Transcutaneous Cervical Spinal Cord Stimulation Combined with Robotic Exoskeleton Rehabilitation for the Upper Limbs in Subjects with Cervical SCI: Clinical Trial

(1) Background: Restoring arm and hand function is a priority for individuals with cervical spinal cord injury (cSCI) for independence and quality of life. Transcutaneous spinal cord stimulation (tSCS) promotes the upper extremity (UE) motor function when applied at the cervical region. The aim of t...

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Bibliographic Details
Published in:Biomedicines 2023-02, Vol.11 (2), p.589
Main Authors: García-Alén, Loreto, Kumru, Hatice, Castillo-Escario, Yolanda, Benito-Penalva, Jesús, Medina-Casanovas, Josep, Gerasimenko, Yury P, Edgerton, Victor Reggie, García-Alías, Guillermo, Vidal, Joan
Format: Article
Language:English
Subjects:
Activities of daily living
Arm
cervical spinal cord injury
Clinical trials
Elbow
Exoskeleton
functionality
Grasping
Intervention
motor function
Physiological aspects
Quality of life
Rehabilitation
Robotics
Spasticity
Spinal cord
Spinal cord injuries
transcutaneous electrical spinal cord stimulation
upper extremity
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Summary:(1) Background: Restoring arm and hand function is a priority for individuals with cervical spinal cord injury (cSCI) for independence and quality of life. Transcutaneous spinal cord stimulation (tSCS) promotes the upper extremity (UE) motor function when applied at the cervical region. The aim of the study was to determine the effects of cervical tSCS, combined with an exoskeleton, on motor strength and functionality of UE in subjects with cSCI. (2) Methods: twenty-two subjects participated in the randomized mix of parallel-group and crossover clinical trial, consisting of an intervention group ( = 15; tSCS exoskeleton) and a control group ( = 14; exoskeleton). The assessment was carried out at baseline, after the last session, and two weeks after the last session. We assessed graded redefined assessment of strength, sensibility, and prehension (GRASSP), box and block test (BBT), spinal cord independence measure III (SCIM-III), maximal voluntary contraction (MVC), ASIA impairment scale (AIS), and WhoQol-Bref; (3) Results: GRASSP, BBT, SCIM III, cylindrical grip force and AIS motor score showed significant improvement in both groups ( ≤ 0.05), however, it was significantly higher in the intervention group than the control group for GRASSP strength, and GRASSP prehension ability ( ≤ 0.05); (4) Conclusion: our findings show potential advantages of the combination of cervical tSCS with an exoskeleton to optimize the outcome for UE.
ISSN:2227-9059
2227-9059
DOI:10.3390/biomedicines11020589