Synergistic implications of combinatorial rehabilitation approaches using spinal stimulation on therapeutic outcomes in spinal cord injury

IF 3.7 3区医学 Q1 CLINICAL NEUROLOGY Clinical Neurophysiology Pub Date : 2024-07-09 DOI:10.1016/j.clinph.2024.06.015

Michelle S. Scheffler, Catherine A. Martin, Valerie Dietz, Amir H. Faraji, Dimitry G. Sayenko

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Abstract

Objective

The objective of this narrative review was to locate and assess recent articles employing a combinatorial approach of transcutaneous spinal cord stimulation or epidural spinal cord stimulation with additional modalities. We sought to provide relevant knowledge of recent literature and advance understanding on outcomes reported, to better equip those working in neurorehabilitation and neuromodulation.

Methods

Articles were selected and analyzed based on study approach, stimulation parameters, outcome measures, and presence of neurophysiological data to support findings.

Results

This narrative review analyzed 44 recent articles employing a combinatorial approach of transcutaneous spinal cord stimulation or epidural spinal cord stimulation with additional modalities. Our findings showed that limited research exists regarding such combinatorial approaches, particularly when considering modalities beyond activity-based training. There is also limited consistency in neurophysiological and quality of life outcomes.

Conclusion

Articles involving transcutaneous spinal cord stimulation or epidural spinal cord stimulation with other modalities are limited in the current body of literature. Authors noted variety in approach, sample size, and use of participant perspective. Opportunities are present to add high quality research to this body of literature.

Significance

Transcutaneous spinal cord stimulation and epidural spinal cord stimulation are emerging in research as viable avenues for targeting improvement of function after traumatic spinal cord injury, particularly when combined with activity-based training. This body of literature demonstrates viable areas for growth from both neurophysiological and functional perspectives. Further, exploration of novel combinatorial approaches holds potential to offer enhanced contributions to clinical and neurophysiological rehabilitation and research.

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脊髓刺激综合康复方法对脊髓损伤治疗效果的协同影响

目的本叙述性综述旨在查找和评估近期采用经皮脊髓刺激或硬膜外脊髓刺激与其他方式相结合方法的文章。方法根据研究方法、刺激参数、结果测量以及支持研究结果的神经生理学数据对文章进行筛选和分析。结果本叙述性综述分析了 44 篇采用经皮脊髓刺激或硬膜外脊髓刺激与其他方式相结合的最新文章。我们的研究结果表明，关于此类组合方法的研究有限，尤其是在考虑基于活动的训练以外的模式时。结论在目前的文献中，涉及经皮脊髓刺激或硬膜外脊髓刺激与其他方式结合的文章非常有限。作者们注意到在方法、样本大小和使用参与者视角方面的多样性。意义经皮脊髓刺激和硬膜外脊髓刺激在研究中逐渐成为改善创伤性脊髓损伤后功能的可行途径，尤其是在与活动训练相结合时。这些文献从神经生理学和功能学的角度展示了可行的发展领域。此外，对新型组合方法的探索有可能为临床和神经生理学康复与研究做出更大贡献。

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来源期刊

Clinical Neurophysiology 医学-临床神经学

CiteScore

8.70

自引率

6.40%

发文量

932

审稿时长

59 days

期刊介绍： As of January 1999, The journal Electroencephalography and Clinical Neurophysiology, and its two sections Electromyography and Motor Control and Evoked Potentials have amalgamated to become this journal - Clinical Neurophysiology. Clinical Neurophysiology is the official journal of the International Federation of Clinical Neurophysiology, the Brazilian Society of Clinical Neurophysiology, the Czech Society of Clinical Neurophysiology, the Italian Clinical Neurophysiology Society and the International Society of Intraoperative Neurophysiology.The journal is dedicated to fostering research and disseminating information on all aspects of both normal and abnormal functioning of the nervous system. The key aim of the publication is to disseminate scholarly reports on the pathophysiology underlying diseases of the central and peripheral nervous system of human patients. Clinical trials that use neurophysiological measures to document change are encouraged, as are manuscripts reporting data on integrated neuroimaging of central nervous function including, but not limited to, functional MRI, MEG, EEG, PET and other neuroimaging modalities.