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. 2024 Apr 19;25(8):4480.
doi: 10.3390/ijms25084480.

Improvement in Motor and Walking Capacity during Multisegmental Transcutaneous Spinal Stimulation in Individuals with Incomplete Spinal Cord Injury

Hatice Kumru  1   2   3 , Aina Ros-Alsina  1 , Loreto García Alén  1   2 , Joan Vidal  1   2   3 , Yury Gerasimenko  4   5 , Agusti Hernandez  1   2 , Mark Wrigth  1   2
Affiliations

Improvement in Motor and Walking Capacity during Multisegmental Transcutaneous Spinal Stimulation in Individuals with Incomplete Spinal Cord Injury

Hatice Kumru et al. Int J Mol Sci. .

Abstract

Transcutaneous multisegmental spinal cord stimulation (tSCS) has shown superior efficacy in modulating spinal locomotor circuits compared to single-site stimulation in individuals with spinal cord injury (SCI). Building on these findings, we hypothesized that administering a single session of tSCS at multiple spinal segments may yield greater enhancements in muscle strength and gait function during stimulation compared to tSCS at only one or two segments. In our study, tSCS was applied at single segments (C5, L1, and Coc1), two segments (C5-L1, C5-Coc1, and L1-Coc1), or multisegments (C5-L1-Coc1) in a randomized order. We evaluated the 6-m walking test (6MWT) and maximum voluntary contraction (MVC) and assessed the Hmax/Mmax ratio during stimulation in ten individuals with incomplete motor SCI. Our findings indicate that multisegmental tSCS improved walking time and reduced spinal cord excitability, as measured by the Hmax/Mmax ratio, similar to some single or two-site tSCS interventions. However, only multisegmental tSCS resulted in increased tibialis anterior (TA) muscle strength. These results suggest that multisegmental tSCS holds promise for enhancing walking capacity, increasing muscle strength, and altering spinal cord excitability in individuals with incomplete SCI.

Keywords: gait; incomplete spinal cord injury; multiple segmental stimulation; muscle strength; spinal cord excitability; transcutaneous spinal cord stimulation.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Flow diagram.
Figure 2
Figure 2
tSCS electrode placements. C—cervical; L—lumbar; Cocc—coccyx.
Figure 3
Figure 3
Six-meter walking test at baseline, during tSCS at different segments, and final control condition. The data were expressed as mean and standard error. * p ≤ 0.05 with respect to the baseline condition.
Figure 4
Figure 4
Maximum voluntary contraction of the tibial anterior muscle (kg). Data were expressed as mean and standard error. * p < 0.05 compared to the baseline condition (Wilcoxon test).
Figure 5
Figure 5
Hmax/Mmax ratio. Data were expressed as mean and standard error. * p < 0.05 compared to the baseline condition (Student’s t-test).
See this image and copyright information in PMC

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