Inﬂuence of sports on cortical excitability in patients with spinal cord injury: a TMS study

Front. Med. Technol., 2024 · DOI: 10.3389/fmedt.2024.1297552 · Published: May 15, 2024

Spinal Cord Injury Neurology Neurorehabilitation

Simple Explanation

Patients with spinal cord injury (SCI) show abnormal cortical excitability that might be caused by deafferentation. We expect a reduced SICI preceding movement in patients compared with healthy participants, which might be inﬂuenced by inhibited afferent sensory input. To test this hypothesis we measured cortical excitability in preparation of a movement in a group of patients with SCI that regularly conduct wheelchair dancing, in a group that practiced other sports including marathon driving, hand-biking, and basketball, and in a non-sportive group of patients with SCI.

Study Duration

Not specified

Participants

22 patients with SCI and 24 healthy controls

Evidence Level

Original Research

Key Findings

1
There were neither signiﬁcant differences between healthy participants and the patients nor between the different patient groups.
2
A non-signiﬁcant trend (p = .238), showed that patients engaged in sports have a stronger increase in cortical excitability compared with patients of the non-sportive group, while the patients in the other sports group expressed the highest increase in cortical excitability.
3
The small sample sizes limit the statistical power of the study, but the trending effect warrants further investigation of different sports on the neuroplasticity in patients with SCI.

Research Summary

We hypothesized a reduced SICI preceding movement in patients with SCI compared with healthy participants; hence, less increase of cortical excitability due to a constant hyper excitability that is induced by inhibited afferent sensory input (9). We also expected differences in SICI preceding movement between the different patient groups, which were hypothesized to be elicited by sports-speciﬁc neuroplasticity. Our results did not show signiﬁcant differences of increased cortical excitability toward movement among the patient groups.

Practical Implications

Further Research

Future studies should focus on the cortical excitability of the lower extremities.

Therapeutic Methods

Investigating how different sports inﬂuence cortical excitability in various conditions might improve therapeutic methods based on exercise on a more individual level.

Larger Sample Size

Future studies should include a greater sample size and a more homogenous group of patients with SCI.

Study Limitations

1
Due to the limited exclusion criteria, a wide range of clinical patterns could be observed in the patients.
2
The patient group was not large enough to be split by age or lesion characteristics, which puts our comparison between the subgroups at risk of being biased by these factors.
3
The examination conditions were not tested in randomized order; hence, a habituation or fatigue effect throughout the experiment cannot be excluded.

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