective for both complete and incomplete SCI.

Research Summary

This review summarizes the effects of five types of neuromodulation (FES, ES, FNS, TSCS and EES) on improving trunk and sitting functions in people with SCI, discussing limitations and future research directions. The review identified 21 articles demonstrating the potential of various neuromodulation techniques in improving trunk and sitting functions following SCI. The findings of this review provide preliminary support for the notion that stimulation may increase muscle tone and activation, which may lead to enhanced motor or functional performance

Practical Implications

Rehabilitation Strategies

Neuromodulation can be used as an alternative rehabilitation strategy, instead of focusing on peripheral limb functions.

Clinical Practice

FES and TSCS techniques could be more suitable in clinical practice for people with incomplete and complete SCI, respectively.

Fall Prevention

ES and TSCS may be used as adjunct treatment to prevent falls in people with SCI if randomized controlled trial can prove the long-term efficacy of these neuromodulation methods in improving trunk function and minimize falls.

Study Limitations

1
Limited to original research published in English.
2
Stimulation parameters are not standardized.
3
Insufficient information regarding stimulation duration and follow-up protocols.

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