Transcutaneous Spinal Cord Stimulation Enables Recovery of Walking in Children with Acute Flaccid Myelitis

Children, 2024 · DOI: 10.3390/children11091116 · Published: September 12, 2024

Simple Explanation

This study investigates the use of transcutaneous spinal cord stimulation (TSS) combined with gait training to improve walking in children with Acute Flaccid Myelitis (AFM). AFM is a condition causing paralysis, and traditional rehabilitation can be challenging. Four children with AFM participated in 22 therapy sessions, receiving TSS during the initial part of each session. The study monitored their walking function, pain levels, and any adverse events. The results showed that TSS is a safe and potentially effective intervention for children with AFM, improving walking function. The children tolerated the stimulation well, and several showed clinically significant improvements in walking endurance and independence.

Study Duration

5–8 weeks

Participants

4 children diagnosed with incomplete SCI secondary to AFM

Evidence Level

Case Series

Key Findings

1
All participants tolerated the TSS intervention without pain or adverse responses, indicating its safety and feasibility for children with AFM.
2
Changes in the 6MWT exceeded the minimal clinically important difference (MCID) for three participants, demonstrating improved walking endurance.
3
Two of the participants showed changes in the WISCI-II exceeding the minimal detectable change (MDC), indicating improved independence with functional ambulation.

Research Summary

This case series highlights the feasibility and efficacy of transcutaneous spinal cord stimulation (TSS) paired with gait training in children diagnosed with acute flaccid myelitis (AFM). The study demonstrated that TSS is safe and clinically feasible for pediatric patients with AFM and may supplement gait-based interventions to facilitate improvements in walking function. Improvements in walking function were demonstrated through increased walking speed, endurance, and independence, elucidating trends in functional improvement within this population.

Practical Implications

Clinical Application

TSS can be incorporated into gait training programs for children with AFM to potentially enhance walking function.

Future Research

Further research with larger sample sizes and control groups is warranted to confirm the efficacy of TSS in this population.

Personalized Therapy

Treatment should be tailored to individual patient needs and functional levels, as improvements varied depending on the initial status.

Study Limitations

1
As this is a case series, the sample size is very small.
2
Most outcome measures in pediatrics look at broad function and participation.
3
the standard clinical measures used here were not sensitive enough to capture subtle biomechanical changes.

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