Cumulative Transcutaneous Spinal Stimulation with Locomotor Training Safely Improves Trunk Control in Children with Spinal Cord Injury: Pilot Study
Background/Objectives: Non-invasive spinal cord transcutaneous stimulation (scTS) has expanded the therapeutic landscape of spinal cord injury (SCI) rehabilitation, offering potential benefits beyond compensatory approaches to paralysis. Children with SCI are particularly susceptible to developing n...
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MDPI AG
2025-06-01
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| Series: | Children |
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| Online Access: | https://www.mdpi.com/2227-9067/12/7/817 |
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| author | Liubov Amirova Anastasia Keller Goutam Singh Molly King Parth Parikh Nicole Stepp Beatrice Ugiliweneza Yury Gerasimenko Andrea L. Behrman |
| author_facet | Liubov Amirova Anastasia Keller Goutam Singh Molly King Parth Parikh Nicole Stepp Beatrice Ugiliweneza Yury Gerasimenko Andrea L. Behrman |
| author_sort | Liubov Amirova |
| collection | DOAJ |
| description | Background/Objectives: Non-invasive spinal cord transcutaneous stimulation (scTS) has expanded the therapeutic landscape of spinal cord injury (SCI) rehabilitation, offering potential benefits beyond compensatory approaches to paralysis. Children with SCI are particularly susceptible to developing neuromuscular scoliosis due to trunk muscle paralysis and ongoing skeletal growth, making targeted interventions crucial. As demonstrated in adults and pediatrics with SCI, the ability of scTS to acutely and safely enable an upright posture and trunk control could be leveraged as a therapeutic adjunct. Activity-based locomotor training (AB-LT) alone significantly improves trunk control in children with SCIs; combining it with scTS may enhance outcomes. This pilot study evaluated the safety, feasibility, and cumulative effects of AB-LT combined with scTS on trunk control in children with SCI. Methods: Three children with SCI completed 19 to 64 sessions of combined AB-LT and scTS. Adverse effects were monitored session to session, and trunk control was assessed pre- and post-intervention. Results: Across 130 interventions in three participants, 88.5% of sessions were free from adverse effects. Reported adverse events included autonomic dysreflexia (5.4%), skin redness at electrode sites (4.6%), and headaches (1.5%). No significant impact of scTS on fatigue or central hemodynamic parameters was observed. Post-intervention, all participants demonstrated improved trunk control during quiet and perturbed sitting. Conclusions: These findings provide the first evidence supporting the safety and feasibility of this combinatorial approach in pediatric SCI rehabilitation while emphasizing the importance of monitoring skin integrity and signs of autonomic dysreflexia. This intervention shows potential synergistic benefits, warranting further research to confirm efficacy and optimize therapeutic protocols. |
| format | Article |
| id | doaj-art-23c103c6a4ba49d4b2749b9d10fd2d8b |
| institution | Kabale University |
| issn | 2227-9067 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Children |
| spelling | doaj-art-23c103c6a4ba49d4b2749b9d10fd2d8b2025-08-20T03:58:27ZengMDPI AGChildren2227-90672025-06-0112781710.3390/children12070817Cumulative Transcutaneous Spinal Stimulation with Locomotor Training Safely Improves Trunk Control in Children with Spinal Cord Injury: Pilot StudyLiubov Amirova0Anastasia Keller1Goutam Singh2Molly King3Parth Parikh4Nicole Stepp5Beatrice Ugiliweneza6Yury Gerasimenko7Andrea L. Behrman8Kentucky Spinal Cord Injury Research Center, University of Louisville, Louisville, KY 40202, USADepartment of Neurological Surgery, University of California, San Francisco, CA 94143, USAKentucky Spinal Cord Injury Research Center, University of Louisville, Louisville, KY 40202, USAKentucky Spinal Cord Injury Research Center, University of Louisville, Louisville, KY 40202, USAKentucky Spinal Cord Injury Research Center, University of Louisville, Louisville, KY 40202, USAKentucky Spinal Cord Injury Research Center, University of Louisville, Louisville, KY 40202, USAKentucky Spinal Cord Injury Research Center, University of Louisville, Louisville, KY 40202, USAPavlov Institute of Physiology, St. Petersburg 199034, RussiaKentucky Spinal Cord Injury Research Center, University of Louisville, Louisville, KY 40202, USABackground/Objectives: Non-invasive spinal cord transcutaneous stimulation (scTS) has expanded the therapeutic landscape of spinal cord injury (SCI) rehabilitation, offering potential benefits beyond compensatory approaches to paralysis. Children with SCI are particularly susceptible to developing neuromuscular scoliosis due to trunk muscle paralysis and ongoing skeletal growth, making targeted interventions crucial. As demonstrated in adults and pediatrics with SCI, the ability of scTS to acutely and safely enable an upright posture and trunk control could be leveraged as a therapeutic adjunct. Activity-based locomotor training (AB-LT) alone significantly improves trunk control in children with SCIs; combining it with scTS may enhance outcomes. This pilot study evaluated the safety, feasibility, and cumulative effects of AB-LT combined with scTS on trunk control in children with SCI. Methods: Three children with SCI completed 19 to 64 sessions of combined AB-LT and scTS. Adverse effects were monitored session to session, and trunk control was assessed pre- and post-intervention. Results: Across 130 interventions in three participants, 88.5% of sessions were free from adverse effects. Reported adverse events included autonomic dysreflexia (5.4%), skin redness at electrode sites (4.6%), and headaches (1.5%). No significant impact of scTS on fatigue or central hemodynamic parameters was observed. Post-intervention, all participants demonstrated improved trunk control during quiet and perturbed sitting. Conclusions: These findings provide the first evidence supporting the safety and feasibility of this combinatorial approach in pediatric SCI rehabilitation while emphasizing the importance of monitoring skin integrity and signs of autonomic dysreflexia. This intervention shows potential synergistic benefits, warranting further research to confirm efficacy and optimize therapeutic protocols.https://www.mdpi.com/2227-9067/12/7/817activity-based locomotor trainingspinal cord transcutaneous stimulationspinal cord injurypediatricstrunk control |
| spellingShingle | Liubov Amirova Anastasia Keller Goutam Singh Molly King Parth Parikh Nicole Stepp Beatrice Ugiliweneza Yury Gerasimenko Andrea L. Behrman Cumulative Transcutaneous Spinal Stimulation with Locomotor Training Safely Improves Trunk Control in Children with Spinal Cord Injury: Pilot Study Children activity-based locomotor training spinal cord transcutaneous stimulation spinal cord injury pediatrics trunk control |
| title | Cumulative Transcutaneous Spinal Stimulation with Locomotor Training Safely Improves Trunk Control in Children with Spinal Cord Injury: Pilot Study |
| title_full | Cumulative Transcutaneous Spinal Stimulation with Locomotor Training Safely Improves Trunk Control in Children with Spinal Cord Injury: Pilot Study |
| title_fullStr | Cumulative Transcutaneous Spinal Stimulation with Locomotor Training Safely Improves Trunk Control in Children with Spinal Cord Injury: Pilot Study |
| title_full_unstemmed | Cumulative Transcutaneous Spinal Stimulation with Locomotor Training Safely Improves Trunk Control in Children with Spinal Cord Injury: Pilot Study |
| title_short | Cumulative Transcutaneous Spinal Stimulation with Locomotor Training Safely Improves Trunk Control in Children with Spinal Cord Injury: Pilot Study |
| title_sort | cumulative transcutaneous spinal stimulation with locomotor training safely improves trunk control in children with spinal cord injury pilot study |
| topic | activity-based locomotor training spinal cord transcutaneous stimulation spinal cord injury pediatrics trunk control |
| url | https://www.mdpi.com/2227-9067/12/7/817 |
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