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  4. Epidural Electrical Stimulation of the Lumbosacral Spinal Cord Improves Trunk Stability During Seated Reaching in Two Humans With Severe Thoracic Spinal Cord Injury

Epidural Electrical Stimulation of the Lumbosacral Spinal Cord Improves Trunk Stability During Seated Reaching in Two Humans With Severe Thoracic Spinal Cord Injury

Front. Syst. Neurosci., 2020 · DOI: 10.3389/fnsys.2020.569337 · Published: November 19, 2020

Spinal Cord InjuryNeurologyNeurorehabilitation

Simple Explanation

This study investigates whether electrical stimulation of the spinal cord can improve trunk stability and reaching ability in people with spinal cord injuries. The researchers applied stimulation to the lower spinal cord in two participants and measured how far they could reach while seated. The researchers found that electrical stimulation increased the distance participants could reach forward. They also tested different locations for the stimulation and found that stimulating the lower part of the spinal cord was more effective for improving forward reach. These findings suggest that spinal cord stimulation could be a useful tool for improving trunk stability and reaching ability in people with spinal cord injuries, potentially increasing their independence in daily activities.

Study Duration
Approximately 34 Months
Participants
Two males with mid-thoracic SCI
Evidence Level
Case Study

Key Findings

  • 1
    Epidural stimulation (ES) enhanced seated reaching-performance of individuals with chronic SCI.
  • 2
    Forward reach distances were greater than lateral reach distances in all environments, mat or wheelchair, for both participants.
  • 3
    Electrode configurations delivering stimulation in caudal regions of the lumbosacral spinal segments may improve reaching ability compared to rostral regions.

Research Summary

This study evaluated the effects of epidural spinal electrical stimulation (ES) on seated reaching performance in two individuals with chronic, complete thoracic spinal cord injury (SCI). The results showed that ES enhanced seated reaching performance, with greater forward reach distances compared to lateral reach distances. Caudal stimulation improved forward reach distance compared to rostral stimulation. The findings suggest that ES, particularly with caudal electrode configurations, may improve trunk stability and reaching ability in individuals with SCI, potentially enhancing their independence in activities of daily living.

Practical Implications

Improved ADL Independence

ES has the potential to improve the independent performance of activities of daily living (ADLs) by increasing trunk stability and reach distance.

Personalized Stimulation Strategies

ES configurations should be optimized based on individual needs and the specific reaching direction (forward vs. lateral) to maximize effectiveness.

Rehabilitation Therapy Enhancement

ES can be integrated with task-specific training to promote neuroplasticity and improve functional outcomes in individuals with SCI.

Study Limitations

  • 1
    Small sample size (two participants)
  • 2
    Heterogeneity of SCI severity
  • 3
    Generalizability of the results may be limited

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