Student Competition (Knowledge Generation) ID 1985170

Functional electrical stimulation (FES)-assisted arm and leg (A&L) cycling is an effective rehabilitative intervention for improving walking following an incomplete spinal cord injury (SCI). The goal of this study was to assess the potential benefits of combining transcutaneous spinal cord stimulation (tSCS) with A&L cycling to potentially improve functional mobility and activities of daily living for persons living with motor complete SCI. This is a case study of a participant with AIS B SCI. The participant has been undergoing FES-assisted A&L cycling training combined with cervical and lumbar tSCS (1 hr/day, 5 days/week) for 37 weeks. Assessments were performed pre-training and every 6 weeks thereafter and include the International Standards for Neurological Classification of SCI (ISNCSCI), time able to stand while assisted, and training load of each exercise session. Although there were no changes in the ISNCSCI scores, the duration of assisted standing increased from 10s per-training to 33.5s at 36 weeks post-training. Interestingly, the addition of tSCS enhanced standing duration to 38.5s. Moreover, the total power output exerted by the participant consistently increased over time. This study provides, for the first time, evidence that FES-assisted A&L cycling paired with non-invasive tSCS can be safely completed after severe SCI and leads to improvements in training load and assisted standing. Additional assessments will be incorporated to further identify improvements in function and quality of life. Future work will assess the benefits of using epidural spinal cord stimulation combined with A&L cycling after motor complete SCI.