fa9ba45a2b308551ce8323213a1c5486 pmc_10452666.pdf 9f0364c6087024894ec21041276f0e5151b14a69 pmc_10452666.pdf ab0a9b13141ca38bf62203fba54c477a66f4d97ff1410418cb4772635b134445 pmc_10452666.pdf Title: Transcutaneous Spinal Cord Stimulation Improves Respiratory Muscle Strength and Function in Subjects with Cervical Spinal Cord Injury: Original Research Subject: (1) Background: Respiratory muscle weakness is common following cervical spinal cord injury (cSCI). Transcutaneous spinal cord stimulation (tSCS) promotes the motor recovery of the upper and lower limbs. tSCS improved breathing and coughing abilities in one subject with tetraplegia. Objective: We therefore hypothesized that tSCS applied at the cervical and thoracic levels could improve respiratory function in cSCI subjects; (2) Methods: This study was a randomized controlled trial. Eleven cSCI subjects received inspiratory muscle training (IMT) alone. Eleven cSCI subjects received tSCS combined with IMT (six of these subjects underwent IMT alone first and then they were given the opportunity to receive tSCS + IMT). The subjects evaluated their sensation of breathlessness/dyspnea and hypophonia compared to pre-SCI using a numerical rating scale. The thoracic muscle strength was assessed by maximum inspiratory (MIP), expiratory pressure (MEP), and spirometric measures. All assessments were conducted at baseline and after the last session. tSCS was applied at C3-4 and Th9-10 at a frequency of 30 Hz for 30 min on 5 consecutive days; (3) Results: Following tSCS + IMT, the subjects reported a significant improvement in breathlessness/dyspnea and hypophonia (p < 0.05). There was also a significant improvement in MIP, MEP, and forced vital capacity (p < 0.05). Following IMT alone, there were no significant changes in any measurement; (4) Conclusions: Current evidence supports the potential of tSCS as an adjunctive therapy to accelerate and enhance the rehabilitation process for respiratory impairments following SCI. However, further research is needed to validate these results and establish the long-term benefits of tSCS in this population. Keywords: transcutaneous electrical spinal cord stimulation; cervical spinal cord injury; respiratory function; rehabilitation Author: Hatice Kumru, Loreto García-Alén, Aina Ros-Alsina, Sergiu Albu, Margarita Valles and Joan Vidal Creator: LaTeX with hyperref Producer: pdfTeX-1.40.21 CreationDate: Wed Aug 9 11:49:23 2023 CEST ModDate: Wed Aug 9 11:54:07 2023 CEST Custom Metadata: no Metadata Stream: no Tagged: no UserProperties: no Suspects: no Form: none JavaScript: no Pages: 13 Encrypted: no Page size: 595.276 x 841.89 pts (A4) Page rot: 0 File size: 1373358 bytes Optimized: no PDF version: 1.7 name type encoding emb sub uni object ID ------------------------------------ ----------------- ---------------- --- --- --- --------- LWJOET+VnURWPalladioL Type 1 Custom yes yes no 10 0 MYAQTB+URWPalladioL-Bold Type 1 Custom yes yes no 15 0 DNDRKU+URWPalladioL-Roma Type 1 Custom yes yes no 20 0 ERMUMX+URWPalladioL-Ital Type 1 Custom yes yes no 24 0 YSPQJI+VnURWPalladioL-Bold Type 1 Custom yes yes no 28 0 EBFBTV+TimesNewRomanPS-BoldItalicMT Type 1C WinAnsi yes yes no 46 0 VSPIKV+CMSY10 Type 1 Builtin yes yes no 71 0 SPZSYO+EURM10 Type 1 Builtin yes yes no 78 0 JAEPPG+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 97 0 JAEPPI+PalatinoLinotype TrueType WinAnsi yes yes no 100 0 JAEPPK+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 103 0 WBVKDJ+URWPalladioL-BoldItal Type 1 Custom yes yes no 110 0 JAEPPG+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 264 0 JAEPPH+PalatinoLinotype CID TrueType Identity-H yes yes yes 267 0 JAEPPI+PalatinoLinotype TrueType WinAnsi yes yes no 273 0 JAEPPK+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 276 0 JAEPPG+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 509 0 JAEPPH+PalatinoLinotype CID TrueType Identity-H yes yes yes 512 0 JAEPPI+PalatinoLinotype TrueType WinAnsi yes yes no 518 0 JAEPPK+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 521 0 JAEPPG+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 695 0 JAEPPH+PalatinoLinotype CID TrueType Identity-H yes yes yes 698 0 JAEPPI+PalatinoLinotype TrueType WinAnsi yes yes no 704 0 JAEPPK+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 707 0 Jhove (Rel. 1.28.0, 2023-05-18) Date: 2024-06-26 02:46:19 CEST RepresentationInformation: pmc_10452666.pdf ReportingModule: PDF-hul, Rel. 1.12.4 (2023-03-16) LastModified: 2024-06-20 02:37:38 CEST Size: 1373358 Format: PDF Version: 1.7 Status: Well-Formed and valid SignatureMatches: PDF-hul MIMEtype: application/pdf PDFMetadata: Objects: 938 FreeObjects: 1 IncrementalUpdates: 0 DocumentCatalog: PageLayout: SinglePage PageMode: UseNone Outlines: Item: Title: Introduction Destination: section.1 Item: Title: Materials and Methods Destination: section.2 Children: Item: Title: Subjects Destination: subsection.2.1 Item: Title: Clinical Assessment of Spinal Cord Injury Destination: subsection.2.2 Item: Title: Assessment of Respiratory Function Destination: subsection.2.3 Item: Title: Neurophysiological Assessment Destination: subsection.2.4 Item: Title: Experimental Design Destination: subsection.2.5 Item: Title: Interventions Destination: subsection.2.6 Item: Title: Transcutaneous Spinal Cord Stimulation Destination: subsection.2.7 Item: Title: Data and Statistical Analysis Destination: subsection.2.8 Item: Title: Results Destination: section.3 Children: Item: Title: Subjects Clinical and Demographic Characteristics Destination: subsection.3.1 Item: Title: Respiratory Assessment Destination: subsection.3.2 Children: Item: Title: Subjective Evaluation Destination: subsubsection.3.2.1 Item: Title: Objective Evaluation Destination: subsubsection.3.2.2 Item: Title: Discussion Destination: section.4 Item: Title: Conclusions Destination: section.5 Item: Title: References Destination: section.6 Info: Title: Transcutaneous Spinal Cord Stimulation Improves Respiratory Muscle Strength and Function in Subjects with Cervical Spinal Cord Injury: Original Research Author: Hatice Kumru, Loreto García-Alén, Aina Ros-Alsina, Sergiu Albu, Margarita Valles and Joan Vidal Subject: (1) Background: Respiratory muscle weakness is common following cervical spinal cord injury (cSCI). Transcutaneous spinal cord stimulation (tSCS) promotes the motor recovery of the upper and lower limbs. tSCS improved breathing and coughing abilities in one subject with tetraplegia. Objective: We therefore hypothesized that tSCS applied at the cervical and thoracic levels could improve respiratory function in cSCI subjects; (2) Methods: This study was a randomized controlled trial. Eleven cSCI subjects received inspiratory muscle training (IMT) alone. Eleven cSCI subjects received tSCS combined with IMT (six of these subjects underwent IMT alone first and then they were given the opportunity to receive tSCS + IMT). The subjects evaluated their sensation of breathlessness/dyspnea and hypophonia compared to pre-SCI using a numerical rating scale. The thoracic muscle strength was assessed by maximum inspiratory (MIP), expiratory pressure (MEP), and spirometric measures. All assessments were conducted at baseline and after the last session. tSCS was applied at C3-4 and Th9-10 at a frequency of 30 Hz for 30 min on 5 consecutive days; (3) Results: Following tSCS + IMT, the subjects reported a significant improvement in breathlessness/dyspnea and hypophonia (p < 0.05). There was also a significant improvement in MIP, MEP, and forced vital capacity (p < 0.05). Following IMT alone, there were no significant changes in any measurement; (4) Conclusions: Current evidence supports the potential of tSCS as an adjunctive therapy to accelerate and enhance the rehabilitation process for respiratory impairments following SCI. However, further research is needed to validate these results and establish the long-term benefits of tSCS in this population. 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