Student Competition (Knowledge Generation) ID 1985159

Abstract

Background When we walk, we swing our arms in rhythm with our legs due to neural connections in the spinal cord. Currently, rehabilitation protocols primarily focus on leg training to improve walking function. However, past research has highlighted the importance of engaging the arms in rehabilitative interventions through arm and leg cycling following an incomplete spinal cord injury (iSCI). Objectives The objective of this study is to determine if the application of non-invasive transcutaneous spinal cord stimulation (tSCS) paired with arm and leg cycling can improve walking for individuals with an iSCI. It is hypothesized that the addition of tSCS will activate previously inaccessible neural circuits within the spinal cord to produce significant improvements in walking capacity. Methods Individuals with an iSCI underwent arm and leg cycling training that was assisted by functional electrical stimulation applied to the main extensor muscles of the leg. tSCS was applied over the cervical and lumbar regions of the spinal cord. Training consisted of 1 hour of cycling, 5 days/week for 12 weeks. A series of clinical and biomechanical assessments were performed to assess changes in functional mobility. Results Preliminary results in three participants showed increases in maximal walking speed on the 10-metre walk test, increases in walking endurance on the 6-minute walk test, and improved balance on the Berg Balance Scale. Preliminary biomechanical results suggested that the addition of tSCS may reduce left-right asymmetry. Conclusions Arm and leg cycling paired with tSCS offers tremendous potential for improvements in walking function following an iSCI.