PMID- 35477745
OWN - NLM
STAT- MEDLINE
DCOM- 20221107
LR  - 20221205
IS  - 1476-5624 (Electronic)
IS  - 1362-4393 (Print)
IS  - 1362-4393 (Linking)
VI  - 60
IP  - 11
DP  - 2022 Nov
TI  - Feasibility of transcutaneous spinal direct current stimulation combined with 
      locomotor training after spinal cord injury.
PG  - 971-977
LID - 10.1038/s41393-022-00801-1 [doi]
AB  - STUDY DESIGN: Feasibility study, consisting of random-order, cross-over study of 
      a single intervention session, followed by a parallel-arm study of 16 sessions. 
      OBJECTIVES: To investigate the feasibility of a novel combinatorial approach with 
      simultaneous delivery of transcutaneous spinal direct current stimulation (tsDCS) 
      and locomotor training (tsDCS + LT) after spinal cord injury, compared to sham 
      stimulation and locomotor training (sham + LT), and examine preliminary effects 
      on walking function. SETTING: Clinical research center in the southeastern United 
      States. METHODS: Eight individuals with chronic incomplete spinal cord injury 
      (ISCI) completed the two-part protocol. Feasibility was assessed based on safety 
      (adverse responses), tolerability (pain, spasticity, skin integrity), and 
      protocol achievement (session duration, intensity). Walking function was assessed 
      with the 10 m and 6 min walk tests. RESULTS: There were no major adverse 
      responses. Minimal reports of skin irritation and musculoskeletal pain were 
      consistent between groups. Average training peak heart rate as percent of maximum 
      (mean(SD); tsDCS + LT: 66 (4)%, sham + LT: 69 (10)%) and Borg ratings of 
      perceived exertion (tsDCS + LT: 17.5 (1.2), sham + LT: 14.4 (1.8)) indicate both 
      groups trained at high intensities. Walking speed gains exceeded the minimal 
      clinically important difference (MCID) in three of four who received tsDCS + LT 
      (0.18 (0.29) m/s) and one of four in sham + LT (-0.05 (0.23) m/s). Gains in 
      walking endurance exceeded the MCID in one of four in each group (tsDCS + LT: 
      36.4 (69.0) m, sham + LT: 4.9 (56.9) m). CONCLUSIONS: Combinatorial tsDCS and 
      locomotor training is safe and feasible for individuals with chronic ISCI, even 
      those with considerable walking impairment. Study outcomes support the need to 
      investigate the efficacy of this approach.
CI  - (c) 2022. The Author(s), under exclusive licence to International Spinal Cord 
      Society.
FAU - Hawkins, Kelly A
AU  - Hawkins KA
AUID- ORCID: 0000-0002-9281-230X
AD  - Department of Physical Therapy, University of Florida, Gainesville, FL, USA.
FAU - DeMark, Louis A
AU  - DeMark LA
AD  - Brooks Rehabilitation, Jacksonville, FL, USA.
FAU - Vistamehr, Arian
AU  - Vistamehr A
AD  - Brooks Rehabilitation, Jacksonville, FL, USA.
FAU - Snyder, Hannah J
AU  - Snyder HJ
AD  - Brooks Rehabilitation, Jacksonville, FL, USA.
FAU - Conroy, Christy
AU  - Conroy C
AD  - Brooks Rehabilitation, Jacksonville, FL, USA.
FAU - Wauneka, Clayton
AU  - Wauneka C
AD  - Brooks Rehabilitation, Jacksonville, FL, USA.
FAU - Tonuzi, Geneva
AU  - Tonuzi G
AD  - Brooks Rehabilitation, Jacksonville, FL, USA.
FAU - Fuller, David D
AU  - Fuller DD
AD  - Department of Physical Therapy, University of Florida, Gainesville, FL, USA.
FAU - Clark, David J
AU  - Clark DJ
AD  - Brain Rehabilitation Research Center of Excellence, North Florida/South Georgia 
      Veterans Health System, Gainesville, FL, USA.
AD  - Department of Aging and Geriatric Research, University of Florida, Gainesville, 
      FL, USA.
FAU - Fox, Emily J
AU  - Fox EJ
AUID- ORCID: 0000-0003-0142-3497
AD  - Department of Physical Therapy, University of Florida, Gainesville, FL, USA. 
      ejfox@phhp.ufl.edu.
AD  - Brooks Rehabilitation, Jacksonville, FL, USA. ejfox@phhp.ufl.edu.
LA  - eng
GR  - P2C HD086851/HD/NICHD NIH HHS/United States
GR  - HD055929/HD/NICHD NIH HHS/United States
GR  - T32 HD043730/HD/NICHD NIH HHS/United States
GR  - K12 HD055929/HD/NICHD NIH HHS/United States
GR  - HD-15-010/HD/NICHD NIH HHS/United States
GR  - T32HD043730/HD/NICHD NIH HHS/United States
PT  - Journal Article
DEP - 20220427
PL  - England
TA  - Spinal Cord
JT  - Spinal cord
JID - 9609749
SB  - IM
MH  - Humans
MH  - Cross-Over Studies
MH  - Feasibility Studies
MH  - Physical Therapy Modalities
MH  - Spinal Cord
MH  - *Spinal Cord Injuries/therapy
MH  - *Spinal Cord Stimulation/methods
PMC - PMC9606142
MID - NIHMS1795119
COIS- Competing interests: The authors declare no competing interests.
EDAT- 2022/04/29 06:00
MHDA- 2022/11/08 06:00
PMCR- 2022/11/07
CRDT- 2022/04/28 05:27
PHST- 2021/11/16 00:00 [received]
PHST- 2022/04/01 00:00 [accepted]
PHST- 2022/03/30 00:00 [revised]
PHST- 2022/04/29 06:00 [pubmed]
PHST- 2022/11/08 06:00 [medline]
PHST- 2022/04/28 05:27 [entrez]
PHST- 2022/11/07 00:00 [pmc-release]
AID - 10.1038/s41393-022-00801-1 [pii]
AID - 10.1038/s41393-022-00801-1 [doi]
PST - ppublish
SO  - Spinal Cord. 2022 Nov;60(11):971-977. doi: 10.1038/s41393-022-00801-1. Epub 2022 
      Apr 27.