A Review of Different Stimulation Methods for Functional Reconstruction and Comparison of Respiratory Function after Cervical Spinal Cord Injury

Abstract

Background. Spinal cord injury (SCI) is a common severe trauma in clinic, hundreds of thousands of people suffer from which every year in the world. In terms of injury location, cervical spinal cord injury (CSCI) has the greatest impact. After cervical spinal cord injury, the lack of innervated muscles is not enough to provide ventilation and other activities to complete the respiratory function. In addition to the decline of respiratory capacity, respiratory complications also have a serious impact on the life of patients. The most commonly used assisted breathing and cough equipment is the ventilator, but in recent years, the functional electrical stimulation method is being used gradually and widely. Methods. About hundred related academic papers are cited for data analysis. They all have the following characteristics: (1) basic conditions of patients were reported, (2) patients had received nerve or muscle stimulation and the basic parameters, and (3) the results were evaluated based on some indicators. Results. The papers mentioned above are classified as four kinds of stimulation methods: muscle electric/magnetic stimulation, spinal dural electric stimulation, intraspinal microstimulation, and infrared light stimulation. This paper describes the stimulation principle and application experiment. Finally, this paper will compare the indexes and effects of typical stimulation methods, as well as the two auxiliary methods: training and operation. Conclusions. Although there is limited evidence for the treatment of respiratory failure by nerve or muscle stimulation after cervical spinal cord injury, the two techniques seem to be safe and effective. At the same time, light stimulation is gradually applied to clinical medicine with its strong advantages and becomes the development trend of nerve stimulation in the future.

The Future of TSCI Treatment: New Approaches through Integrating Traditional Chinese and Modern Medicine

“…Based on stimulation parameters, tSCS can be roughly divided into two types: direct current stimulation (tsDCS) and pulsed current stimulation (tsPCS). FES is a neuromodulation technology that applies short-pulse electrical stimulation during specific simulated activities (like walking or cycling) [25] , with many benefits including enhancing residual muscle strength, increasing flexibility and range of motion in joints or limbs, and reducing spasticity, thereby enhancing sensorimotor functions [29] , improving cardiopulmonary health such as peak ventilation, thus enhancing airflow rate and airway pressure [30] , and reducing common post-SCI neuropathic or injury-related pain and spasms . It also helps in controlling bowel/bladder dysfunctions and improving erectile and ejaculatory dysfunctions, increasing blood circulation and metabolic rate, ultimately improving muscle mass and balance, and controlling posture [30] , thus having a wide application in rehabilitation.…”

“…FES is a neuromodulation technology that applies short-pulse electrical stimulation during specific simulated activities (like walking or cycling) [25] , with many benefits including enhancing residual muscle strength, increasing flexibility and range of motion in joints or limbs, and reducing spasticity, thereby enhancing sensorimotor functions [29] , improving cardiopulmonary health such as peak ventilation, thus enhancing airflow rate and airway pressure [30] , and reducing common post-SCI neuropathic or injury-related pain and spasms . It also helps in controlling bowel/bladder dysfunctions and improving erectile and ejaculatory dysfunctions, increasing blood circulation and metabolic rate, ultimately improving muscle mass and balance, and controlling posture [30] , thus having a wide application in rehabilitation. Epidural SCS is an effective neuromodulatory therapy that can alleviate chronic pain, reduce spasticity severity, increase specific rhythmic movement activity in lower limbs, activate respiratory muscles, improve bladder control, enhance sensory nerve activities, and affect various organs in the autonomic nervous system or viscerosomatic reflexes.…”

Trans-Spinal Electrical Stimulation Therapy for Functional Rehabilitation after Spinal Cord Injury: Review

“…FES has a wide range of applications in rehabilitation, as it has both direct and indirect effects [ 30 ]. FES mostly enhances and brings back upper and lower limb muscle functions [ 31 , 32 ], improves cardiopulmonary fitness such as rising peak ventilation, thereby enhancing the airflow rate and airway pressure [ 33 ], and decreases neuropathic or nociceptive pain and spasticity which commonly arise after SCI [ 34 ]. Pressure ulcers are another common complication after SCI, where FES plays an important role to increase the pressure ulcer healing rate [ 35 ].…”