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Updated: Jul 6, 2025
08:07
Paradigms of Lower Extremity Electrical Stimulation Training After Spinal Cord Injury
Published on: February 1, 2018
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Combining transcutaneous spinal stimulation and functional electrical stimulation increases force generated by lower
Alexander G Steele1, Albert H Vette2,3, Catherine Martin1
1Department of Neurosurgery, Center for Neuroregeneration, Houston Methodist Research Institute, 6550 Fannin Street, Houston, Texas, 77030, United States of America.
Biorxiv : the Preprint Server for Biology
|January 8, 2024
Summary
Optimizing the timing between transcutaneous spinal stimulation (TSS) and functional electrical stimulation (FES) can significantly enhance muscle force generation. A delay of 15-30 ms between TSS and FES improved knee and ankle joint force in participants.
Area of Science:
- Neuroscience
- Biomedical Engineering
- Rehabilitation Science
Background:
- Transcutaneous spinal stimulation (TSS) shows potential for improving motor function in neurological conditions by activating lower limb and trunk muscles.
- Individual responses to TSS vary, often insufficient for self-supported standing.
- Functional electrical stimulation (FES) can augment muscle activation but requires precise timing with TSS.
Approach:
- Ten neurologically intact participants were tested under three conditions: TSS only, FES only, and combined TSS + FES.
- TSS involved four electrodes (T10-T11 to L1-L2); FES targeted knee extensors and plantarflexors.
- Stimuli (3 pulses, 0.5 ms, 15 Hz) were delivered, with TSS-FES timing adjusted in 16.5 ms increments.
Key Points:
- Combining TSS and FES, with TSS preceding FES, resulted in greater force production.
- Specific timing intervals modulated muscle activation amplitudes, demonstrating facilitating and inhibitory effects.
- A delay of 15–30 ms between TSS and FES yielded higher mean force generation in knee (112.0%) and ankle (103.1%) joints.
Conclusions:
- Optimal timing between TSS and FES is crucial for maximizing muscle force output.
- The findings provide a basis for refining combined neuromodulation strategies for enhanced motor control.
- This research contributes to developing more effective interventions for individuals with impaired motor function.
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