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Spinal Rhythm Generation by Step-Induced Feedback and Transcutaneous Posterior Root Stimulation in Complete Spinal Cord-Injured Individuals
Journal article   Open access   Peer reviewed

Spinal Rhythm Generation by Step-Induced Feedback and Transcutaneous Posterior Root Stimulation in Complete Spinal Cord-Injured Individuals

Karen Minassian, Ursula S Hofstoetter, Simon M Danner, Winfried Mayr, Joy A Bruce, W Barry McKay and Keith E Tansey
Neurorehabilitation and neural repair, v 30(3)
Mar 2016
DOI: https://doi.org/10.1177/1545968315591706
PMID: 26089308
Featured in Collection :   UN Sustainable Development Goals @ Drexel
url
https://doi.org/10.1177/1545968315591706View
Published, Version of Record (VoR)Maybe Open Access (Publisher Bronze),  Open

Abstract

Adult Central Pattern Generators - physiology Electric Stimulation Therapy - methods Electromyography Feedback, Physiological - physiology Female Humans Leg - physiopathology Lumbosacral Region Male Middle Aged Muscle, Skeletal - physiopathology Orthotic Devices Periodicity Reflex - physiology Robotics Spinal Cord Injuries - physiopathology Spinal Cord Injuries - rehabilitation Spinal Nerve Roots - physiopathology Walking - physiology
The human lumbosacral spinal circuitry can generate rhythmic motor output in response to different types of inputs after motor-complete spinal cord injury. To explore spinal rhythm generating mechanisms recruited by phasic step-related sensory feedback and tonic posterior root stimulation when provided alone or in combination. We studied stepping in 4 individuals with chronic, clinically complete spinal cord injury using a robotic-driven gait orthosis with body weight support over a treadmill. Electromyographic data were collected from thigh and lower leg muscles during stepping with 2 hip-movement conditions and 2 step frequencies, first without and then with tonic 30-Hz transcutaneous spinal cord stimulation (tSCS) over the lumbar posterior roots. Robotic-driven stepping alone generated rhythmic activity in a small number of muscles, mostly in hamstrings, coinciding with the stretch applied to the muscle, and in tibialis anterior as stance-phase synchronized clonus. Adding tonic 30-Hz tSCS increased the number of rhythmically responding muscles, augmented thigh muscle activity, and suppressed clonus. tSCS could also produce rhythmic activity without or independent of step-specific peripheral feedback. Changing stepping parameters could change the amount of activity generated but not the multimuscle activation patterns. The data suggest that the rhythmic motor patterns generated by the imposed stepping were responses of spinal reflex circuits to the cyclic sensory feedback. Tonic 30-Hz tSCS provided for additional excitation and engaged spinal rhythm-generating networks. The synergistic effects of these rhythm-generating mechanisms suggest that tSCS in combination with treadmill training might augment rehabilitation outcomes after severe spinal cord injury.

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10 Record Views
102 citations in Web of Science
103 citations in Scopus

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UN Sustainable Development Goals (SDGs)

This publication has contributed to the advancement of the following goals:

#3 Good Health and Well-Being

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Collaboration types
Domestic collaboration
International collaboration
Web of Science research areas
Clinical Neurology
Rehabilitation
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