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Patient-reported effects of transcutaneous spinal cord stimulation on spasticity in patients with spinal cord injury
Vivien Jørgensen1, Anne Birgitte Flaaten2, Páll E Ingvarsson3
1Department of Research, Sunnaas Rehabilitation Hospital, Bjørnemyr, Norway.
Objectives:
Assess pateint-reported effects of transcutaneous spinal cord stimulation (tSCS) on spasticity after multiple treatment.
Design:
An uncontrolled prospective case series study.
Setting:
A rehabilitation hospital.
Participants:
A convenience sample of hospitalized adults with spinal cord injury (SCI) and lower-body spasticity limiting physical function and/or reducing quality of life (i.e. pain, sleep disturbance).
Interventions:
Participants received 30 minutes of tSCS (continuous, asymmetrical, biphasic rectangular impulses, 100 Hz) applied for 3-6 consecutive days using NeuroTrac multiTENS® (http://quintet.no). Two electrodes were placed paravertebrally at Th11-Th12 level and two on lower abdomen.
Outcome Measures:
Penn`s Spasm Frequency and Severity Scales were used for quantifying spasticity, Numeric Rating Scales (NRS 0-10) for perceived impact of spasticity on one chosen activity of a daily living, sleep-disturbance, and pain in trunk/lower limbs due to spasticity. The outcome measures were completed through interviews conducted before the first treatment, and immediately after the last treatment.
Results:
Seventeen people participated; injury levels C6-T12, AIS A-D, and mean age 51 years (SD 14). Fourteen participants reported a clinical important improvement in ADL performance, sleep disturbance and/or a decrease in pain due to spasticity (≥ two points on NRS). Minimal change was reported on Penn`s Spasm frequency and Severity Scales. No adverse events were observed.
Conclusions:
The majority of the participants perceived clinically relevant improvements on at least one patient-reported outcome measure, and no adverse events were reported. This is a simple and a non-invasive treatment that may have a potential of reducing the troublesome effects of spasticity.
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