Al'joboori Yazi, Massey Sarah J, Knight Sarah L, Donaldson Nick de N, Duffell Lynsey D
Department of Medical Physics & Biomedical Engineering, UCL, London WC1E 6BT, UK.
Aspire CREATe, UCL, Stanmore HA7 4LP, UK.
J Clin Med. 2020 Aug 26;9(9):2765. doi: 10.3390/jcm9092765.
Spinal cord stimulation may enable recovery of volitional motor control in people with chronic Spinal Cord Injury (SCI). In this study we explored the effects of adding SCS, applied transcutaneously (tSCS) at vertebral levels T10/11, to a sit-to-stand training intervention in people with motor complete and incomplete SCI. Nine people with chronic SCI (six motor complete; three motor incomplete) participated in an 8-week intervention, incorporating three training sessions per week. Participants received either tSCS combined with sit-to-stand training (STIM) or sit-to-stand training alone (NON-STIM). Outcome measures were carried out before and after the intervention. Seven participants completed the intervention (STIM N = 5; NON-STIM N = 2). Post training, improvements in International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI) motor scores were noted in three STIM participants (range 1.0-7.0), with no change in NON-STIM participants. Recovery of volitional lower limb muscle activity and/or movement (with tSCS off) was noted in three STIM participants. Unassisted standing was not achieved in any participant, although standing with minimal assistance was achieved in one STIM participant. This pilot study has shown that the recruitment of participants, intervention and outcome measures were all feasible in this study design. However, some modifications are recommended for a larger trial.
脊髓刺激可能使慢性脊髓损伤（SCI）患者恢复自主运动控制能力。在本研究中，我们探讨了在T10/11椎体水平经皮施加脊髓刺激（tSCS）并将其添加到坐立训练干预中，对运动完全性和不完全性SCI患者的影响。9名慢性SCI患者（6名运动完全性；3名运动不完全性）参与了为期8周的干预，每周进行3次训练。参与者接受了tSCS与坐立训练相结合（刺激组）或仅接受坐立训练（非刺激组）。在干预前后进行了结果测量。7名参与者完成了干预（刺激组N = 5；非刺激组N = 2）。训练后，3名刺激组参与者的脊髓损伤神经学分类国际标准（ISNCSCI）运动评分有所改善（范围为1.0 - 7.0），而非刺激组参与者没有变化。3名刺激组参与者出现了自主下肢肌肉活动和/或运动的恢复（tSCS关闭时）。没有任何参与者实现独立站立，尽管1名刺激组参与者在最小辅助下实现了站立。这项初步研究表明，在本研究设计中，参与者的招募、干预和结果测量都是可行的。然而，对于更大规模的试验，建议进行一些修改。
