Optimizing Transcutaneous Spinal Stimulation: Excitability of Evoked Spinal Reflexes is Dependent on Electrode Montage.

Background: There is growing interest in use of transcutaneous spinal stimulation (TSS) for people with neurologic conditions both to augment volitional control (by facilitating motoneuron excitability), and to decrease spasticity (by activating inhibitory networks). Various electrode montages are used during TSS, with little understanding of how electrode position influences spinal circuit activation. We sought to identify the thoracolumbar electrode montage associated with the most robust activation of spinal circuits by comparing posterior root-muscle reflexes (PRM reflexes) elicited by 6 montages.

Mastering Our Own Magic in the Evolution Toward Precision Practice.

Edelle (Edee) Field-Fote, PT, PhD, FASIA, FAPTA, the 54th Mary McMillan lecturer, is director of the Shepherd Center Spinal Cord Injury Research Program & Hulse Laboratory; professor in the division of physical therapy at Emory University School of Medicine; and professor of the practice in the school of biological sciences at the Georgia Institute of Technology. In her role as the director of spinal cord injury (SCI) research at Shepherd Center, Field-Fote leads a team dedicated to improving motor function in people with SCI through the development of neuromodulation and neurorehabilitation approaches informed by the latest neuroscience research and guided by outcomes that have meaning for people with SCI. With a clinical background as a physical therapist, PhD training in a preclinical model of SCI, and postdoctoral training in motor control physiology, her 25-plus years of SCI research have spanned the breadth of basic and clinical/translational research related to SCI.

Electrical stimulation modifies spinal and cortical neural circuitry.

Sensory input shapes and refines motor performance. It also modulates, on both a short- and long-term basis, the neural circuitry underlying motor performance. Evidence suggests that electrical stimulation can be used to mimic these modulatory effects on neural circuitry, perhaps providing a tool to influence motor function in both able-bodied individuals and those with motor dysfunction caused by neurological injury.

Quantification of functional behavior in humans and animals: time for a paradigm shift.

Measuring the effectiveness of interventions aimed at restoring motor function will be critical in deciding which animal trials should be translated to human studies. While various methods of quantifying motor behavior exist, many of these rely on observation and interpretation. Kinematic analysis is an objective means of quantifying temporal relationships and coordination within and between limbs during motor performance.

Improved intralimb coordination in people with incomplete spinal cord injury following training with body weight support and electrical stimulation.

Background And Purpose: Limb coordination is an element of motor control that is frequently disrupted following spinal cord injury (SCI). The authors assessed intralimb coordination in subjects with SCI following a 12-week program combining body weight support, electrical stimulation, and treadmill training.

Subjects: Fourteen subjects with long-standing (mean time post-SCI=70 months, range=12-171 months), incomplete SCI participated.