Hybrid Home-Based FES Protocol for Spinal Cord Injury Rehabilitation: A Single-Center Observational Cohort Study.

Area of Science:

• Neuroscience
• Rehabilitation Medicine
• Biomedical Engineering

Background:

• Spinal cord injury (SCI) leads to sensorimotor deficits, significantly impacting the quality of life for affected individuals.
• Neuroplasticity-based therapies, including functional electrical stimulation (FES), show promise but face accessibility challenges.
• Developing accessible, home-based rehabilitation solutions is crucial for long-term recovery in people with SCI (PwSCI).

Purpose of the Study:

• To assess the effectiveness and usability of a home-based, multidisciplinary rehabilitation protocol.
• The protocol integrates FES neuromodulation with virtual-based therapy for PwSCI.
• To evaluate a hybrid intervention model combining synchronous and asynchronous elements.

Main Methods:

• Eighty PwSCI participated in a hybrid intervention using a portable, app-based FES system with cloud monitoring.
• Outcome measures included SCIM-III, Motor Index Score (MIS), Timed Up & Go, and American Spinal Injury Association Impairment Scale (AIS) changes.
• Feasibility and usability were assessed through adherence, patient satisfaction, and heuristic analysis.

Main Results:

• Motor incomplete paraplegia (AIS C/D) demonstrated significant improvements in SCIM-III (Δ +10 points) and MIS (Δ +4 points).
• High adherence (70%) and patient satisfaction (84%) were reported.
• Approximately 32.5% of patients showed AIS changes, with limited gains in motor-complete injuries.

Conclusions:

• A multidisciplinary protocol combining virtual therapy and FES can enhance motor recovery and independence in PwSCI.
• This approach offers a scalable and accessible alternative to traditional rehabilitation methods.
• Technology-driven strategies hold significant potential for overcoming barriers in SCI care and improving patient outcomes.