Morad Zaaya1, Timothy S Pulverenti2, Maria Knikou1,3. 1. Klab4Recovery Research Laboratory, Department of Physical Therapy, College of Staten Island, New York, NY, USA. 2. Klab4Recovery Research Laboratory, Department of Physical Therapy, College of Staten Island, New York, NY, USA. timothy.pulverenti@csi.cuny.edu. 3. PhD Program in Biology and Collaborative Neuroscience Program, Graduate Center of The City University of New York, New York, NY, USA.
Abstract
STUDY DESIGN: Pilot study (case series). OBJECTIVE: The objective of this study was to establish spinal neurophysiological changes following high-frequency transspinal stimulation during robot-assisted step training in individuals with chronic motor complete spinal cord injury (SCI). SETTING: University research laboratory (Klab4Recovery). METHODS: Four individuals with motor complete SCI received an average of 18 sessions of transspinal stimulation over the thoracolumbar region with a pulse train at 333 Hz during robotic-assisted step training. Each session lasted ~1 h, with an average of 240 stimulations delivered during each training session. Before and after the combined intervention, we evaluated the amplitude modulation of the long-latency tibialis anterior (TA) flexion reflex and transspinal evoked potentials (TEP) recorded from flexors and extensors during assisted stepping, and the TEP recruitment curves at rest. RESULTS: The long-latency TA flexion reflex was depressed in all phases of the step cycle and the phase-dependent amplitude modulation of TEPs was altered during assisted stepping, while spinal motor output based on TEP recruitment curves was increased after the combined intervention. CONCLUSION: This is the first study documenting noninvasive transspinal stimulation coupled with locomotor training depresses flexion reflex excitability and concomitantly increases motoneuron output over multiple spinal segments for both flexors and extensors in people with motor complete SCI. While both transspinal stimulation and locomotor training may act via similar activity-dependent neuroplasticity mechanisms, combined interventions for rehabilitation of neurological disorders has not been systematically assessed. Our current findings support locomotor training induced neuroplasticity may be augmented with transspinal stimulation.
STUDY DESIGN: Pilot study (case series). OBJECTIVE: The objective of this study was to establish spinal neurophysiological changes following high-frequency transspinal stimulation during robot-assisted step training in individuals with chronic motor complete spinal cord injury (SCI). SETTING: University research laboratory (Klab4Recovery). METHODS: Four individuals with motor complete SCI received an average of 18 sessions of transspinal stimulation over the thoracolumbar region with a pulse train at 333 Hz during robotic-assisted step training. Each session lasted ~1 h, with an average of 240 stimulations delivered during each training session. Before and after the combined intervention, we evaluated the amplitude modulation of the long-latency tibialis anterior (TA) flexion reflex and transspinal evoked potentials (TEP) recorded from flexors and extensors during assisted stepping, and the TEP recruitment curves at rest. RESULTS: The long-latency TA flexion reflex was depressed in all phases of the step cycle and the phase-dependent amplitude modulation of TEPs was altered during assisted stepping, while spinal motor output based on TEP recruitment curves was increased after the combined intervention. CONCLUSION: This is the first study documenting noninvasive transspinal stimulation coupled with locomotor training depresses flexion reflex excitability and concomitantly increases motoneuron output over multiple spinal segments for both flexors and extensors in people with motor complete SCI. While both transspinal stimulation and locomotor training may act via similar activity-dependent neuroplasticity mechanisms, combined interventions for rehabilitation of neurological disorders has not been systematically assessed. Our current findings support locomotor training induced neuroplasticity may be augmented with transspinal stimulation.
Authors: Yury P Gerasimenko; Daniel C Lu; Morteza Modaber; Sharon Zdunowski; Parag Gad; Dimitry G Sayenko; Erika Morikawa; Piia Haakana; Adam R Ferguson; Roland R Roy; V Reggie Edgerton Journal: J Neurotrauma Date: 2015-08-20 Impact factor: 5.269
Authors: Ravi Raithatha; Cheryl Carrico; Elizabeth Salmon Powell; Philip M Westgate; Kenneth C Chelette Ii; Kara Lee; Laura Dunsmore; Sara Salles; Lumy Sawaki Journal: NeuroRehabilitation Date: 2016 Impact factor: 2.138