A case study of percutaneous epidural stimulation to enable motor control in two men after spinal cord injury.

Autor: Gorgey AS; Spinal Cord Injury and Disorders Center, Hunter Holmes McGuire VAMC, 1201 Broad Rock Boulevard, Richmond, VA, 23249, USA. ashraf.gorgey@va.gov.; Virginia Commonwealth University, Department of Physical Medicine & Rehabilitation, Richmond, VA, 23298, USA. ashraf.gorgey@va.gov., Trainer R; Physical Medicine and Rehabilitation, Hunter Holmes McGuire VAMC, 1201 Broad Rock Boulevard, Richmond, VA, 23249, USA., Sutor TW; Spinal Cord Injury and Disorders Center, Hunter Holmes McGuire VAMC, 1201 Broad Rock Boulevard, Richmond, VA, 23249, USA., Goldsmith JA; Spinal Cord Injury and Disorders Center, Hunter Holmes McGuire VAMC, 1201 Broad Rock Boulevard, Richmond, VA, 23249, USA., Alazzam A; Spinal Cord Injury and Disorders Center, Hunter Holmes McGuire VAMC, 1201 Broad Rock Boulevard, Richmond, VA, 23249, USA., Goetz LL; Spinal Cord Injury and Disorders Center, Hunter Holmes McGuire VAMC, 1201 Broad Rock Boulevard, Richmond, VA, 23249, USA.; Virginia Commonwealth University, Department of Physical Medicine & Rehabilitation, Richmond, VA, 23298, USA., Lester D; Physical Medicine and Rehabilitation, Hunter Holmes McGuire VAMC, 1201 Broad Rock Boulevard, Richmond, VA, 23249, USA., Lavis TD; Spinal Cord Injury and Disorders Center, Hunter Holmes McGuire VAMC, 1201 Broad Rock Boulevard, Richmond, VA, 23249, USA.; Virginia Commonwealth University, Department of Physical Medicine & Rehabilitation, Richmond, VA, 23298, USA.
Jazyk: angličtina
Zdroj: Nature communications [Nat Commun] 2023 Apr 12; Vol. 14 (1), pp. 2064. Date of Electronic Publication: 2023 Apr 12.
DOI: 10.1038/s41467-023-37845-7
Abstrakt: Two persons with chronic motor complete spinal cord injury (SCI) were implanted with percutaneous spinal cord epidural stimulation (SCES) leads to enable motor control below the injury level (NCT04782947). Through a period of temporary followed by permanent SCES implantation, spinal mapping was conducted primarily to optimize configurations enabling volitional control of movement and training of standing and stepping as a secondary outcome. In both participants, SCES enabled voluntary increased muscle activation and movement below the injury and decreased assistance during exoskeleton-assisted walking. After permanent implantation, both participants voluntarily modulated induced torques but not always in the intended directions. In one participant, percutaneous SCES enabled motor control below the injury one-day following temporary implantation as confirmed by electromyography. The same participant achieved independent standing with minimal upper extremity self-balance assistance, independent stepping in parallel bars and overground ambulation with a walker. SCES via percutaneous leads holds promise for enhancing rehabilitation and enabling motor functions for people with SCI.
(© 2023. The Author(s).)
Databáze: MEDLINE
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