Abstract
Spinal cord injury (SCI) is one of the most debilitating injuries in the world. Complications after SCI, such as respiratory issues, bowel/bladder incontinency, pressure ulcers, autonomic dysreflexia, spasticity, pain, etc., lead to immense suffering, a remarkable reduction in life expectancy, and even premature death. Traditional rehabilitations for people with SCI are often insignificant or ineffective due to the severity and complexity of the injury. However, the recent development of noninvasive electrical neuromodulation treatments to the spinal cord have shed a ray of hope for these individuals to regain some of their lost functions, a reduction in secondary complications, and an improvement in their life quality. For this review, 250 articles were screened and about 150 were included to summarize the two most promising noninvasive spinal cord electrical stimulation methods of SCI rehabilitation treatment, namely, trans-spinal direct current stimulation (tsDCS) and trans-spinal pulsed current stimulation (tsPCS). Both treatments have demonstrated good success in not only improving the sensorimotor function, but also autonomic functions. Due to the noninvasive nature and lower costs of these treatments, in the coming years, we expect these treatments to be integrated into regular rehabilitation therapies worldwide.
Highlights
Spinal cord injury (SCI) is sudden, devastating, debilitating, and life-altering neurological damage that is correlated with severe physical, mental, social, and vocational impacts on the individual, family members, and healthcare systems [1–5]
An individual with an SCI is at risk of different types of secondary complications which leads to premature death in most of the cases [9]
More than 80% of SCI patients have reported that they had been suffering from pain and 70% reported their suffering from spasticity after injury which had hampered their ability to partake in activities of daily living [11,75,76]. trans-spinal direct current stimulation (tsDCS) is a simple and low-cost neuromodulation technique used in rehabilitation after neurological injury [16]
Summary
Spinal cord injury (SCI) is sudden, devastating, debilitating, and life-altering neurological damage that is correlated with severe physical, mental, social, and vocational impacts on the individual, family members, and healthcare systems [1–5]. An individual with an SCI is at risk of different types of secondary complications which leads to premature death in most of the cases [9]. Conventional treatment approaches aim to reduce secondary complications and improve the functions that have been retained after the injury [13]. The goal of this study is to determine and compare the efficacy of these two noninvasive trans-spinal electrical stimulations for functional rehabilitation in SCI. This narrative review discusses tsDCS and tsPCS with a brief description of their usage, mechanisms, limitations, and implementation as well as subjectively compares them with other noninvasive stimulations, FESs, for SCI rehabilitation. About 150 articles were selected based on SCI rehabilitation, which encompass motor recovery, electrical stimulation, and the mechanism, management, and treatments for SCI
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