Self-assisted standing enabled by non-invasive spinal stimulation after spinal cord injury

Sayenko, DG; Rath, M; Ferguson, AR; Burdick, JW; Havton, LA; Edgerton, VR; Gerasimenko, YP

Self-assisted standing enabled by non-invasive spinal stimulation after spinal cord injury

Sayenko, DG Rath, M Ferguson, AR Burdick, JW Havton, LA Edgerton, VR Gerasimenko, YP

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Publication Type:: Journal Article
Citation:: Journal of Neurotrauma, 2019, 36 (9), pp. 1435 - 1450
Issue Date:: 2019-05-01

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Field	Value	Language
dc.contributor.author	Sayenko, DG	en_US
dc.contributor.author	Rath, M	en_US
dc.contributor.author	Ferguson, AR	en_US
dc.contributor.author	Burdick, JW	en_US
dc.contributor.author	Havton, LA	en_US
dc.contributor.author	Edgerton, VR	en_US
dc.contributor.author	Gerasimenko, YP	en_US
dc.date.issued	2019-05-01	en_US
dc.identifier.citation	Journal of Neurotrauma, 2019, 36 (9), pp. 1435 - 1450	en_US
dc.identifier.issn	0897-7151	en_US
dc.identifier.uri	http://hdl.handle.net/10453/136508
dc.description.abstract	© Copyright 2019, Mary Ann Liebert, Inc., publishers 2019. Neuromodulation of spinal networks can improve motor control after spinal cord injury (SCI). The objectives of this study were to (1) determine whether individuals with chronic paralysis can stand with the aid of non-invasive electrical spinal stimulation with their knees and hips extended without trainer assistance, and (2) investigate whether postural control can be further improved following repeated sessions of stand training. Using a double-blind, balanced, within-subject cross-over, and sham-controlled study design, 15 individuals with SCI of various severity received transcutaneous electrical spinal stimulation to regain self-assisted standing. The primary outcomes included qualitative comparison of need of external assistance for knee and hip extension provided by trainers during standing without and in the presence of stimulation in the same participants, as well as quantitative measures, such as the level of knee assistance and amount of time spent standing without trainer assistance. None of the participants could stand unassisted without stimulation or in the presence of sham stimulation. With stimulation all participants could maintain upright standing with minimum and some (n = 7) without external assistance applied to the knees or hips, using their hands for upper body balance as needed. Quality of balance control was practice-dependent, and improved with subsequent training. During self-initiated body-weight displacements in standing enabled by spinal stimulation, high levels of leg muscle activity emerged, and depended on the amount of muscle loading. Our findings indicate that the lumbosacral spinal networks can be modulated transcutaneously using electrical spinal stimulation to facilitate self-assisted standing after chronic motor and sensory complete paralysis.	en_US
dc.relation.ispartof	Journal of Neurotrauma	en_US
dc.relation.isbasedon	10.1089/neu.2018.5956	en_US
dc.subject.classification	Neurology & Neurosurgery	en_US
dc.title	Self-assisted standing enabled by non-invasive spinal stimulation after spinal cord injury	en_US
dc.type	Journal Article
utslib.citation.volume	9	en_US
utslib.citation.volume	36	en_US
utslib.for	1103 Clinical Sciences	en_US
utslib.for	1109 Neurosciences	en_US
pubs.embargo.period	Not known	en_US
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Science
pubs.organisational-group	/University of Technology Sydney/Faculty of Science/School of Life Sciences
utslib.copyright.status	closed_access
pubs.issue	9	en_US
pubs.publication-status	Published	en_US
pubs.volume	36	en_US

Abstract:

© Copyright 2019, Mary Ann Liebert, Inc., publishers 2019. Neuromodulation of spinal networks can improve motor control after spinal cord injury (SCI). The objectives of this study were to (1) determine whether individuals with chronic paralysis can stand with the aid of non-invasive electrical spinal stimulation with their knees and hips extended without trainer assistance, and (2) investigate whether postural control can be further improved following repeated sessions of stand training. Using a double-blind, balanced, within-subject cross-over, and sham-controlled study design, 15 individuals with SCI of various severity received transcutaneous electrical spinal stimulation to regain self-assisted standing. The primary outcomes included qualitative comparison of need of external assistance for knee and hip extension provided by trainers during standing without and in the presence of stimulation in the same participants, as well as quantitative measures, such as the level of knee assistance and amount of time spent standing without trainer assistance. None of the participants could stand unassisted without stimulation or in the presence of sham stimulation. With stimulation all participants could maintain upright standing with minimum and some (n = 7) without external assistance applied to the knees or hips, using their hands for upper body balance as needed. Quality of balance control was practice-dependent, and improved with subsequent training. During self-initiated body-weight displacements in standing enabled by spinal stimulation, high levels of leg muscle activity emerged, and depended on the amount of muscle loading. Our findings indicate that the lumbosacral spinal networks can be modulated transcutaneously using electrical spinal stimulation to facilitate self-assisted standing after chronic motor and sensory complete paralysis.

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http://hdl.handle.net/10453/136508