AUTHOR=Tefertiller Candace , Rozwod Meghan , VandeGriend Eric , Bartelt Patricia , Sevigny Mitch , Smith Andrew C. 

TITLE=Transcutaneous Electrical Spinal Cord Stimulation to Promote Recovery in Chronic Spinal Cord Injury

JOURNAL=Frontiers in Rehabilitation Sciences

VOLUME=Volume 2 - 2021

YEAR=2022

URL=https://www.frontiersin.org/journals/rehabilitation-sciences/articles/10.3389/fresc.2021.740307

DOI=10.3389/fresc.2021.740307

ISSN=2673-6861

ABSTRACT=Objective: To evaluate the impact of using transcutaneous electrical spinal cord stimulation (TSCSTSCS) on upper and lower extremity function in individuals with chronic spinal cord injury (SCI)
Design:  Prospective case series
Setting:  SCI specific rehabilitation hospital
Participants:  A convenience sample (N=7) of individuals with tetraplegia who had previously been discharged from outpatient therapy due to a plateau in progress. 
Interventions:  Individuals participated in 60 minutes of upper extremity (UE) functional task-specific practice (FTP) in combination with TSCS and 60 minutes of locomotor training in combination with TSCS 5x/week.
Main Outcome Measures:  The primary outcome for this analysis was the Capabilities of Upper Extremity Test (CUE-T). Secondary outcomes include UE motor score (UEMS), LE motor score (LEMS), sensation (light touch and pin prick), Nine-Hole Peg Test, 10 meter walk test, 6 minute walk test, and 5 minute stand test.
Results: Seven individuals (four motor complete; three motor incomplete) completed 20-80 sessions UE and LE training augmented with TSCS and without any serious adverse events. Improvements were reported on the CUE-T in all seven individuals. Two individuals improved their ASIA impairment scale (AIS) classification (B to C; C to D) and two individuals improved their neurologic level of injury by one level (C4 to C5; C5-C6). Sensation improved in five individuals and all four who started out with motor complete SCIs were able to voluntarily activate their LEs on command in the presence of stimulation. 
Conclusion: Individuals with chronic SCI who had previously demonstrated a plateau in function after an intensive outpatient therapy program were able to improve in a variety of UE and LE outcomes in response to TSCS without any adverse events. This was a small pilot study and future fully powered studies with comparative interventions need to be completed to assess efficacy.