Trans-Spinal Electrical Stimulation Therapy for Functional Rehabilitation after Spinal Cord Injury: Review

J. Clin. Med., 2022 · DOI: 10.3390/jcm11061550 · Published: March 11, 2022

Spinal Cord Injury Neurology Rehabilitation

Simple Explanation

Spinal cord injury (SCI) is a devastating condition with limited effective treatments. This review explores the potential of noninvasive electrical neuromodulation, specifically trans-spinal direct current stimulation (tsDCS) and trans-spinal pulsed current stimulation (tsPCS), to aid functional rehabilitation after SCI. tsDCS and tsPCS are noninvasive methods that stimulate the spinal cord with electrical currents. They have shown promise in improving sensorimotor and autonomic functions in individuals with SCI. Due to their noninvasive nature and lower costs, tsDCS and tsPCS could be integrated into regular rehabilitation therapies for SCI patients worldwide, offering a new avenue for regaining lost functions and improving quality of life.

Study Duration

Not specified

Participants

Not specified

Evidence Level

Level 5, Review

Key Findings

1
Both tsDCS and tsPCS treatments have demonstrated success in improving sensorimotor function, as well as autonomic functions.
2
tsDCS facilitates cortical sensitivity and can prevent neuronal dysfunctions which may develop after SCI, decreasing pain severity and promoting functional movements.
3
tsPCS activates the trunk musculature, helping to maintain posture, and enhances motor movement of the ankle in SCI.

Research Summary

This review summarizes two promising noninvasive spinal cord electrical stimulation methods for SCI rehabilitation: trans-spinal direct current stimulation (tsDCS) and trans-spinal pulsed current stimulation (tsPCS). Both tsDCS and tsPCS have shown potential in improving sensorimotor and autonomic functions, and are expected to be integrated into regular rehabilitation therapies due to their noninvasive nature and lower costs. The review highlights the mechanisms, limitations, and implementation of tsDCS and tsPCS, and subjectively compares them with other noninvasive stimulations, like FES, for SCI rehabilitation.

Practical Implications

Improved Rehabilitation Strategies

tsDCS and tsPCS offer new non-invasive options for SCI rehabilitation, potentially enhancing sensorimotor and autonomic functions.

Cost-Effective Treatment

The lower costs of tsDCS and tsPCS compared to invasive methods make them more accessible for widespread use in rehabilitation programs.

Personalized Therapy

Further studies on stimulation parameters can lead to tailored treatment plans, optimizing functional rehabilitation outcomes for individual SCI patients.

Study Limitations

1
The medium- or long-term effects of such a neuromodulation have not yet been evaluated and are very difﬁcult to predict.
2
The effect of neuromodulation vary from person to person as no injury or condition is exactly the same even though falling under the same cohort.
3
More studies on the effects of the speciﬁc stimulation parameters of tsDCS and tsPCS on the functional rehabilitation of SCI would provide a better clinical guideline.

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