A Survey of Tests and Assessments Used for Spinal Cord Injury Transspinal Stimulation Research

Unite 2 Fight Paralysis organized virtual meetings with spinal cord injury (SCI) researchers to address challenges in analyzing outcomes of transspinal stimulation studies in individuals with SCI.

The group aims to reach consensus on methods to improve patient profiling, assess the most feasible and important assessments, and share data for comparative analysis.

A subcommittee developed a questionnaire to gather researchers' opinions on outcome measure value, feasibility, and usage in SCI neuromodulation studies. The survey covered 44 measurements across 17 domains, including clinical, neurophysiological, and imaging tests. Responses were analyzed and correlated with professional demographics.

Thirty-four investigators responded. Outcome assessments highly valued by responders included surface electromyographic (EMG) measurements of volitional muscle activity, transspinal evoked potentials, medications taken, and assessment for discomplete injury. Outcome measures deemed high in feasibility included those focused on clinical sensorimotor impairment via the International Standards for the Neurological Classification of SCI (ISNCSCI), EMG assessments of volitional activity, transspinal evoked potentials, general functional assessment via the SCI Independence Measure, and medications taken. Outcome measures most often used included EMG assessment of volitional activity, transspinal evoked potentials, ISNCSCI examination, spasticity assessment, medications taken, peripheral nerve conduction studies, and assessments for discomplete SCI.

Survey outcomes provide insights into researchers' opinions on the value and feasibility of specific assessments for SCI clinical research with transspinal stimulation. The authors hope these results spark further discussion and actions to develop expert recommendations for a common set of outcomes to collect and analyze in SCI neuromodulation studies.