Feasibility and utility of transcutaneous spinal cord stimulation combined with walking-based therapy for people with motor incomplete spinal cord injury.
Feasibility and utility of transcutaneous spinal cord stimulation combined with walking-based therapy for people with motor incomplete spinal cord injury.
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DOI：
10.1038/s41394-020-00359-1
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发表时间：
2020-11-25
影响因子：
1.2
通讯作者：
Martin RH
中科院分区：
文献类型：
--
作者：
McHugh LV;Miller AA;Leech KA;Salorio C;Martin RH
前瞻性病例系列。目的探讨经皮脊髓电刺激（TSCS）联合步行运动疗法的可行性及初步疗效。位于美国马里兰州的医院门诊中心。10名慢性（>1年）运动不完全性脊髓损伤（iSCI）患者在8周内完成了23次2小时治疗。在每次治疗的前30分钟，使用临床可用的可调电流器械输送TSCS。为了评估干预的可行性，我们跟踪了疼痛，不良事件和参与者的保留。通过评估干预后步行速度、耐力和质量的变化以及选择的功能结局指标（10米步行试验（10 MWT）、6分钟步行试验（6 MWT）、计时起身和行走以及脊髓损伤II的步行指数）来评估初步疗效。我们发现，在门诊临床环境中，联合干预是可行的。参与者对TSCS耐受良好，没有报告重大不良事件或其他问题（例如，中断训练的皮肤刺激或疼痛）。没有参与者选择停止研究。参与者在干预后的每项步行功能测量中也显示出显着改善。通过10 MWT测量的步行速度变化（0.56 ± 0.29 m/s至0.72 ± 0.36 m/s）超过了iSCI患者的最小临床重要差异。步行质量和耐力的变化，通过6 MWT测量（149.88 ± 99.87 m至194.53 ± 106.56 m），超过了iSCI患者的最小可检测变化。这些结果表明，TSCS在临床上是可行的，可能是有用的辅助步行为基础的治疗成人iSCI。
Prospective case series. To evaluate the feasibility and preliminary efficacy of combining transcutaneous spinal cord stimulation (TSCS) with walking-based physical therapy. Hospital-based outpatient center in Maryland, United States. Ten individuals with chronic (>1 year) motor incomplete spinal cord injury (iSCI) completed 23 sessions of 2-h therapy over 8 weeks. TSCS was delivered for the first 30 min of each session using a clinically available device with adjustable current. To assess feasibility of the intervention, we tracked pain, adverse events, and participant retention. Preliminary efficacy was assessed by evaluating changes in walking speed, endurance, and quality following the intervention with select functional outcome measures (10-m walk test (10MWT), 6-min walk test (6MWT), timed up and go, and walking index for spinal cord injury II). We found that the combined intervention was feasible in an outpatient clinical setting. Participants tolerated the TSCS well, with no reports of significant adverse events or other issues (e.g., skin irritation or pain that disrupted training). None of the participants elected to discontinue the study. Participants also showed significant improvements in each measure of walking function following the intervention. Changes in walking speed, as measured by the 10MWT (0.56 ± 0.29 m/s to 0.72 ± 0.36 m/s), exceeded the minimal clinically important difference for individuals with iSCI. Changes in walking quality and endurance, as measured by the 6MWT (149.88 ± 99.87 m to 194.53 ± 106.56 m), exceeded the minimal detectable change for individuals with iSCI. These results indicate that TSCS is clinically feasible and may be useful as an adjunct to walking-based therapy for adults with iSCI.
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DOI：
10.1016/j.apmr.2017.10.003
发表时间：
2018-03-01
影响因子：
4.3
作者：
Morrison, Sarah A.;Lorenz, Douglas;Basso, D. Michele
通讯作者：
Basso, D. Michele
影响因子：
2.9
作者：
Lam, Tania;Eng, Janice J;Whittaker, Maura
通讯作者：
Whittaker, Maura
影响因子：
3.2
作者：
Behmran, AL;Harkema, SJ
通讯作者：
Harkema, SJ
影响因子：
4.2
作者：
Burns, Anthony S.;Delparte, Jude J.;Ditunno, John F.
通讯作者：
Ditunno, John F.
影响因子：
4.6
作者：
Murray, Lynda M.;Tahayori, Behdad;Knikou, Maria
通讯作者：
Knikou, Maria