Synergistic integration of epidural spinal cord stimulation with robotic therapy and neurorehabilitation to facilitate functional recovery in chronic sensorimotor complete spinal cord injury: A case series.
Objective: To present the rehabilitation considerations in prehabilitation and the rehabilitation phase post spinal cord stimulator implantation; and to evaluate the efficacy of synergistic combination of epidural spinal cord stimulation (SCS) with motor imagery, trunk rehabilitation, robotic and ov...
| Publicado en: | Advances in Rehabilitation Science & Practice pp. 1 - 27 |
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| Autores principales: | , , , , , , , |
| Formato: | clinical trial diagnostic images pictorial research tables/charts Journal Article |
| Publicado: |
Sage Publications Inc.
6/24/2025
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=186160830&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 186160830 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 27536351 N7A5 jtl: Advances in Rehabilitation Science & Practice issn: 27536351 maglogo: Y pubinfo: dt: 6/24/2025 pid: 344 pub: Sage Publications Inc. place: Thousand Oaks, California artinfo: ui: 186160830 186160830 186160830 10.1177/27536351251343738 186160830 ppf: 1 ppct: 26 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Synergistic integration of epidural spinal cord stimulation with robotic therapy and neurorehabilitation to facilitate functional recovery in chronic sensorimotor complete spinal cord injury: A case series. aug: au: Wee, Seng Kwee Valerie, Zhi Yan Ng Phua, Min Wee Lui, Wen Li Misbaah, Fatimah Ker, Rui Xin Justin Ng, Wai Hoe Rui Wan, Kai affil: Department of Rehabilitation Medicine, Tan Tock Seng Hospital, Singapore sug: subj: Spinal Cord Injuries Surgery Spinal Cord Injuries Rehabilitation Electric Stimulation Methods Robotics Methods Nervous System Diseases Rehabilitation Functional Status Chronic Disease Rehabilitation Sensory Motor Integration Methods Gait Training Methods Combined Modality Therapy Methods Treatment Outcomes Evaluation Guided Imagery Methods Motor Skills Evaluation Human Male Female Adult Middle Age Clinical Trials Case Studies Prehabilitation Methods Physical Mobility Pretest-Posttest Control Group Design Thoracic Vertebrae Physiopathology Scales Task Performance and Analysis Balance, Postural Walking Speed Evaluation Exoskeleton Devices Therapeutic Use Pilot Studies Electrophysiology Neuronal Plasticity Muscle, Skeletal Physiology Torso Physiology Body Weight Hip Joint Physiology Knee Joint Physiology Ankle Joint Physiology Toe Joint Physiology Recovery Descriptive Statistics Data Analysis Software Adult: 19-44 years Middle Aged: 45-64 years Male Female ab: Objective: To present the rehabilitation considerations in prehabilitation and the rehabilitation phase post spinal cord stimulator implantation; and to evaluate the efficacy of synergistic combination of epidural spinal cord stimulation (SCS) with motor imagery, trunk rehabilitation, robotic and overground gait training in improving mobility in persons with sensorimotor complete spinal cord injury (SCI). Design: A non-controlled before-after clinical trial. Methods: Epidural spinal cord stimulators were implanted into 3 participants with complete thoracic SCI (Thoracic 4, Thoracic 2 and Thoracic 10 respectively). They underwent 1 month of prehabilitation, followed by 7 months of daily rehabilitation post-implantation, consisting of SCS, motor imagery, trunk rehabilitation, robotic therapy and overground gait training. Pre-post assessments include the American Spinal Injury Association Impairment Scale (AIS) examination, Spinal Cord Independence Measure version III (Mobility subscale) (SCIM-III), Walking Index for Spinal Cord Injury II (WISCI-II), Trunk Assessment Scale for Spinal Cord Injury (TASS), Five Times Sit-to-Stand (5×STS) and 2-minute Walk Test (2mWT). Results: Post rehabilitation, there were improvements in WISCI-II, TASS, 5×STS and 2mWT in all 3 participants; and no change in AIS sensory scores. Only participants 2 and 3 exhibited slight improvement in SCIM-III. The WISCI-II of all participants improved, ranging from 3 levels to 9 levels, which was considered a clinically meaningful change. Furthermore, the change in TASS exceeded the minimal clinically important difference (MCID) of 4 points for two participants. The change in 5×STS exceeded the MCID of 2.27 seconds for all participants. These significant improvements translated into the participants' ability to perform sit-to-stand independently and ambulate with a rollator frame under supervision of a carer. Conclusion: This clinical trial demonstrated proof-of-concept and promising findings that support our rehabilitation protocol in improving functional mobility of people with sensorimotor complete SCI, which may be replicated in future studies. *The study protocol was registered with Clinical-trials.gov (NCT05644171; Registered 13 November 2022. https://clinicaltrials.gov/ct2/show/NCT05644171) pubtype: Academic Journal doctype: clinical trial diagnostic images pictorial research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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