Transcutaneous Spinal Stimulation From Adults to Children: A Review

Top Spinal Cord Inj Rehabil, 2023 · DOI: 10.46292/sci21-00084 · Published: January 1, 2023

Simple Explanation

Spinal cord stimulation can help people with spinal cord injuries (SCI) regain movement. A non-invasive method called transcutaneous spinal stimulation (scTS) uses electrodes on the skin to stimulate the spinal cord. scTS has shown promise in adults with SCI, improving leg movement, posture, and arm function. Research is now expanding to children with SCI, cerebral palsy, and spina bifida, exploring its potential benefits and safety. This review looks at scTS studies in adults, its possible mechanisms, and ongoing trials in children with SCI. It identifies gaps in knowledge to help adapt this approach for pediatric use.

Study Duration

Not specified

Participants

Adults and children with and without SCI, CP, and spina bifida

Evidence Level

Review

Key Findings

1
scTS can modulate spinal circuitry to optimize the integration of task-specific input, facilitating and enhancing motor output, originally focused on sitting posture, standing, and stepping, and more recently extended to arm and hand function.
2
Studies in children with cerebral palsy suggest scTS combined with activity-based therapies can improve hip and knee function, coordination, and locomotor performance.
3
A case study showed scTS combined with functional electrical stimulation improved sensation, circulation, and muscle activation in an infant with spina bifida.

Research Summary

Transcutaneous spinal stimulation (scTS) is a non-invasive neuromodulation technique showing promise for improving motor function in individuals with spinal cord injury (SCI). Studies in adults demonstrate that scTS can improve locomotion, standing, posture, and upper extremity function. Research is now being conducted to determine the safety and feasibility of scTS in children with SCI. While preliminary results are promising, further research is needed to optimize stimulation parameters, training protocols, and electrode placement for both adults and children with SCI.

Practical Implications

Rehabilitation Strategies

scTS may be a valuable adjunct to activity-based rehabilitation, potentially enhancing motor recovery in individuals with SCI.

Personalized Treatment

Individual variability in response to scTS highlights the need for personalized treatment approaches, considering factors such as injury level, motor neuron presentation, and muscle response to stimulation.

Pediatric Applications

Further research is needed to determine the optimal and safe application of scTS in children with SCI, considering anatomical and developmental differences from adults.

Study Limitations

1
Limited knowledge in training approaches necessary for successful translation to clinical practice.
2
Lack of high-quality empirical investigations that determine optimal neurotherapeutic interventions for children with SCI.
3
Fundamental anatomical, physiological, and biomechanical differences between adults and children.

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