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Published on: August 9, 2024
Transcutaneous Spinal Stimulation and Short-Burst Interval Treadmill Training in Children With Cerebral Palsy: A
Insights
Transcutaneous spinal cord stimulation combined with treadmill training improved spasticity and maintained mobility in children with cerebral palsy. These positive effects on spasticity and walking function were sustained for 8 weeks post-intervention.
Area of Science:
- Neuroscience
- Pediatrics
- Rehabilitation Medicine
Background:
- Cerebral palsy (CP) is a common neurodevelopmental disorder affecting motor function.
- Spasticity and impaired mobility are significant challenges for children with CP.
- Novel therapeutic strategies are needed to improve outcomes in pediatric CP populations.
Purpose of the Study:
- To evaluate the effects of transcutaneous spinal cord stimulation (tSCS) and short-burst interval locomotor treadmill training (SBLTT) on spasticity and mobility in children with CP.
- To compare the efficacy of SBLTT alone versus the combination of tSCS + SBLTT.
Main Methods:
- A single-arm pilot study involving four children with CP.
- Participants underwent 24 sessions of SBLTT only, followed by 24 sessions of tSCS + SBLTT.
- Evaluations included spasticity (Modified Ashworth Scale), neuromuscular coordination, and walking function (1-minute walk test) before, immediately after, and 8 weeks post-intervention.
Main Results:
- tSCS + SBLTT significantly reduced lower-extremity spasticity compared to SBLTT alone.
- Walking distance was maintained during both interventions.
- tSCS + SBLTT improved peak hip and knee extension, increasing joint dynamic range and leading to reported reductions in fatigue and improved gait.
- Improvements in spasticity and walking function were sustained for 8 weeks after tSCS + SBLTT.
Conclusions:
- The combination of tSCS + SBLTT shows promise for improving spasticity in ambulatory children with CP.
- This combined approach may simultaneously maintain neuromuscular coordination and walking function.
- Preliminary findings support further investigation into tSCS and tSCS + SBLTT for pediatric CP rehabilitation.
Objective:
The purpose of this pilot study was to evaluate the effects of transcutaneous spinal cord stimulation (tSCS) and short-burst interval locomotor treadmill training (SBLTT) on spasticity and mobility in children with cerebral palsy (CP).
Methods:
We employed a single-arm design with two interventions: SBLTT only, and tSCS + SBLTT, in four children with CP. Children received 24-sessions each of SBLTT only and tSCS + SBLTT. Spasticity, neuromuscular coordination, and walking function were evaluated before, immediately after, and 8-weeks following each intervention.
Results:
Spasticity, measured via the Modified Ashworth Scale (MAS), reduced in four lower-extremity muscles after tSCS + SBLTT (1.40 ± 0.22), more than following SBLTT only (0.43 ± 0.39). One-minute walk test (1-MWT) distance was maintained during both interventions. tSCS + SBLTT led to improvements in peak hip and knee extension (4.9 ± 7.3° and 6.5 ± 7.7°), that drove increases in joint dynamic range of 4.3 ± 2.4° and 3.8 ± 8.7° at the hip and knee, respectively. Children and parents reported reduction in fatigue and improved gait outcomes after tSCS + SBLTT. Improvements in spasticity and walking function were sustained for 8-weeks after tSCS + SBLTT.
Conclusion:
These preliminary results suggest that tSCS + SBLTT may improve spasticity while simultaneously maintaining neuromuscular coordination and walking function in ambulatory children with CP.
Significance:
This work provides preliminary evidence on the effects of tSCS and the combination of tSCS + SBLTT in children with CP.

