8195ae366513a4117736cc6a53bc72e5 pmc_11050444.pdf a15f9655c08f4c84c5ce7a9c0f8d35e10e7e2e01 pmc_11050444.pdf 76b94c49747960065f631884ed2b3034a460327494c7a81daef69e763f4f26cb pmc_11050444.pdf Title: Improvement in Motor and Walking Capacity during Multisegmental Transcutaneous Spinal Stimulation in Individuals with Incomplete Spinal Cord Injury Subject: Transcutaneous multisegmental spinal cord stimulation (tSCS) has shown superior efficacy in modulating spinal locomotor circuits compared to single-site stimulation in individuals with spinal cord injury (SCI). Building on these findings, we hypothesized that administering a single session of tSCS at multiple spinal segments may yield greater enhancements in muscle strength and gait function during stimulation compared to tSCS at only one or two segments. In our study, tSCS was applied at single segments (C5, L1, and Coc1), two segments (C5-L1, C5-Coc1, and L1-Coc1), or multisegments (C5-L1-Coc1) in a randomized order. We evaluated the 6-m walking test (6MWT) and maximum voluntary contraction (MVC) and assessed the Hmax/Mmax ratio during stimulation in ten individuals with incomplete motor SCI. Our findings indicate that multisegmental tSCS improved walking time and reduced spinal cord excitability, as measured by the Hmax/Mmax ratio, similar to some single or two-site tSCS interventions. However, only multisegmental tSCS resulted in increased tibialis anterior (TA) muscle strength. These results suggest that multisegmental tSCS holds promise for enhancing walking capacity, increasing muscle strength, and altering spinal cord excitability in individuals with incomplete SCI. Keywords: transcutaneous spinal cord stimulation; multiple segmental stimulation; incomplete spinal cord injury; gait; muscle strength; spinal cord excitability Author: Hatice Kumru, Aina Ros-Alsina, Loreto García Alén, Joan Vidal, Yury Gerasimenko, Agusti Hernandez and Mark Wrigth Creator: LaTeX with hyperref Producer: pdfTeX-1.40.25 CreationDate: Mon Apr 22 09:26:11 2024 CEST ModDate: Mon Apr 22 09:51:45 2024 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: 1750619 bytes Optimized: no PDF version: 1.7 name type encoding emb sub uni object ID ------------------------------------ ----------------- ---------------- --- --- --- --------- YSPQJI+VnURWPalladioL-Bold Type 1 Custom yes yes yes 10 0 TFZZCI+URWPalladioL-Bold Type 1 Custom yes yes yes 16 0 QMCEKB+URWPalladioL-Roma Type 1 Custom yes yes yes 22 0 ESKMKJ+URWPalladioL-Ital Type 1 Custom yes yes yes 27 0 CLFMAD+VnURWPalladioL Type 1 Custom yes yes yes 32 0 IRWHZX+TimesNewRomanPSMT Type 1C WinAnsi yes yes no 48 0 CKUPDE+TimesNewRomanPS-BoldItalicMT Type 1C WinAnsi yes yes no 51 0 TNBSFT+CMSY10 Type 1 Builtin yes yes yes 68 0 JJMFNK+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 76 0 JJMFNM+PalatinoLinotype TrueType WinAnsi yes yes no 79 0 JJMFNO+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 82 0 JJMGEM+PalatinoLinotype TrueType MacRoman yes yes no 85 0 JJMHJG+PalatinoLinotype,BoldItalic TrueType WinAnsi yes yes no 88 0 JJMFNK+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 105 0 JJMFNM+PalatinoLinotype TrueType WinAnsi yes yes no 108 0 JJMFNO+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 111 0 JJMFNK+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 120 0 JJMFNL+PalatinoLinotype CID TrueType Identity-H yes yes yes 123 0 JJMFNM+PalatinoLinotype TrueType WinAnsi yes yes no 129 0 JJMFNO+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 132 0 JJMGEM+PalatinoLinotype TrueType MacRoman yes yes no 135 0 JJMFNK+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 148 0 JJMFNL+PalatinoLinotype CID TrueType Identity-H yes yes yes 151 0 JJMFNM+PalatinoLinotype TrueType WinAnsi yes yes no 157 0 JJMFNO+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 160 0 JJMGEM+PalatinoLinotype TrueType MacRoman yes yes no 163 0 JJMFNK+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 170 0 JJMFNL+PalatinoLinotype CID TrueType Identity-H yes yes yes 173 0 JJMFNM+PalatinoLinotype TrueType WinAnsi yes yes no 179 0 JJMFNO+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 182 0 JJMGEM+PalatinoLinotype TrueType MacRoman yes yes no 185 0 Jhove (Rel. 1.28.0, 2023-05-18) Date: 2024-06-21 02:47:58 CEST RepresentationInformation: pmc_11050444.pdf ReportingModule: PDF-hul, Rel. 1.12.4 (2023-03-16) LastModified: 2024-06-20 02:36:58 CEST Size: 1750619 Format: PDF Version: 1.7 Status: Well-Formed and valid SignatureMatches: PDF-hul MIMEtype: application/pdf PDFMetadata: Objects: 357 FreeObjects: 1 IncrementalUpdates: 0 DocumentCatalog: PageLayout: SinglePage PageMode: UseNone Outlines: Item: Title: Introduction Destination: section.1 Item: Title: Results Destination: section.2 Children: Item: Title: 6 Meter Walking Test (6MWT) Destination: subsection.2.1 Item: Title: Maximum Voluntary Contraction of the Quadriceps Muscle (MVC-QM) Destination: subsection.2.2 Item: Title: Maximum Voluntary Contraction of the TA Muscle (MVC-TA) Destination: subsection.2.3 Item: Title: Hmax/Mmax Destination: subsection.2.4 Item: Title: Discussion Destination: section.3 Item: Title: Conclusion Destination: section.4 Item: Title: Methods Destination: section.5 Children: Item: Title: Clinical Assessments Destination: subsection.5.1 Item: Title: Experimental Setup Destination: subsection.5.2 Item: Title: Study Conditions Destination: subsection.5.3 Item: Title: Stimulation Destination: subsection.5.4 Item: Title: Data Analysis and Statistics Destination: section.6 Item: Title: References Destination: section.7 Info: Title: Improvement in Motor and Walking Capacity during Multisegmental Transcutaneous Spinal Stimulation in Individuals with Incomplete Spinal Cord Injury Author: Hatice Kumru, Aina Ros-Alsina, Loreto García Alén, Joan Vidal, Yury Gerasimenko, Agusti Hernandez and Mark Wrigth Subject: Transcutaneous multisegmental spinal cord stimulation (tSCS) has shown superior efficacy in modulating spinal locomotor circuits compared to single-site stimulation in individuals with spinal cord injury (SCI). Building on these findings, we hypothesized that administering a single session of tSCS at multiple spinal segments may yield greater enhancements in muscle strength and gait function during stimulation compared to tSCS at only one or two segments. In our study, tSCS was applied at single segments (C5, L1, and Coc1), two segments (C5-L1, C5-Coc1, and L1-Coc1), or multisegments (C5-L1-Coc1) in a randomized order. We evaluated the 6-m walking test (6MWT) and maximum voluntary contraction (MVC) and assessed the Hmax/Mmax ratio during stimulation in ten individuals with incomplete motor SCI. Our findings indicate that multisegmental tSCS improved walking time and reduced spinal cord excitability, as measured by the Hmax/Mmax ratio, similar to some single or two-site tSCS interventions. However, only multisegmental tSCS resulted in increased tibialis anterior (TA) muscle strength. These results suggest that multisegmental tSCS holds promise for enhancing walking capacity, increasing muscle strength, and altering spinal cord excitability in individuals with incomplete SCI. 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