Feasibility of a Home-based Transcutaneous Spinal Stimulation Program on Autonomic-Cardiovascular Safety After...

Area of Science:

• Neurology
• Rehabilitation Medicine
• Cardiovascular Physiology

Background:

• Incomplete tetraplegia presents significant challenges for autonomic and cardiovascular regulation.
• Home-based rehabilitation programs are crucial for improving accessibility and adherence in individuals with spinal cord injury (SCI).

Purpose of the Study:

• To assess the safety and feasibility of a home-based transcutaneous spinal stimulation (TSS) program for individuals with incomplete tetraplegia.
• To evaluate the cardiovascular-autonomic safety during the home-based TSS program.

Main Methods:

• A 20-week program involving supervised in-person and telehealth-assisted home-based training.
• Participants with chronic incomplete tetraplegia were randomized to either a TSS and blood flow restriction enhanced neuromuscular electrical stimulation exercise (BES) program (TSS+BES) or a sham TSS+BES group.
• Cardiovascular parameters, including blood pressure and autonomic function, were monitored throughout the study.

Main Results:

• Six participants completed the trial with high adherence rates (80-95%).
• No adverse events, autonomic dysreflexia, or orthostatic hypotension were reported, indicating cardiovascular safety.
• The program demonstrated feasibility, though caregiver availability was a barrier to enrollment for some.

Conclusions:

• Home-based TSS is a feasible rehabilitation strategy for individuals with incomplete tetraplegia.
• The study provides evidence for the cardiovascular safety of TSS, with no adverse autonomic events observed.
• Future trials should leverage telehealth and caregiver support to expand access to TSS for enhancing autonomic and hemodynamic stability in SCI.