PMID- 38515546
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20240323
IS  - 2689-288X (Electronic)
IS  - 2689-288X (Linking)
VI  - 5
IP  - 1
DP  - 2024
TI  - Robotic Postural Training With Epidural Stimulation for the Recovery of Upright 
      Postural Control in Individuals With Motor Complete Spinal Cord Injury: A Pilot 
      Study.
PG  - 277-292
LID - 10.1089/neur.2024.0013 [doi]
AB  - Activity-based training and lumbosacral spinal cord epidural stimulation (scES) 
      have the potential to restore standing and walking with self-balance assistance 
      after motor complete spinal cord injury (SCI). However, improvements in upright 
      postural control have not previously been addressed in this population. Here, we 
      implemented a novel robotic postural training with scES, performed with free 
      hands, to restore upright postural control in individuals with chronic, cervical 
      (n = 5) or high-thoracic (n = 1) motor complete SCI, who had previously undergone 
      stand training with scES using a walker or a standing frame for self-balance 
      assistance. Robotic postural training re-enabled and/or largely improved the 
      participants' ability to control steady standing, self-initiated trunk movements 
      and upper limb reaching movements while standing with free hands, receiving only 
      external assistance for pelvic control. These improvements were associated with 
      neuromuscular activation pattern adaptations above and below the lesion. These 
      findings suggest that the human spinal cord below the level of injury can 
      generate meaningful postural responses when its excitability is modulated by 
      scES, and can learn to improve these responses. Upright postural control 
      improvements can enhance functional motor recovery promoted by scES after severe 
      SCI.
CI  - (c) Enrico Rejc et al., 2024; Published by Mary Ann Liebert, Inc.
FAU - Rejc, Enrico
AU  - Rejc E
AD  - Tim and Caroline Reynolds Center for Spinal Stimulation, Kessler Foundation, West 
      Orange, New Jersey, USA.
AD  - Department of Medicine, University of Udine, Udine, Italy.
AD  - Kentucky Spinal Cord Injury Research Center, University of Louisville, 
      Louisville, Kentucky, USA.
FAU - Bowersock, Collin
AU  - Bowersock C
AD  - Kentucky Spinal Cord Injury Research Center, University of Louisville, 
      Louisville, Kentucky, USA.
AD  - Department of Mechanical Engineering, Northern Arizona University, Flagstaff, 
      Arizona, USA.
FAU - Pisolkar, Tanvi
AU  - Pisolkar T
AD  - Kentucky Spinal Cord Injury Research Center, University of Louisville, 
      Louisville, Kentucky, USA.
FAU - Omofuma, Isirame
AU  - Omofuma I
AD  - Department of Mechanical Engineering, Columbia University, New York, New York, 
      USA.
FAU - Luna, Tatiana
AU  - Luna T
AD  - Department of Mechanical Engineering, Columbia University, New York, New York, 
      USA.
FAU - Khan, Moiz
AU  - Khan M
AD  - Department of Radiology at BWH, Harvard Medical School, Boston, Massachusetts, 
      USA.
FAU - Santamaria, Victor
AU  - Santamaria V
AD  - Department of Physical Therapy, New York Medical College, Valhalla, New York, 
      USA.
FAU - Ugiliweneza, Beatrice
AU  - Ugiliweneza B
AD  - Kentucky Spinal Cord Injury Research Center, University of Louisville, 
      Louisville, Kentucky, USA.
AD  - Department of Neurological Surgery, University of Louisville, Louisville, 
      Kentucky, USA.
FAU - Angeli, Claudia A
AU  - Angeli CA
AD  - Tim and Caroline Reynolds Center for Spinal Stimulation, Kessler Foundation, West 
      Orange, New Jersey, USA.
FAU - Forrest, Gail F
AU  - Forrest GF
AD  - Tim and Caroline Reynolds Center for Spinal Stimulation, Kessler Foundation, West 
      Orange, New Jersey, USA.
AD  - Department of Physical Medicine and Rehabilitation, Rutgers New Jersey Medical 
      School, Newark, New Jersey, USA.
FAU - Stein, Joel
AU  - Stein J
AD  - Department of Rehabilitation and Regenerative Medicine, Columbia University, New 
      York, New York, USA.
FAU - Agrawal, Sunil
AU  - Agrawal S
AD  - Department of Mechanical Engineering, Columbia University, New York, New York, 
      USA.
AD  - Department of Rehabilitation and Regenerative Medicine, Columbia University, New 
      York, New York, USA.
FAU - Harkema, Susan J
AU  - Harkema SJ
AD  - Kentucky Spinal Cord Injury Research Center, University of Louisville, 
      Louisville, Kentucky, USA.
AD  - Department of Neurological Surgery, University of Louisville, Louisville, 
      Kentucky, USA.
LA  - eng
PT  - Journal Article
DEP - 20240315
PL  - United States
TA  - Neurotrauma Rep
JT  - Neurotrauma reports
JID - 101773091
PMC - PMC10956531
OTO - NOTNLM
OT  - epidural stimulation
OT  - postural control
OT  - spinal cord injury
OT  - standing
OT  - training
COIS- No competing financial interests exist.
EDAT- 2024/03/22 06:45
MHDA- 2024/03/22 06:46
PMCR- 2024/03/15
CRDT- 2024/03/22 03:56
PHST- 2024/03/22 06:46 [medline]
PHST- 2024/03/22 06:45 [pubmed]
PHST- 2024/03/22 03:56 [entrez]
PHST- 2024/03/15 00:00 [pmc-release]
AID - 10.1089/neur.2024.0013 [pii]
AID - 10.1089/neur.2024.0013 [doi]
PST - epublish
SO  - Neurotrauma Rep. 2024 Mar 15;5(1):277-292. doi: 10.1089/neur.2024.0013. 
      eCollection 2024.