Study shows improvement in upper extremity motor strength and function following spinal cord injury
Spinal cord injury (SCI) is a devastating neurological condition that leads to loss of motor and sensory function. Spinal cord injury symptoms often lead to impairments in limb movement, respiration, bowel and bladder function, and second complications such as pain, spasticity and pressure ulcers. Numerous treatment interventions, such as neuroprotection, regeneration, pharmacology, rehabilitation training and functional electrical stimulation have been investigated to improve function after SCI.
In a recent study published in Nature Medicine on May 20, 2024, researchers from University of Washington, Emory University School of Medicine, and Craig Hospital discovered several spinal cord injury treatment options, such as spinal stimulation and physical therapy. These treatments improved strength, mobility, sensation, and function of arms and hands for most of the study’s participants.
How does a spinal cord injury affect your body and impact your life? A SCI disrupts the bidirectional communication between the regions of the brain and spinal cord that produce and regulate essential neurological functions. When the SCI occurs in the cervical (neck) segments, the result is often permanent impairment of arm and hand function.
Researchers conducted a prospective, single-arm, multicenter, open-label, non-significant risk trial to evaluate the safety and efficacy of ARCEX Therapy in people with chronic SCI and neck injuries. The treatment involved externally applied electrical stimulation over the cervical spine cord during structured rehabilitation. 72% of participants demonstrated improvements in strength and functional domains. Significant improvements were noted in fingertip pinch force, hand prehension and strength, upper extremity motor and sensory abilities, and self-reported increases in quality of life.
The ARCEX device is under evaluation for the improvement of arm and hand functions after chronic cervical SCI. This trial assessed the safety of this tool to modulate the activity of the cervical spinal cord and the effectiveness of ARCEX Therapy to improve arm and hand functions compared to rehabilitation alone.
Lead author to this study, Professor of Electrical and Computer Engineering and Rehabilitation Medicine at the University of Washington, Chet Moritz, recently told Seattle’s KUOW in an interview:
“What we think is happening is the sensory nerves are helping the motor neurons become ready to fire, so that any remaining signal that can make it through the spinal cord injury from the brain is able to have that immediate effect and cause that movement,” Moritz said.
“The goal is to bring the neurons in the spinal cord closer to threshold so that your brain can turn them on when you want to move,” Moritz said.
Over the long term, the device aids in neural plasticity, which enables learning and memory. Neurons that fire together eventually wire together.
“If two neurons are active at about the same time, and one neuron causes another neuron to become active, the synapses between those neurons become stronger,” Moritz said.
Moritz and his colleagues were excited that the progress that patients’ made often continued even after the device was detached.
References: Moritz, C., Field-Fote, E.C., Tefertiller, C. et al. Non-invasive spinal cord electrical stimulation for arm and hand function in chronic tetraplegia: a safety and efficacy trial. Nat Med 30, 1276–1283 (2024). https://doi.org/10.1038/s41591-024-02940-9
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