Spinal Cord Stimulation for Poststroke Hemiparesis: A Scoping Review

American Journal of Occupational Therapy, 2024 · DOI: https://doi.org/10.5014/ajot.2024.050533 · Published: March 1, 2024

Neurology Neurorehabilitation

Simple Explanation

This study reviews how spinal cord stimulation (SCS) might help people regain motor function after a stroke. Unlike previous methods that focus on the brain, SCS targets the spinal cord, which remains largely intact after a stroke, offering a new approach to motor recovery. The review suggests SCS could be an alternative way to improve movement after stroke by stimulating spinal cord circuitry.

Study Duration

Studies varied from 1 day to 6 months

Participants

14 articles reviewed; poststroke patients with hemiparesis

Evidence Level

Scoping Review

Key Findings

1
Seven studies found a significant improvement in motor function in groups receiving SCS.
2
Twelve of the fourteen studies reported significant improvements in at least one neurophysiological or behavioral outcome.
3
Three studies found significant differences in behavioral outcomes in groups receiving SCS compared with control groups.

Research Summary

This scoping review summarizes current evidence on spinal cord stimulation (SCS) for poststroke hemiparesis, indicating it may offer an alternative way to improve motor function. The review identifies obstacles to further research, including variations in SCS types and parameters, dosage variability, and the lack of paired therapeutic interventions. The review highlights the need for consistent protocols, parameters, outcome measures, larger sample sizes, and paired activity-based rehabilitation with SCS.

Practical Implications

Poststroke Recovery

SCS may assist with poststroke recovery from both upper and lower extremity hemiparesis.

Versatile Implementation

The ability to complete SCS as a preparatory activity or concurrent with activity-based rehabilitation offers versatile implementation in a therapeutic session.

Safety of the Technique

No adverse events were reported in the studies analyzed in this review, and participants reported tolerating the stimulation, which speaks to the overall safety of the technique.

Study Limitations

1
Large variations in study design yielding small sample sizes and those that included no control group.
2
Many of the studies did not incorporate any activity-based rehabilitation into the treatment.
3
Stimulation parameters varied across studies, and there are no specific guidelines for determining the optimal stimulation parameters at this time.

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