Tharu Niraj Singh, Wong Arnold Yu Lok, Zheng Yong-Ping
Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong SAR, China.
Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong SAR, China.
Brain Sci. 2024 Jun 26;14(7):640. doi: 10.3390/brainsci14070640.
The recovery of locomotion is greatly prioritized, and neuromodulation has been emerging as a promising approach in recent times.
Single-subject research design.
A laboratory at The Hong Kong Polytechnic University.
To investigate the effects of augmenting activity-based therapy (ABT) to transcutaneous electrical spinal cord stimulation (TSCS) on enhancing specific lower limb muscle strength and improving locomotor ability in an individual with chronic incomplete spinal cord injury (iSCI).
An individual with iSCI underwent two phases of treatment, ABT alone followed by combined ABT+TSCS, each for a period of 10 weeks. The TSCS stimulated T10-T11 and T12-L1 segments with a frequency of 30 Hz at an intensity between 105 mA and 130 mA. Manual muscle testing, 6 min walk test (6MWT), and surface electromyography (EMG) responses of specific lower limb muscles were measured. Additionally, spasticity and sensorimotor examinations were conducted every two weeks, while pain tolerance was recorded after each treatment session.
After the ABT+TSCS treatment, there was an increase in overall muscle strength grading (from 1.8 ± 0.3 to 2.2 ± 0.6 out of 5.0). The 6MWT showed a greater increase in walking distance (3.5 m to 10 m) after combined treatment than ABT alone. In addition, the EMG response of the anterior rectus femoris, biceps femoris, medial gastrocnemius, and tibialis anterior after ABT+TSCS increased more than after ABT alone. The spasticity grade was reduced (from 0.8 ± 0.7 to 0.5 ± 0.6) whereas the average lower limb motor score increased from 17 to 23 points. No adverse effects were reported.
ABT+TSCS increased the target-specific lower limb muscle strength and walking ability more than ABT alone in an individual with chronic iSCI.
运动功能的恢复被高度重视，近年来神经调节已成为一种有前景的方法。
单受试者研究设计。
香港理工大学的一个实验室。
探讨在慢性不完全性脊髓损伤（iSCI）个体中，将基于活动的疗法（ABT）与经皮脊髓电刺激（TSCS）相结合对增强特定下肢肌肉力量和改善运动能力的影响。
一名iSCI个体接受了两个阶段的治疗，先单独进行ABT，然后是ABT + TSCS联合治疗，每个阶段为期10周。TSCS刺激T10 - T11和T12 - L1节段，频率为30Hz，强度在105mA至130mA之间。测量特定下肢肌肉的徒手肌力测试、6分钟步行试验（6MWT）和表面肌电图（EMG）反应。此外，每两周进行一次痉挛和感觉运动检查，每次治疗后记录疼痛耐受性。
ABT + TSCS治疗后，整体肌肉力量分级增加（从5.0分中的1.8±0.3提高到2.2±0.6）。联合治疗后的6MWT显示步行距离增加幅度（从3.5米到10米）大于单独的ABT治疗。此外，ABT + TSCS治疗后股直肌、股二头肌、腓肠肌内侧头和胫骨前肌的EMG反应比单独ABT治疗后增加更多。痉挛等级降低（从0.8±0.7降至0.5±0.6），而平均下肢运动评分从17分提高到23分。未报告不良反应。
在慢性iSCI个体中，ABT + TSCS比单独的ABT更能增强目标特定的下肢肌肉力量和步行能力。
