학술논문

Minimal handgrip force is needed for transcutaneous electrical stimulation to improve hand functions of patients with severe spinal cord injury
Document Type
article
Source
Scientific Reports. 12(1)
Subject
Allied Health and Rehabilitation Science
Biomedical and Clinical Sciences
Clinical Sciences
Health Sciences
Spinal Cord Injury
Neurodegenerative
Physical Injury - Accidents and Adverse Effects
Rehabilitation
Traumatic Head and Spine Injury
Clinical Research
Neurosciences
Neurological
Buspirone
Cross-Over Studies
Hand Strength
Humans
Spinal Cord
Spinal Cord Injuries
Spinal Cord Stimulation
Transcutaneous Electric Nerve Stimulation
Language
Abstract
Spinal cord stimulation enhanced restoration of motor function following spinal cord injury (SCI) in unblinded studies. To determine whether training combined with transcutaneous electrical spinal cord stimulation (tSCS), with or without systemic serotonergic treatment with buspirone (busp), could improve hand function in individuals with severe hand paralysis following SCI, we assessed ten subjects in a double-blind, sham-controlled, crossover study. All treatments-busp, tSCS, and the busp plus tSCS-reduced muscle tone and spasm frequency. Buspirone did not have any discernible impact on grip force or manual dexterity when administered alone or in combination with tSCS. In contrast, grip force, sinusoidal force generation and grip-release rate improved significantly after 6 weeks of tSCS in 5 out of 10 subjects who had residual grip force within the range of 0.1-1.5 N at the baseline evaluation. Improved hand function was sustained in subjects with residual grip force 2-5 months after the tSCS and buspirone treatment. We conclude that tSCS combined with training improves hand strength and manual dexterity in subjects with SCI who have residual grip strength greater than 0.1 N. Buspirone did not significantly improve the hand function nor add to the effect of stimulation.