Spinal Cord Stimulation with Activity-Based Training: Effect on Spasticity.

Spasticity is common after a spinal cord injury (SCI). Pharmacological treatments for spasticity often have adverse effects on neurorehabilitation. Spinal cord transcutaneous stimulation (scTS) and activity-based training (ABT) have been shown to be useful tools for neurorehabilitation which can lead to improved function for people with SCI.

Differential Corticospinal Excitability and Cortical Functional Connectivity Modulation by Spinal Cord Transcutaneous Stimulation-based Motor Training versus Motor Training alone in Able-bodied and SCI participants: A Multiple Case Study.

Spinal cord transcutaneous stimulation (scTS) has shown its potential for boosting motor, sensory, and autonomic function recovery after a spinal cord injury. Despite the demonstrated benefits, little is known about the exact neuromodulatory mechanisms triggered by scTS and the cortex involvement in the beneficial effects observed. Here, we examine the effects of scTS-based motor training and motor training alone on sensorimotor cortical functional connectivity and corticospinal excitability in able-bodied and SCI participants.

Improved Gait symmetry with spinal cord transcutaneous stimulation in individuals with spinal cord injury.

A previous study by our group showed preliminary results showcasing the usage of optimal and individualized spinal cord transcutaneous stimulation (scTS) parameters during overground gait training to facilitate more repeatable gait kinematics profiles for one participant with an incomplete spinal cord injury (SCI). The goal of this study was to use the combined targeted scTS and training to improve spatial and temporal parameters to achieve a symmetrical gait profile after completing activity-based training (ABT) (stepping and stand training) and exoskeleton training with and without scTS. Our data indicates that stimulation with optimal and individualized parameters can lead to more effective, stable and symmetric gait patterns in participants with varied levels of SCI.

Small Random Angular Variations in Pelvic Tilt and Lower Extremity Can Cause Error in Static Image-based Preoperative Hip Arthroplasty Planning: A Computer Modeling Study.

Background: Many THA simulation models rely on a limited set of preoperative static radiographs to replicate sagittal pelvic tilt during functional positions and to recommend an implant orientation that minimizes the risk of prosthetic impingement. However, possible random changes in pelvic or lower extremity angular motions and the effect of coronal and axial pelvic tilt are not included in these preoperative models.

Questions/purposes: (1) Can prosthetic impingement occur if the pelvic tilt or lower extremity alignment randomly varies up to ± 5° from what is measured on a single preoperative static radiographic image? (2) Do changes in coronal and axial pelvic tilt or lower extremity alignment angles have a similar effect on the risk of prosthetic impingement?

Methods: A de-identified pelvis and lower-body CT image of a male patient without previous THA or lower extremity surgery was used to import the pelvis, femur, and tibia into a verified MATLAB computer model.

Femoral stem neck geometry determines hip range of motion shape : a computer simulation study.

Aims: In computer simulations, the shape of the range of motion (ROM) of a stem with a cylindrical neck design will be a perfect cone. However, many modern stems have rectangular/oval-shaped necks. We hypothesized that the rectangular/oval stem neck will affect the shape of the ROM and the prosthetic impingement.