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Trunk Stability Enabled by Noninvasive Spinal Electrical Stimulation after Spinal Cord Injury

Rath, Mrinal and Vette, Albert H. and Ramasubramaniam, Shyamsundar and Li, Kun and Burdick, Joel and Edgerton, Victor Reggie and Gerasimenko, Yury and Sayenko, Dimitry (2018) Trunk Stability Enabled by Noninvasive Spinal Electrical Stimulation after Spinal Cord Injury. Journal of Neurotrauma, 35 (21). pp. 2540-2553. ISSN 0897-7151. https://resolver.caltech.edu/CaltechAUTHORS:20180529-075351546

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Abstract

Electrical neuromodulation of spinal networks improves the control of movement of the paralyzed limbs after spinal cord injury (SCI). However, the potential of noninvasive spinal stimulation to facilitate postural trunk control during sitting in humans with SCI has not been investigated. We hypothesized that transcutaneous electrical stimulation of the lumbosacral enlargement can improve trunk posture. Eight participants with non-progressive SCI at C3-T9, American Spinal Injury Association Impairment Scale (AIS) A or C, performed different motor tasks during sitting. Electromyography of the trunk muscles, three-dimensional kinematics, and force plate data were acquired. Spinal stimulation improved trunk control during sitting in all tested individuals. Stimulation resulted in elevated activity of the erector spinae, rectus abdominis, and external obliques, contributing to improved trunk control, more natural anterior pelvic tilt and lordotic curve, and greater multi-directional seated stability. During spinal stimulation, the center of pressure (COP) displacements decreased to 1.36 ± 0.98 mm compared with 4.74 ± 5.41 mm without stimulation (p = 0.0156) in quiet sitting, and the limits of stable displacement increased by 46.92 ± 35.66% (p = 0.0156), 36.92 ± 30.48% (p = 0.0156), 54.67 ± 77.99% (p = 0.0234), and 22.70 ± 26.09% (p = 0.0391) in the forward, backward, right, and left directions, respectively. During self-initiated perturbations, the correlation between anteroposterior arm velocity and the COP displacement decreased from r = 0.5821 (p = 0.0007) without to r = 0.5115 (p = 0.0039) with stimulation, indicating improved trunk stability. These data demonstrate that the spinal networks can be modulated transcutaneously with tonic electrical spinal stimulation to physiological states sufficient to generate a more stable, erect sitting posture after chronic paralysis.


Item Type:Article
Related URLs:
URLURL TypeDescription
https://doi.org/10.1089/neu.2017.5584DOIArticle
Additional Information:© 2018 Mary Ann Liebert, Inc. publishers. Online Ahead of Print: July 5, 2018; Online Ahead of Editing: May 22, 2018.
Subject Keywords:spinal cord injury; neuroplasticity; rehabilitation
Issue or Number:21
Record Number:CaltechAUTHORS:20180529-075351546
Persistent URL:https://resolver.caltech.edu/CaltechAUTHORS:20180529-075351546
Official Citation:Trunk Stability Enabled by Noninvasive Spinal Electrical Stimulation after Spinal Cord Injury. Mrinal Rath, Albert H. Vette, Shyamsundar Ramasubramaniam, Kun Li, Joel Burdick, Victor R. Edgerton, Yury P. Gerasimenko, and Dimitry G. Sayenko. Journal of Neurotrauma 2018 35:21, 2540-2553
Usage Policy:No commercial reproduction, distribution, display or performance rights in this work are provided.
ID Code:86643
Collection:CaltechAUTHORS
Deposited By: Tony Diaz
Deposited On:29 May 2018 16:18
Last Modified:03 Oct 2019 19:46

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