Чрескожная электрическая стимуляция спинного мозга в двигательной реабилитации пациентов с травмой спинного мозга

Abstract

It was previously demonstrated that the transcutaneous electrical spinal cord stimulation (TESCS) can be used to increase muscle strength, to initiate and improve voluntary movements in patients with chronic spinal cord injury (SCI). The paper focuses on the use of TESCS in motor rehabilitation of SCI patients. It presents the results of a single TESCS treatment in a representative sample 60 patients with SCI after a spinal injury at the upper cervical, cervicothoracic, thoracic, and lumbosacral levels. All patients had severe movement disorders, and many had SCI complications. The stimulation above the cervical and lumbar thickening of the spinal cord by single and rhythmic impulses resulted in motor reactions in 59 patients (movements of toes and / or fingers, contraction of leg muscles, etc.). Changes in spasticity, an increase in cutaneous blood flow, chronic pain decrease, and sensitivity improvement were also observed. 50 out of 60 patients underwent a course of motor rehabilitation with TESCS. A rehabilitation goal was defined for each patient (sitting without support, increased handgrip strength, moving from a wheelchair to a couch, etc.). Motor function improvements were recorded for all the patients, while 35 patients achieved the rehabilitation goal. The paper presents case reports of patients with different severity of movement disorders. The study includes records of the kinematics of movements demonstrating normalization of the sitting and standing posture after the course. As a result, the study has shown that the rehabilitation with TESCS facilitates the restoration of motor skills. The study has also revealed significant changes in visceral functions, which requires additional research.