[Spinal cord stimulation for post-apoplectic spastic hemiplegia]

Area of Science:

• Neurology
• Rehabilitation Medicine
• Biomedical Engineering

Background:

• Spinal cord stimulation (SCS) is explored for managing spastic movement disorders, with some evidence supporting its use in multiple sclerosis.
• Reducing spasticity is a key goal in physical therapy for post-stroke patients, offering potential for improved mobility and function.
• The efficacy of SCS for post-apoplectic spastic hemiplegia remains an area of investigation.

Observation:

• Two patients with post-stroke spastic hemiplegia underwent SCS using a Medtronic system, with electrodes placed in the lower cervical/upper thoracic region.
• Stimulation parameters included 30-75 Hz frequency and 0.3-0.5 voltage, applied for 12-14 hours daily.
• Clinical assessments included H/M ratio and H-wave recovery curves to quantify spasticity and nerve function.

Findings:

• Both patients experienced significant reductions in spasticity in lower and upper extremities following SCS.
• Gait and overall limb function showed marked improvement in both cases.
• Objective measures, including H/M ratio and H-wave recovery, demonstrated positive changes, indicating reduced spasticity and improved neural function.

Implications:

• SCS demonstrates potential as a therapeutic option for managing spasticity after stroke.
• The findings suggest SCS can contribute to functional recovery and enhance physical therapy outcomes for hemiplegic patients.
• Further research is warranted to confirm these benefits and optimize SCS protocols for stroke rehabilitation.