Transcutaneous Spinal Cord Stimulation and Motor Rehabilitation in Spinal Cord Injury: A Systematic Review
| Autor: | Diego Serrano-Muñoz, Alvaro Megía García, Julio Gómez-Soriano, Julian Taylor, Juan Avendaño-Coy |
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| Rok vydání: | 2019 |
| Předmět: |
medicine.medical_specialty
0206 medical engineering Stimulation 02 engineering and technology Electromyography Spinal cord stimulation Motor Activity 03 medical and health sciences 0302 clinical medicine Lumbar Physical medicine and rehabilitation Outcome Assessment Health Care Humans Medicine Muscle Skeletal Spinal cord injury Spinal Cord Injuries Spinal Cord Stimulation medicine.diagnostic_test business.industry Central pattern generator Recovery of Function General Medicine medicine.disease 020601 biomedical engineering Neuromodulation (medicine) Clinical trial business 030217 neurology & neurosurgery |
| Zdroj: | Neurorehabilitation and Neural Repair. 34:3-12 |
| ISSN: | 1552-6844 1545-9683 |
| Popis: | Background. Epidural spinal electrical stimulation at the lumbar spinal level evokes rhythmic muscle activation of lower-limb antagonists, attributed to the central pattern generator. However, the efficacy of noninvasive spinal stimulation for the activation of lower-limb muscles is not yet clear. This review aimed to analyze the feasibility and efficacy of noninvasive transcutaneous spinal cord stimulation (tSCS) on motor function in individuals with spinal cord injury. Methods. A search for tSCS studies was made of the following databases: PubMed; Cochrane Registry; and Physiotherapy Evidence Database (PEDro). In addition, an inverse manual search of the references cited by the identified articles was carried out. The keywords transcutaneous, non-invasive, electrical stimulation, spinal cord stimulation [Mesh term], and spinal cord injury were used. Results. A total of 352 articles were initially screened, of which 13 studies met the inclusion criteria for systematic review. The total participant sample comprised 55 persons with spinal cord injury. All studies with tSCS provided evidence of induced muscle activation in the lower and upper limbs, and applied stimulation at the level of the T11-T12 and C4-C7 interspinous space, respectively. All studies reported an increase in motor response measured by recording surface electromyography, voluntary movement, muscle strength, or function. Conclusions. Although this review highlights tSCS as a feasible therapeutic neuromodulatory strategy to enhance voluntary movement, muscle strength, and function in patients with chronic spinal cord injury, the clinical impact and efficacy of electrode location and current intensity need to be characterized in statistically powered and controlled clinical trials. |
| Databáze: | OpenAIRE |
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