Methodologies to elicit and record pudendal somatosensory evoked potentials in adult humans: A systematic review.

Objective: The purpose of this systematic review was to characterize methodologies reported in the literature to elicit and record pudendal somatosensory evoked potentials (SEPs) in human adults.

Methods: We conducted an electronic literature search in MEDLINE, Embase, CENTRAL, and CINAHL for studies that elicited pudendal SEPs via electrical stimulation and recorded responses though electroencephalography. From included studies, we extracted methodological details of how the SEPs were evoked and recorded.

Motor and autonomic concomitant health improvements with neuromodulation and exercise (MACHINE) training: a randomised controlled trial in individuals with spinal cord injury.

Introduction: Motor and autonomic dysfunctions are widespread among people with spinal cord injury (SCI), leading to poor health and reduced quality of life. Exercise interventions, such as locomotor training (LT), can promote sensorimotor and autonomic recovery post SCI. Recently, breakthroughs in SCI research have reported beneficial effects of electrical spinal cord stimulation (SCS) on motor and autonomic functions.

Effects of motor stimulation of the tibial nerve on corticospinal excitability of abductor hallucis and pelvic floor muscles.

Introduction: Peripheral nerve stimulation can modulate the excitability of corticospinal pathways of muscles in the upper and lower limbs. Further, the pattern of peripheral nerve stimulation (continuous vs. intermittent) may be an important factor determining the modulation of this corticospinal excitability.

Probing the deployment of peripheral visual attention during obstacle-crossing planning.

Gaze is directed to one location at a time, making peripheral visual input important for planning how to negotiate different terrain during walking. Whether and how the brain attends to this input is unclear. We developed a novel paradigm to probe the deployment of sustained covert visual attention by testing orientation discrimination of a Gabor patch at stepping and non-stepping locations during obstacle-crossing planning.

Effects of non-invasive spinal cord stimulation on lower urinary tract, bowel, and sexual functions in individuals with chronic motor-complete spinal cord injury: Protocol for a pilot clinical trial.

Introduction: Electrical spinal cord neuromodulation has emerged as a leading intervention for restoring autonomic functions, such as blood pressure, lower urinary tract (LUT), bowel, and sexual functions, following spinal cord injury (SCI). While a few preliminary studies have shown the potential effect of non-invasive transcutaneous spinal cord stimulation (tSCS) on autonomic recovery following SCI, the optimal stimulation parameters, as well as real-time and long-term functional benefits of tSCS are understudied. This trial entitled "Non-invasive Neuromodulation to Treat Bladder, Bowel, and Sexual Dysfunction following Spinal Cord Injury" is a pilot trial to examine the feasibility, dosage effect and safety of tSCS on pelvic organ function for future large-scale randomized controlled trials.

Knowledge, Attitudes, and Practice of Pelvic Floor Muscle Training in People With Spinal Cord Injury: A Cross-Sectional Survey.

Background: There is emerging evidence that pelvic floor muscle training (PFMT) may be useful for treating some urogenital conditions in people with spinal cord injury (SCI). Future clinical investigations would benefit from understanding the extent to which people with SCI are aware of and practicing PFMT, and their attitude toward this therapy.

Objective: The goal of this study was to assess the knowledge, attitudes, and practices related to PFMT among people with SCI.

Trunk muscle activity and kinematics during boxing and battle rope exercise in people with motor-complete spinal cord injury.

Context: Recovery of seated balance is a rehabilitation priority for people with motor-complete spinal cord injury (mcSCI). Previous research has demonstrated that people with mcSCI can voluntarily engage their trunk muscles during different exercise programs that have the potential to improve seated balance control. Boxing and battle rope exercises could offer another opportunity to improve seated balance for people with mcSCI, but it is unknown if this type of exercise engages trunk musculature and challenges seated balance.

Exoskeleton gait training to improve lower urinary tract function in people with motor-complete spinal cord injury: A randomized pilot trial.

Objective: The primary aim of this study was to determine the feasibility of delivering an exoskeleton-assisted walking intervention targeting lower urinary tract function in people with motor-complete spinal cord injury. Secondary aims were to determine if exoskeleton walking activates the pelvic floor muscles, and compare 2 exoskeleton programmes regarding lower urinary tract function.

Design: Randomized pilot trial.

Noninvasive Neuroprosthesis Promotes Cardiovascular Recovery After Spinal Cord Injury.

Spinal cord injury (SCI) leads to severe impairment in cardiovascular control, commonly manifested as a rapid, uncontrolled rise in blood pressure triggered by peripheral stimuli-a condition called autonomic dysreflexia. The objective was to demonstrate the translational potential of noninvasive transcutaneous stimulation (TCS) in mitigating autonomic dysreflexia following SCI, using pre-clinical evidence and a clinical case report. In rats with SCI, we show that TCS not only prevents the instigation of autonomic dysreflexia, but also mitigates its severity when delivered during an already-triggered episode.

Accidental boosting in an individual with tetraplegia - considerations for the interpretation of cardiopulmonary exercise testing.

Context: Autonomic dysreflexia (AD), characterized by a transient increase in systolic blood pressure (BP), is experienced by individuals with spinal cord injury (SCI) and can be purposefully induced ('boosting') to counteract autonomic dysfunction that impairs cardiovascular responses to exercise. Herein, we demonstrate the impact of unintentional boosting observed during cardiopulmonary exercise testing (CPET) in an inactive male with SCI (C5, motor-complete).

Findings: On two separate occasions the individual performed a standard arm-crank CPET (1-min stages, 7W increase in resistance) following by a longer CPET (4-min stages, 12W increase in resistance), both to volitional exhaustion.

Effects of Exercise-Based Interventions on Urogenital Outcomes in Persons with Spinal Cord Injury: A Systematic Review and Meta-Analysis.

In this systematic review, objectives were to investigate dropout rates, adverse events, and effects of exercise-based therapies on urogenital function and quality of life (QoL) in persons with spinal cord injury (SCI). Database searches were conducted on MEDLINE, EMBASE, and CINAHL for studies examining any form of exercise intervention on urogenital function and/or QoL in adults with SCI. Quality of publications was evaluated using the Joanna Briggs Institute critical evaluation tools.

Residual Innervation of the Pelvic Floor Muscles in People with Motor-Complete Spinal Cord Injury.

Individuals classified clinically as having a motor-complete spinal cord injury (mcSCI) should lack voluntary motor function below their injury level. Neurophysiological assessments using electromyography (EMG) and transcranial magnetic stimulation (TMS), however, have demonstrated that persons with mcSCI retain limited cortical descending innervation and voluntary activation of muscles below their level of injury, including muscles of the trunk and lower limb. We explored the possibility of whether there is also preserved innervation of the pelvic floor muscles (PFM) in persons with mcSCI.

Quantifying muscle coactivation in individuals with incomplete spinal cord injury using wavelets.

Background: Individuals with incomplete spinal cord injury often have decreased gait function and coactivation of antagonistic muscle pairs. Common ways of quantifying coactivation using electromyographic signals do not consider frequency information in the signal. As electromyographic signals from different motor unit types have different frequency components and muscle fiber type can change in individuals with spinal cord injury, it may be beneficial to consider frequency components.

The sensorimotor effects of a lower limb proprioception training intervention in individuals with a spinal cord injury.

Proprioception is critical for movement control. After a spinal cord injury (SCI), individuals not only experience paralysis but may also experience proprioceptive deficits, further confounding motor recovery. The objective of this study was to test the effects of a robotic-based proprioception training protocol on lower limb proprioceptive sense in people with incomplete SCI.

Arm crank ergometer "spin" training improves seated balance and aerobic capacity in people with spinal cord injury.

Background: There is some evidence that upper-body training modalities can improve not only aerobic capacity but also seated balance in people with spinal cord injury (SCI), even in those classified with motor-complete paralysis above T6. Here, we evaluated the effect of arm crank ergometry (ACE) "spin" training on trunk muscle recruitment and its effects on seated balance and aerobic capacity.

Methods: Eight individuals with high-level complete and 6 with either a low-level complete or a motor-incomplete SCI participated in this study.

Improvements in skilled walking associated with kinematic adaptations in people with spinal cord injury.

Introduction: Individuals with motor-incomplete SCI (m-iSCI) remain limited community ambulators, partly because they have difficulty with the skilled walking requirements of everyday life that require adaptations in inter-joint coordination and range of motion of the lower limbs. Following locomotor training, individuals with SCI show improvements in skilled walking and walking speed, however there is limited understanding of how adaptations in lower limb kinematics following training contribute to improvements in walking.

Objective: To determine the relationship between changes in lower limb kinematics (range of motion and inter-joint coordination) and improvements in walking function (walking speed and skilled walking) following locomotor training.

Acquisition of a precision walking skill and the impact of proprioceptive deficits in people with motor-incomplete spinal cord injury.

Many people with motor-incomplete spinal cord injury (m-iSCI) experience difficulty navigating obstacles, such as curbs and stairs. The ability to relearn walking skills may be limited by proprioceptive deficits. The purpose of this study was to determine the capacity of participants to acquire a precision walking skill, and to evaluate the influence of proprioceptive deficits on the skill acquisition in individuals with m-iSCI.

Overground walking with a robotic exoskeleton elicits trunk muscle activity in people with high-thoracic motor-complete spinal cord injury.

Background: The trunk muscles are critical for postural control. Recent neurophysiological studies have revealed sparing of trunk muscle function in individuals with spinal cord injury (SCI) classified with thoracic or cervical motor-complete injuries. These findings raise the possibility for recruiting and retraining this spared trunk function through rehabilitation.

Association of Epidural Stimulation With Cardiovascular Function in an Individual With Spinal Cord Injury.

This study assesses the association between lumbosacral epidural stimulation to the lumbosacral spinal cord with cardiovascular function in an individual with a spinal cord injury.

A systematic review of the effectiveness of task-specific rehabilitation interventions for improving independent sitting and standing function in spinal cord injury.

Context: Impaired balance function after a spinal cord injury (SCI) hinders performance of daily activities.

Objective: To assess the evidence on the effectiveness of task-specific training on sitting and standing function in individuals with SCI across the continuum of care.

Methods: A systematic search was conducted on literature published to June 2016 using people (acute or chronic SCI), task-specific interventions compared to conventional physical therapy, and outcome (sitting or standing balance function).

Exploring the ecological validity and variability of a 10-min bout of wheeling.

Purpose: To determine the ecological validity of using able-bodied participants to perform a 10-min wheeling trial by (1) evaluating changes in biomechanics over the trial in manual wheelchair users and able-bodied participants naïve to wheeling and (2) describing differences in changes and variability between groups.

Materials And Methods: Manual wheelchair users (n = 7, 2-27 years' experience) and able-bodied participants (n = 11) wheeled for 10 min. Kinetic and temporal variables were collected and averaged over each minute, while wheeling strategy (movement pattern) was categorized at minutes 1 and 10.