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Spinal Cord Epidural Stimulation Improves Lower Spine Sitting Posture Following Severe Cervical Spinal Cord Injury

Cervical spinal cord injury (SCI) leads to impaired trunk motor control, negatively impacting the performance of activities of daily living in the affected individuals. Improved trunk control with better sitting posture has been previously observed due to neuromuscular electrical stimulation and tra...

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Autores principales: Joshi, Kundan, Rejc, Enrico, Ugiliweneza, Beatrice, Harkema, Susan J., Angeli, Claudia A.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10525621/
https://www.ncbi.nlm.nih.gov/pubmed/37760167
http://dx.doi.org/10.3390/bioengineering10091065
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author Joshi, Kundan
Rejc, Enrico
Ugiliweneza, Beatrice
Harkema, Susan J.
Angeli, Claudia A.
author_facet Joshi, Kundan
Rejc, Enrico
Ugiliweneza, Beatrice
Harkema, Susan J.
Angeli, Claudia A.
author_sort Joshi, Kundan
collection PubMed
description Cervical spinal cord injury (SCI) leads to impaired trunk motor control, negatively impacting the performance of activities of daily living in the affected individuals. Improved trunk control with better sitting posture has been previously observed due to neuromuscular electrical stimulation and transcutaneous spinal stimulation, while improved postural stability has been observed with spinal cord epidural stimulation (scES). Hence, we studied how trunk-specific scES impacts sitting independence and posture. Fourteen individuals with chronic, severe cervical SCI with an implanted neurostimulator performed a 5-min tall-sit task without and with trunk-specific scES. Spine posture was assessed by placing markers on five spine levels and evaluating vertical spine inclination angles. Duration of trunk manual assistance was used to assess independence along with the number of independence changes and average independence score across those changes. With scES, the sacrum-L1 inclination and number of independence changes tended to decrease by 1.64 ± 3.16° (p = 0.07; Cohen’s d = 0.53) and 9.86 ± 16.8 (p = 0.047; Cohen’s d = 0.59), respectively. Additionally, for the participants who had poor sitting independence without scES, level of independence tended to increase by 12.91% [0%, 31.52%] (p = 0.38; Cohen’s d = 0.96) when scES was present. Hence, trunk-specific scES promoted improvements in lower spine posture and lower levels of trunk assistance.
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spelling pubmed-105256212023-09-28 Spinal Cord Epidural Stimulation Improves Lower Spine Sitting Posture Following Severe Cervical Spinal Cord Injury Joshi, Kundan Rejc, Enrico Ugiliweneza, Beatrice Harkema, Susan J. Angeli, Claudia A. Bioengineering (Basel) Article Cervical spinal cord injury (SCI) leads to impaired trunk motor control, negatively impacting the performance of activities of daily living in the affected individuals. Improved trunk control with better sitting posture has been previously observed due to neuromuscular electrical stimulation and transcutaneous spinal stimulation, while improved postural stability has been observed with spinal cord epidural stimulation (scES). Hence, we studied how trunk-specific scES impacts sitting independence and posture. Fourteen individuals with chronic, severe cervical SCI with an implanted neurostimulator performed a 5-min tall-sit task without and with trunk-specific scES. Spine posture was assessed by placing markers on five spine levels and evaluating vertical spine inclination angles. Duration of trunk manual assistance was used to assess independence along with the number of independence changes and average independence score across those changes. With scES, the sacrum-L1 inclination and number of independence changes tended to decrease by 1.64 ± 3.16° (p = 0.07; Cohen’s d = 0.53) and 9.86 ± 16.8 (p = 0.047; Cohen’s d = 0.59), respectively. Additionally, for the participants who had poor sitting independence without scES, level of independence tended to increase by 12.91% [0%, 31.52%] (p = 0.38; Cohen’s d = 0.96) when scES was present. Hence, trunk-specific scES promoted improvements in lower spine posture and lower levels of trunk assistance. MDPI 2023-09-09 /pmc/articles/PMC10525621/ /pubmed/37760167 http://dx.doi.org/10.3390/bioengineering10091065 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Joshi, Kundan
Rejc, Enrico
Ugiliweneza, Beatrice
Harkema, Susan J.
Angeli, Claudia A.
Spinal Cord Epidural Stimulation Improves Lower Spine Sitting Posture Following Severe Cervical Spinal Cord Injury
title Spinal Cord Epidural Stimulation Improves Lower Spine Sitting Posture Following Severe Cervical Spinal Cord Injury
title_full Spinal Cord Epidural Stimulation Improves Lower Spine Sitting Posture Following Severe Cervical Spinal Cord Injury
title_fullStr Spinal Cord Epidural Stimulation Improves Lower Spine Sitting Posture Following Severe Cervical Spinal Cord Injury
title_full_unstemmed Spinal Cord Epidural Stimulation Improves Lower Spine Sitting Posture Following Severe Cervical Spinal Cord Injury
title_short Spinal Cord Epidural Stimulation Improves Lower Spine Sitting Posture Following Severe Cervical Spinal Cord Injury
title_sort spinal cord epidural stimulation improves lower spine sitting posture following severe cervical spinal cord injury
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10525621/
https://www.ncbi.nlm.nih.gov/pubmed/37760167
http://dx.doi.org/10.3390/bioengineering10091065
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