Non-Invasive Neuromodulation and Rehabilitation to Promote Functional Restoration In Persons with Spinal Cord Injury

Curr Opin Neurol, 2021 · DOI: 10.1097/WCO.0000000000000997 · Published: December 1, 2021

Spinal Cord Injury Neurology Rehabilitation

Simple Explanation

This review focuses on using accessible neuromodulation techniques to help people with spinal cord injuries regain function. Non-invasive methods that target the brain, spinal cord, and peripheral nerves can change how excitable these neural structures are. Combining these approaches with training shows promising early results for restoring function and reducing secondary complications after SCI.

Study Duration

Not specified

Participants

Persons with spinal cord injury (SCI)

Evidence Level

Review

Key Findings

1
Clinically accessible neuromodulatory modalities have the potential to augment therapeutic protocols.
2
Combining device interventions with rehabilitation yields the strongest evidence for meaningful outcomes.
3
Movement plays an important role in plasticity after SCI and the optimal time window for interventions is early after injury.

Research Summary

Clinically accessible modalities have great potential value as adjuncts to conventional therapeutic protocols due to their ease of application, cost effectiveness, and demonstrated neuromodulatory and functional effects. Combinatorial approaches are most likely to have meaningful impact. Studies with increased sample sizes are needed to address questions regarding variability in stimulation responsiveness and dosing before novel stimulation modalities can be integrated into standard clinical practice.

Practical Implications

Improved Rehabilitation Strategies

Combining non-invasive neuromodulation with training can enhance functional restoration in SCI patients.

Personalized Treatment

Identifying biomarkers to predict stimulation responsiveness is crucial for tailoring interventions to individual patients.

Clinical Integration

Addressing questions about optimal dosing and variability is necessary to integrate neuromodulation into standard clinical practice.

Study Limitations

1
Limited studies on clinically accessible neuromodulatory approaches in SCI.
2
Heterogeneity in SCI populations necessitates biomarker identification for predicting stimulation responsiveness.
3
Need for research on optimal dosing parameters for stimulation.

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