Journal of Spinal Cord Medicine最新文献

{"title":"Spinal cord injury and male infertility: Effect of the inflammasome proteins on semen quality.","authors":"Karla Pacheco de Melo, Giovana Salla Siqueira de Souza, Emad Ibrahim, Charles M Lynne, Nancy L Brackett, Ricardo Pimenta Bertolla, Mariana Camargo","doi":"10.1080/10790268.2025.2472095","DOIUrl":"https://doi.org/10.1080/10790268.2025.2472095","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate seminal plasma levels of Biglycan, Cystatin-S, β-2 microglobulin and inflammasome proteins and to investigate their role in seminal toxicity in men with spinal cord injury (SCI).</p><p><strong>Study design: </strong>cross-sectional study.</p><p><strong>Setting: </strong>Miami Project to Cure Paralysis - University of Miami / Miller School of Medicine and Federal University of Sao Paulo.</p><p><strong>Participants: </strong>Eight men with spinal cord injury and eight men without spinal cord injury (controls).</p><p><strong>Intervention: </strong>none. Outcome measures: semen analysis as per WHO 2010 guidelines; seminal plasma ELISA for IL-1β, IL-18 and caspase-1; and Western blotting for Biglycan, β-2microglobulin and Cystatin-S proteins.</p><p><strong>Results: </strong>Proteins from the inflammasome complex are elevated in men with SCI, as previously described. In addition, β-2-microgobulin, Cystatin-S and two different isoforms of Byglican are elevated in men with SCI.</p><p><strong>Conclusion: </strong>a different pathway to activate the inflammasome complex is present in men with spinal cord injury. This pathway can be a potential target for new interventions in the future.</p>","PeriodicalId":50044,"journal":{"name":"Journal of Spinal Cord Medicine","volume":" ","pages":"1-7"},"PeriodicalIF":1.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143755527","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Priming with transcutaneous spinal direct current stimulation followed by robotic exoskeleton gait training in individuals with spinal cord injury: A case series.","authors":"Marcie Kern, Catherine Velasquez-Ignacio, Taimoor Afzal, Shih-Chiao Tseng, Gerard E Francisco, Shuo-Hsiu Chang","doi":"10.1080/10790268.2025.2479955","DOIUrl":"https://doi.org/10.1080/10790268.2025.2479955","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate the safety and feasibility of repeated transcutaneous spinal direct current stimulation (tsDCS) as priming strategy during exoskeleton-assisted locomotor training in individuals with SCI and evaluate potential neurophysiologic and functional gait changes.</p><p><strong>Study design: </strong>Case series experimental design.</p><p><strong>Setting: </strong>Research laboratory at a post-acute rehabilitation hospital.</p><p><strong>Participants: </strong>Four participants with chronic incomplete SCI.</p><p><strong>Interventions: </strong>Four participants with chronic incomplete SCI received three weeks of training consisting of two types of interventions after baseline (A): 20-minute tsDCS (anode or cathode) applied over the spinous processes of T10 followed by 20-minute exoskeleton-assisted locomotor training (B, B1, B2) and 20-minute exoskeleton-assisted locomotor training (C, C1, C2). Each phase consisted of five consecutive intervention sessions. Two participants underwent sequence A-B1-C-B2 and two sequence A-C1-B-C2. Soleus Hoffmann Reflex (H-reflex) and gait speed (10-m walk test) were assessed on the first and fifth days of training for each training type.</p><p><strong>Outcome measures: </strong>Adverse skin reactions or other events, H-reflex (Hmax/Mmax ratio), and gait speed (10-m walk test).</p><p><strong>Results: </strong>No adverse events occurred. All participants tolerated tsDCS with no negative effects on their skin. Participants demonstrated varied responses in their H/M ratios after tsDCS followed by exoskeleton-assisted locomotor training as well as after exoskeleton-assisted locomotor training. No consistent pattern can be identified in this case series. Three participants showed an increase in gait speed after tsDCS combined with exoskeleton-assisted locomotor training.</p><p><strong>Conclusions: </strong>Noninvasive repeated spinal stimulation can safely be used in individuals with incomplete SCI. Further large-scale research is necessary to determine the efficacy of tsDCS for priming the spinal cord in facilitating recovery of gait in individuals with SCI.</p>","PeriodicalId":50044,"journal":{"name":"Journal of Spinal Cord Medicine","volume":" ","pages":"1-8"},"PeriodicalIF":1.8,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143755513","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Feasibility and impact of a Water Specific Therapy program in individuals with subacute incomplete spinal cord injury: A non-randomized controlled trial.","authors":"Raquel Menchero, Inés Martínez-Galán, Mónica Alcobendas-Maestro, Helena Romay-Barrero, Araceli Fernández-Maestra, Javier Güeita-Rodríguez","doi":"10.1080/10790268.2025.2472098","DOIUrl":"10.1080/10790268.2025.2472098","url":null,"abstract":"<p><strong>Objectives: </strong>To study the feasibility of a Water Specific Therapy (WST) program in subjects with incomplete spinal cord injury (iSCI) and <6 months since injury. Secondary: To analyze the impact on balance and gait.</p><p><strong>Design: </strong>Pilot study with single-subject repeated-measures.</p><p><strong>Setting: </strong>Rehabilitation center.</p><p><strong>Participants: </strong>Twelve individuals with subacute (≤6 months) motor iSCI (T1-L5).</p><p><strong>Intervention: </strong>WST program comprising 18 sessions, 40-minute-long, including warm up, balance training, aerobic exercises, and cool-down, monitored via the Rating of Perceived Effort scale.</p><p><strong>Outcome measures: </strong>Feasibility was assessed through adherence to treatment, safety and attrition rate. Self-perceived improvement (balance, gait, and lower limb strength) and difficulties encountered by physical therapists were also evaluated. Secondary outcomes included the Berg Balance Scale (BBS), Timed Up and Go test, 10-meter walk test (10-MWT), 6-minute walk test (6-MWT), and Walking Index for Spinal Cord Injury II (WISCI-II).</p><p><strong>Results: </strong>Adherence to treatment reached 83%, with only two unrelated dropouts. No adverse effects were recorded, deeming the treatment safe. Self-perceived improvements were noted by 88.9% of subjects, with moderate and substantial gains in the three reported variables. Physiotherapists referred difficulties in reaching intensity targets, prompting program adaptations. Statistical significance (P < 0.05) was reached in BBS, 10-MWT, 6-MWT and WISCI-II outcomes.</p><p><strong>Conclusion: </strong>WST is a feasible, safe, well-accepted method for treating subacute iSCI, potentially enhancing gait and balance in these subjects. Individualized program adaptations may be required. Controlled studies are warranted to determine it is effectiveness.<b>Trial registration:</b> ClinicalTrials.gov identifier: NCT03962218..</p>","PeriodicalId":50044,"journal":{"name":"Journal of Spinal Cord Medicine","volume":" ","pages":"1-9"},"PeriodicalIF":1.8,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143755510","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Occupational balance and caregiver burden among caregivers of individuals with spinal cord injuries.","authors":"Asma Hemmati Qaracheh, Mahnaz Hejazi-Shirmard, Alireza Akbarzadeh Baghban, Mehdi Rezaee","doi":"10.1080/10790268.2025.2472097","DOIUrl":"https://doi.org/10.1080/10790268.2025.2472097","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate the occupational balance, caregiver burden, and factors affecting them in caregivers of individuals with spinal cord injuries in Iran.</p><p><strong>Design: </strong>A cross-sectional study with multiple linear regression analyses to specify factors related to occupational balance and caregiver burden.</p><p><strong>Settings: </strong>Community-dwelling individuals with spinal cord injury (SCI).</p><p><strong>Participants: </strong>A convenience sample of 84 individuals with SCI.</p><p><strong>Interventions: </strong>Not applicable.</p><p><strong>Measures: </strong>The Occupational Balance Questionnaire-11, Caregiver Burden Scale (CBS), and Hospital Anxiety and Depression Scale (HADS) were used to assess the occupational balance, caregiver burden, and stress/anxiety levels of the caregivers, respectively. Functional independence, anxiety/depression levels, and the participants' ability for self-management were evaluated using the Barthel index, HADS, Partners In Health (PIH), and Patient Activation Measure (PAM), respectively.</p><p><strong>Results: </strong>There was a positive and significant correlation between the self-management skills of the participants and their independence in daily activities with their caregivers' occupational balance. A negative and significant correlation was found between the individuals' self-management skills and their independence in daily activities with caregiver burden. In addition, a significant correlation existed between the anxiety and depression of the participants and their caregivers with occupational balance and caregiver burden. Finally, there was a negative and significant correlation between occupational balance and caregiver burden (P<i> </i>≤ 0.05).</p><p><strong>Conclusion: </strong>This study demonstrated that factors such as participants' self-management skills, their independence in daily activities, and the level of anxiety and depression in participants and caregivers affect the occupational balance and burden experienced by caregivers of individuals with SCIs.</p>","PeriodicalId":50044,"journal":{"name":"Journal of Spinal Cord Medicine","volume":" ","pages":"1-6"},"PeriodicalIF":1.8,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143755512","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical validation of a rule-based decision tree algorithm for classifying hip movements in people with spinal cord injury.","authors":"Susanne Lillelund Sørensen, Matthijs Lipperts, Jørgen Feldbæk Nielsen, Erhard Næss-Schmidt","doi":"10.1080/10790268.2025.2472096","DOIUrl":"https://doi.org/10.1080/10790268.2025.2472096","url":null,"abstract":"<p><strong>Objective: </strong>To assess a rule-based decision tree algorithm's performance for classifying and counting specific hip flexion repetitions in able-bodied people and to validate the algorithm's efficacy for people with spinal cord injury (SCI). Alternative placement of the accelerometer was tested.</p><p><strong>Study design: </strong>A validation study.</p><p><strong>Setting: </strong>Specialized SCI center in Denmark.</p><p><strong>Methods: </strong>Ten able-bodied people and 10 people with SCI were recruited. All participants completed a 15-minute predefined protocol with the following movements: hip flexion in supine 90°, 45° and 20°, hip abduction, pelvic lift, transfer from supine to sitting, sit-to-stand, transfer to a wheelchair, pushed in a wheelchair, Motomed cycling, walking and steps in Nustep fitness trainer. All wore accelerometers on the thigh and a chest-mounted GoPro camera to establish ground truth.</p><p><strong>Results: </strong>Confusion matrixes showed that able-bodied people's activities and specific hip movements can be classified and the number of repetitions counted with 0.86 accuracy. The algorithm's performance did not change substantially depending on the position of the accelerometer. For people with movement deficits caused by SCI, the accuracy lowered to 0.66 but could be improved to 0.79 for classifying and counting this population's activities/movements overall.</p><p><strong>Conclusion: </strong>The algorithm tested could classify specific hip movements and other activities in the SCI population. This method using a single accelerometer may be applied in clinical trials for people with SCI to objectively assess the change in the number of repetitions over time of hip flexion movements, walking and sit-to-stand activities and to some extent hip abduction and pelvic lift.<b>Trial registration:</b> ClinicalTrials.gov NCT05558254. Registered 28th September 2022.</p>","PeriodicalId":50044,"journal":{"name":"Journal of Spinal Cord Medicine","volume":" ","pages":"1-10"},"PeriodicalIF":1.8,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143755509","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"'She didn't know what to do with me': The experience of seeking community mental health support after spinal cord injury.","authors":"Katherine A Finlay, Phoebe Brook-Rowland, Margaret Tilley","doi":"10.1080/10790268.2025.2479957","DOIUrl":"https://doi.org/10.1080/10790268.2025.2479957","url":null,"abstract":"<p><strong>Context/objectives: </strong>Adults with spinal cord injury in the UK do not currently have specialized access to SCI-informed community-based mental health support, despite their elevated risk of mental health decline. The lack of SCI-informed therapeutic support may increase the likelihood of mental health treatment failure. This study sought to qualitatively explore the experience of accessing, or attempting to access, generic (non-SCI-informed) mental health support when living with a spinal cord injury.</p><p><strong>Design: </strong>Qualitative, exploratory study using thematic analysis.</p><p><strong>Setting: </strong>Community-based sample in the UK.</p><p><strong>Participants: </strong>Twenty people with spinal cord injury (10 female, 10 male) were recruited from a UK-based, SCI-specific support charity.</p><p><strong>Interventions: </strong>Semi-structured interviews (mean length = 83 min, SD = 13.5 min).</p><p><strong>Outcome measures: </strong>9-item semi-structured interview schedule, addressing mental health service use.</p><p><strong>Results: </strong>Three themes were identified: (1) Therapeutic timeliness; (2) A disconnect with standard services; and (3) Successful systems for support. The inpatient-to-outpatient transition represents a critical time window during which mental health is vulnerable to decline, requiring responsive access to mental health services throughout the lifespan. The lack of tailored, SCI-informed mental health services inhibits therapeutic engagement and limits perceived treatment outcomes.</p><p><strong>Conclusions: </strong>Without SCI-informed care, generic mental health service referrals risk early termination of support and treatment disengagement. Mental health treatment withdrawal is initiated by both patients and their allocated healthcare professionals. This study demonstrates an evident need to develop programs for people with SCI to train as (peer) mental health practitioners, and to develop SCI-specific training modules for mental health care practitioners.</p>","PeriodicalId":50044,"journal":{"name":"Journal of Spinal Cord Medicine","volume":" ","pages":"1-9"},"PeriodicalIF":1.8,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143755514","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Benefits and barriers to return to education and relationship to quality of life for people living with spinal cord injury: Results of a mixed methods study.","authors":"Shelly Hsieh, Adria De Simone, Trevor Dyson-Hudson, John O'Neill, Amanda Botticello, Ada Chen, Steven Kirshblum","doi":"10.1080/10790268.2023.2294520","DOIUrl":"10.1080/10790268.2023.2294520","url":null,"abstract":"<p><strong>Context: </strong>There is limited research on return to education (RTE) after spinal cord injury (SCI). As a result, few programs exist to help people achieve this goal.</p><p><strong>Objective: </strong>The primary objective was to investigate the barriers and facilitators to RTE, and the relationship between RTE and quality of life (QOL). The secondary objective was to examine the role of a Vocational Resource Facilitation (VRF) program on RTE.</p><p><strong>Methods: </strong>A mixed methods approach with a semi-structured interview and online survey was used. Participants included 15 people with SCI with RTE goals who received VRF services at an acute inpatient rehabilitation hospital. Qualitative responses on the barriers, facilitators and perceived benefits of RTE were analyzed using a grounded theory strategy.</p><p><strong>Results: </strong>Barriers to RTE included physical and mental health, transportation, time, environmental barriers, finances, lack of knowledge about available resources, and discrimination. Facilitators to RTE included the VRF program, social support, financial support, virtual learning, organizational support, and policy constructs. People who RTE after SCI reported better QOL, less depressed mood than those who did not, and were more likely to have returned to work.</p><p><strong>Conclusions: </strong>This study highlighted common barriers and facilitators to RTE, and potential areas of intervention. VRF is a potentially efficacious early intervention vocational rehabilitation approach that improves participation in education and employment for people with SCI. People who received VRF and achieved RTE may have better QOL outcomes and improved employability.</p>","PeriodicalId":50044,"journal":{"name":"Journal of Spinal Cord Medicine","volume":" ","pages":"327-337"},"PeriodicalIF":1.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11864026/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139492527","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Severe traumatic dislocation of the lower cervical spine with mild neurological symptoms: Case reports and literature review.","authors":"Qian Yang, Ze-Chuan Yang, Chao-Xu Liu, Heng Zeng","doi":"10.1080/10790268.2024.2374131","DOIUrl":"10.1080/10790268.2024.2374131","url":null,"abstract":"<p><strong>Context: </strong>Severe traumatic fractures and dislocations of the lower cervical spine are usually accompanied by irreversible spinal cord injuries. Such patients rarely have mild or no neurological symptoms.</p><p><strong>Findings: </strong>We report three cases of severe lower cervical dislocation without spinal cord injury and discuss the mechanisms underlying this type of injury. All three patients had severe lower cervical dislocation, but their neurological symptoms were mild. In all cases, the fractures occurred at the bilateral junctions of the lamina and pedicle, resulting in severe cervical spondylolisthesis, whereas the posterior structure remained in place, thereby increasing the cross-sectional area of the spinal canal. After preoperative skull traction for a few days, the patients underwent anterior or combined anterior and posterior cervical surgeries. All surgeries were successfully completed and the patient's symptoms disappeared at the last follow-up.</p><p><strong>Conclusion: </strong>Severe traumatic dislocation of the lower cervical spine with an intact neurological status is rare in clinical practice. Pathological canal enlargement preserves neurological function, and the most commonly injured segment is C7. Preoperative traction for closed reduction remains controversial. We suggest that if no obvious anterior compression is observed, closed reduction should be pursued. Anterior or combined anterior and posterior cervical surgeries can provide rigid fixation with satisfactory results.</p>","PeriodicalId":50044,"journal":{"name":"Journal of Spinal Cord Medicine","volume":" ","pages":"357-363"},"PeriodicalIF":1.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11864024/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141602054","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dose escalation in intrathecal baclofen therapy based on disease etiology: Can an <i>a priori</i> target dose be established? A ten-year follow-up study.","authors":"Muhammet Enes Gündüz, Finn Haak, Veerle Visser-Vandewalle, Georgios Matis","doi":"10.1080/10790268.2023.2266614","DOIUrl":"10.1080/10790268.2023.2266614","url":null,"abstract":"<p><strong>Context: </strong>Intrathecal baclofen (ITB) therapy is administered for severe, persistent spasticity that cannot be addressed by oral medication or other treatments.</p><p><strong>Objective: </strong>We aimed to evaluate the target dose of ITB for severe, persistent spasticity based on disease etiology.</p><p><strong>Methods: </strong>Data at baseline (discharge), 1, and 10 years from 102 patients who received ITB therapy between 1985 and 2011 were retrospectively collected. Patients were divided based on disease etiology (cerebral, spinal, or multiple sclerosis [MS]) to evaluate differences in dose requirements. A comprehensive literature review of the dose trends in ITB therapy was conducted.</p><p><strong>Results: </strong>Patients with cerebral spasticity (<i>n</i> = 62) required the highest dose after discharge (102.66 ± 30.9 µg), 1 (402.29 ± 300.2 µg), and 10 years (578.74 ± 421.2 µg). Patients with spinal spasticity (<i>n</i> = 19) required an average of 82.89 ± 30.7 µg baclofen at discharge, 296.3 ± 224.6 µg after 1 year, and 522.63 ± 425.97 µg after 10 years. Patients with MS-related spasticity (<i>n</i> = 21) had a dose of 82.73 ± 39.3 µg baclofen at discharge, 226.95 ± 193.3 µg after 1 year, and 320.6 ± 261.4 µg after 10 years. The differences among the categories were significant after 1 and 10 years of therapy.</p><p><strong>Conclusions: </strong>The largest dose escalation occurs within the first year of ITB therapy. Our work provides a guideline for the initial dose setting during the inpatient stay after implantation and potentially expected dosage over the years thereafter, although this must always be adjusted individually.</p>","PeriodicalId":50044,"journal":{"name":"Journal of Spinal Cord Medicine","volume":" ","pages":"283-289"},"PeriodicalIF":1.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11864033/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138048370","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Motor priming to enhance the effect of physical therapy in people with spinal cord injury.","authors":"Radha Kumari, Aleksandra Dybus, Mariel Purcell, Aleksandra Vučković","doi":"10.1080/10790268.2024.2317011","DOIUrl":"10.1080/10790268.2024.2317011","url":null,"abstract":"<p><strong>Context: </strong>Brain-Computer Interface (BCI) is an emerging neurorehabilitation therapy for people with spinal cord injury (SCI).</p><p><strong>Objective: </strong>The study aimed to test whether priming the sensorimotor system using BCI-controlled functional electrical stimulation (FES) before physical practice is more beneficial than physical practice alone.</p><p><strong>Methods: </strong>Ten people with subacute SCI participated in a randomized control trial where the experimental (<i>N</i> = 5) group underwent BCI-FES priming (∼15 min) before physical practice (30 min), while the control (<i>N</i> = 5) group performed physical practice (40 min) of the dominant hand. The primary outcome measures were BCI accuracy, adherence, and perceived workload. The secondary outcome measures were manual muscle test, grip strength, the range of motion, and Electroencephalography (EEG) measured brain activity.</p><p><strong>Results: </strong>The average BCI accuracy was 85%. The experimental group found BCI-FES priming mentally demanding but not frustrating. Two participants in the experimental group did not complete all sessions due to early discharge. There were no significant differences in physical outcomes between the groups. The ratio between eyes closed to eyes opened EEG activity increased more in the experimental group (theta P_θ= 0.008, low beta P_lβ= 0.009, and high beta P_hβ= 1.48e-04) indicating better neurological outcomes. There were no measurable immediate effects of BCI-FES priming.</p><p><strong>Conclusion: </strong>Priming the brain before physical therapy is feasible but may require more than 15 min. This warrants further investigation with an increased sample size.</p>","PeriodicalId":50044,"journal":{"name":"Journal of Spinal Cord Medicine","volume":" ","pages":"312-326"},"PeriodicalIF":1.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11864022/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139933863","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}