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Updated: Aug 26, 2025
Author Spotlight: Repetitive Transcranial Magnetic Stimulation Combined with Movement Observation in Cerebral Palsy
Published on: August 9, 2024
A pilot study combining noninvasive spinal neuromodulation and activity-based neurorehabilitation therapy in children
Susan Hastings1, Hui Zhong2, Rochel Feinstein3
1Susan Hastings Pediatric Physical Therapy, San Jose, CA, 95128, USA.
Insights
This pilot study found that combining spinal neuromodulation with activity-based neurorehabilitation therapy significantly improved motor function in children with cerebral palsy (CP). The intervention showed positive results in Gross Motor Function Measure scores.
Area of Science:
- Neurology
- Pediatrics
- Rehabilitation Medicine
Background:
- Cerebral Palsy (CP) is a leading pediatric motor disability impacting sensorimotor function and participation.
- Current rehabilitation strategies aim to improve motor function in children with CP.
- Understanding novel therapeutic approaches is crucial for enhancing outcomes.
Purpose of the Study:
- To evaluate the efficacy of combining non-invasive spinal neuromodulation with activity-based neurorehabilitation therapy (ABNT) in children with CP.
- To assess improvements in voluntary sensory-motor function using the Gross Motor Function Measure (GMFM-88).
- To determine the safety and feasibility of this combined intervention.
Main Methods:
- A single-arm, unblinded pilot study involving 16 children with CP (Gross Motor Function Classification Scale I-V).
- Participants received a combined intervention of non-invasive spinal neuromodulation and ABNT twice weekly for 8 weeks.
- The primary outcome measure was the change in GMFM-88 scores.
Main Results:
- The combined intervention resulted in clinically and statistically significant improvements in GMFM-88 scores across all participants.
- The study met its primary endpoint, demonstrating the intervention's effectiveness.
- No serious adverse events were reported, indicating a favorable safety profile.
Conclusions:
- Combining non-invasive spinal neuromodulation with ABNT is a promising therapeutic approach for improving motor function in children with CP.
- Further research is warranted to explore the specific contributions of ABNT alone and to optimize treatment protocols.
- This intervention offers a potential avenue for enhancing the quality of life for children affected by cerebral palsy.
Abstract:
Cerebral Palsy (CP) is the most common pediatric motor disability with multiple symptoms and etiologies. CP is exhibited through sensorimotor delays, impaired posture resulting in limited activities and participation. Our recently concluded, single arm, unblinded, pilot study (NCT04882592) explored whether an intervention combining non-invasive spinal neuromodulation during an activity-based neurorehabilitation therapy (ABNT) can improve voluntary sensory-motor function captured via the Gross Motor Function Measure (GMFM-88) scores (primary outcome). Sixteen children diagnosed with CP with Gross Motor Function Classification Scale levels I-V were recruited and received the same intervention (2x/week for 8 weeks) to correct the dysfunctional connectivity between supraspinal and spinal networks using the normally developed proprioception. We demonstrate that the intervention was associated with clinically and statistically significant improvement in GMFM-88 scores in all children, thus meeting the prespecified primary endpoint. However, the improvement with ABNT alone needs further exploration. No serious adverse events were observed (safety endpoint).
