Effects of paired associative magnetic stimulation between nerve root and cortex on motor function of lower limbs after spinal cord injury: study protocol for a randomized controlled trial

This study investigates whether paired associative magnetic stimulation (PAMS) can help people with spinal cord injuries (SCI) regain motor function in their lower limbs. PAMS involves stimulating both the nerve roots and the cortex. The researchers believe that the combined stimulation will enhance the function of synapses, which are connections between nerve cells, ultimately improving motor function. They aim to measure changes in various factors, including motor and sensory function, and overall quality of life. Participants will be divided into two groups: one receiving active PAMS with conventional rehabilitation, and the other receiving sham stimulation with conventional rehabilitation. The study will assess outcomes at baseline and at 4, 12, and 24 weeks after the start of the intervention.

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  The primary outcome measure is the change in the lower limb American Spinal Injury Association (ASIA) Impairment Scale motor function score from baseline to the last follow-up.
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  Secondary outcome measures include changes in lower limb ASIA sensory function score, motor evoked potentials, sensory evoked potentials, Modified Ashworth Scale score, Maslach Burnout Inventory score, and Hamilton Depression Scale score over time.
• 3
  Motor evoked potential latency reflects corticospinal tract transmission time, while amplitude reflects recruitment ability; both measures can help elucidate the mechanism underlying the effect of paired associative magnetic stimulation on synaptic efficiency.