Exploring the feasibility of combining transcutaneous electrical spinal cord stimulation and overground robotic exoskeleton for gait rehabilitation in patients with spinal cord injury
Abstract
INTRODUCTION: Spinal cord injury (SCI) is a traumatic condition that causes severe sensory and mobility impairments, including gait dysfunction. Combining exoskeleton-assisted gait training (EGT) with transcutaneous spinal cord stimulation (tSCS) may enhance motor recovery in SCI patients. This study explores the feasibility and immediate effects of combining these two neurorehabilitation strategies, without pursuing clinical benefits.
METHODS: We present a 3-of-1 case series of incomplete SCI patients (AIS C-D) who participated in two walking sessions: tSCS-assisted gait, then combined with the robotic exoskeleton Exo-H3. Each session included three phases of 3 min each: before, during and after tSCS. Surface electromyography (EMG) was recorded to analyze muscle activation and the level of effort generated using root mean square (RMS) and integrated EMG (iEMG). Functional outcomes were assessed with the Timed Up and Go (TUG) test, Visual Analog Scale (VAS) for discomfort and fatigue and distance covered.
RESULTS: Immediate effects varied among patients. Participant 1 showed increased muscle activation and effort without the Exo-H3 after tSCS, particularly in the Rectus Femoris (ReFe) muscle, along with improved TUG performance and walking speed. However, during the combined tSCS-Exo session, muscle activation did not decrease, but effort was significantly reduced, masking the tSCS effects seen without the exoskeleton. Walking speed and TUG also worsened. Participant 2…
How strong is the evidence?
Evidence Hub reads this as a case series, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health.
Read the paper
Related studies
- Combining in silico and in vitro approaches to identification of potent inhibitor against phospholipase A2 (PLA2)
- In silico and in vitro studies: investigating the chemical composition, DFT, molecular docking, and dynamic simulation of Satureja candidissima (Munby) Briq essential oil as a potential antibacterial agent
- Quercetin combined with ciprofloxacin and gentamicin inhibits biofilm formation and virulence in Staphylococcus aureus
- In silico study of the mechanism of action, pharmacokinetic and toxicological properties of some N-methylanthranilates and their analogs
- Anticonvulsant Effects of Citronellal, Daidzin, and Phytol, Possibly Through GABAA Receptor and Voltage-Gated Sodium Channel Interaction Pathways: In Vivo and In Silico Studies
- 2-Phenylcyclopropylmethylamine (PCPMA) Derivatives as D3R-Selective Ligands for 3D-QSAR, Docking and Molecular Dynamics Simulation Studies
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.