The role of electrical stimulation for rehabilitation and regeneration after spinal cord injury

Journal of Orthopaedics and Traumatology, 2022 · DOI: https://doi.org/10.1186/s10195-021-00623-6 · Published: January 1, 2022

Spinal Cord Injury Neurology Neurorehabilitation

Simple Explanation

Electrical stimulation is a therapeutic intervention used to improve motor function in patients with spinal cord injuries. It works by eliciting muscle contraction and can be paired with voluntary motor training for neurorehabilitation. Different forms of electrical stimulation technology exist, including Transcutaneous Electrical Nerve Stimulation (TENS), Neuromuscular Electrical Stimulation (NMES) and Functional Electrical Stimulation (FES). Electrical stimulation is believed to work by inducing neuroplastic changes at synapses within the spinal cord, which involves the reorganization and adaptation of axons and synapses to their cellular environment.

Study Duration

Not specified

Participants

Not specified

Evidence Level

Level 5, Review Article

Key Findings

1
Electrical stimulation induces neuroplasticity by increasing the baseline level of spinal excitability, allowing low levels of input to result in voluntary motor function.
2
Functional electrical stimulation (FES) can increase muscle power output and resistance, helping to restore upper and lower extremity function following SCI and improving gait parameters.
3
Spinal cord stimulation (SCS) improves motor function via neuroplasticity following SCI and has been shown to increase upper and lower extremity function.

Research Summary

Electrical stimulation is used in various forms to improve the well-being and functionality of patients with SCI. The neuroplasticity induced by electrical stimulation portends a promising future for developing better therapeutic interventions that can lessen the functional disability and enhance the quality of life of patients with SCI. The prevalence of electrical stimulation will likely increase in the future, with neuroprosthetic devices playing an important role in rehabilitation.

Practical Implications

Improved Motor Function

Electrical stimulation can lead to significant improvements in motor function for SCI patients when combined with voluntary motor training.

Enhanced Rehabilitation

Early neurorehabilitation with electrical stimulation has the potential to reduce morbidity and mortality in patients with SCI.

Future Technologies

Emerging technologies like brain-computer interfaces (BCI) combined with electrical stimulation show promise for restoring more complex movements and functions.

Study Limitations

1
Optimal electrode placement and intensity of electrical stimuli require trial and error.
2
Early recruitment of large muscles commonly leads to muscle fatigue.
3
Lower extremity neuroprostheses still face significant limitations due to the rapid onset of muscle fatigue and upper-body effort required to maintain balance.

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