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Self-assisted standing enabled by non-invasive spinal stimulation after spinal cord injury

Sayenko, Dimitry and Rath, Mrinal and Ferguson, Adam R. and Burdick, Joel and Havton, Leif and Edgerton, Victor Reggie and Gerasimenko, Yury (2018) Self-assisted standing enabled by non-invasive spinal stimulation after spinal cord injury. Journal of Neurotrauma . ISSN 0897-7151. (In Press) http://resolver.caltech.edu/CaltechAUTHORS:20181105-083600090

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Abstract

Neuromodulation of spinal networks can improve motor control after spinal cord injury (SCI). The objectives of this study were to (1) determine whether individuals with chronic paralysis can stand with the aid of non-invasive electrical spinal stimulation with their knees and hips extended without trainer assistance, and (2) investigate whether postural control can be further improved following repeated sessions of stand training. Using a double-blind, balanced, within-subject cross-over, and “sham”-controlled study design, 15 individuals with SCI of various severity received transcutaneous electrical spinal stimulation to regain self-assisted standing. The primary outcomes included qualitative comparison of need of external assistance for knee and hip extension provided by trainers during standing without and in the presence of stimulation in the same participants, as well as quantitative measures, such as the level of knee assistance and amount of time spent standing without trainer assistance. None of the participants could stand unassisted without stimulation or in the presence of “sham” stimulation. With stimulation all participants could maintain upright standing with minimum and some (n=7) without external assistance applied to the knees or hips, using their hands for upper body balance as needed. Quality of balance control was practice-dependent, and improved with subsequent training. During self-initiated body weight displacements in standing enabled by spinal stimulation, high level of leg muscle activity emerged, and depended on the amount of muscle loading. Our findings indicate that the lumbosacral spinal networks can be modulated transcutaneously using electrical spinal stimulation to facilitate self-assisted standing after chronic motor and sensory complete paralysis.


Item Type:Article
Related URLs:
URLURL TypeDescription
https://doi.org/10.1089/neu.2018.5956DOIArticle
Additional Information:© 2018 Mary Ann Liebert, Inc., publishers. Published Online: 26 Oct 2018.
Subject Keywords:human studies; neuroplasticity; rehabilitation; therapeutic approaches for the treatment of CNS injury; traumatic spinal cord injury
Record Number:CaltechAUTHORS:20181105-083600090
Persistent URL:http://resolver.caltech.edu/CaltechAUTHORS:20181105-083600090
Usage Policy:No commercial reproduction, distribution, display or performance rights in this work are provided.
ID Code:90627
Collection:CaltechAUTHORS
Deposited By: Tony Diaz
Deposited On:06 Nov 2018 18:45
Last Modified:06 Nov 2018 18:45

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