| Autor: |
Moon Y; Shirley Ryan AbilityLab, Chicago, IL 60611, USA.; Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA., Zuleger T; Department of Neuroscience, University of Cincinnati, Cincinnati, OH, 45221, USA., Lamberti M; Clinical Neurophysiology, University of Twente, 7522 NH Enschede, The Netherlands., Bansal A; Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA., Mummidisetty CK; Shirley Ryan AbilityLab, Chicago, IL 60611, USA., McKenzie KA; Shirley Ryan AbilityLab, Chicago, IL 60611, USA., Yingling L; Shirley Ryan AbilityLab, Chicago, IL 60611, USA., Madhavan S; Department of Physical Therapy, University of Illinois, Chicago, IL 60612, USA., Roth EJ; Shirley Ryan AbilityLab, Chicago, IL 60611, USA.; Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA., Lieber RL; Shirley Ryan AbilityLab, Chicago, IL 60611, USA.; Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA.; Edward Hines Jr, V.A. Hospital, Maywood IL 60141, USA., Jayaraman A; Shirley Ryan AbilityLab, Chicago, IL 60611, USA.; Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA. |
| Abstrakt: |
An increasing number of studies suggests that a novel neuromodulation technique targeting the spinal circuitry enhances gait rehabilitation, but research on its application to stroke survivors is limited. Therefore, we investigated the characteristics of spinal motor-evoked responses (sMERs) from lower-limb muscles obtained by transcutaneous spinal cord stimulation (tSCS) after stroke compared to age-matched and younger controls without stroke. Thirty participants (ten stroke survivors, ten age-matched controls, and ten younger controls) completed the study. By using tSCS applied between the L1 and L2 vertebral levels, we compared sMER characteristics (resting motor threshold (RMT), slope of the recruitment curve, and latency) of the tibialis anterior (TA) and medial gastrocnemius (MG) muscles among groups. A single pulse of stimulation was delivered in 5 mA increments, increasing from 5 mA to 250 mA or until the subjects reached their maximum tolerance. The stroke group had an increased RMT (27-51%) compared to both age-matched (TA: p = 0.032; MG: p = 0.005) and younger controls (TA: p < 0.001; MG: p <0.001). For the TA muscle, the paretic side demonstrated a 13% increased latency compared to the non-paretic side in the stroke group ( p = 0.010). Age-matched controls also exhibited an increased RMT compared to younger controls (TA: p = 0.002; MG: p = 0.007), suggesting that altered sMER characteristics present in stroke survivors may result from both stroke and normal aging. This observation may provide implications for altered spinal motor output after stroke and demonstrates the feasibility of using sMER characteristics as an assessment after stroke. |
