Tapping the Neural Circuitry: Surface Spinal Stimulation in Spinal Cord Injury: A Case Report

Context/Objective: To examine the effect of Surface Spinal Stimulation with varied beat frequency on muscle fibre recruitment in lower limb in Incomplete Spinal Cord Injury. Design: Interventional Study. Setting: Department of Physiotherapy, Punjabi University Patiala, Punjab, India. Interventions: Surface Spinal Stimulation (SSS) was delivered at the T 10 ?L1 vertebral level with the adhesive electrodes placed para-vertebrally on each side of spine, 5 cm apart. Rectangular self-adhesive electrodes of size 4.5 cm * 9 cm were used. The electrical stimulations had an amplitude modulated Alternating Current (AC), with a carrier frequency of 2500 Hz, modulated to “beat” frequency of 30 Hz,50 Hz,70 Hz and 90Hz .Stimulation amplitude was raised to elicit sensory stimulation. Outcome Measure: Surface Electromyography (EMG) was used to assess the alterations in muscle fibre recruitment of various muscle groups. Pre/Post Test design was adopted. Results: Pre to Post test SSS values changed significantly with all the varied beat frequencies. Conclusion: This case study showed that the SSS, similar to epidural stimulation can be used in enhancing muscle recruitment, without negatively impacting residual motor control in incomplete SCI. Further studies are required to explore more about this non invasive method of tapping the neural circuitry