Transcutaneous (non-invasive) spinal cord stimulation (tSCS) has been shown to facilitate volitional motor activity in patients with spinal cord injury. tSCS is known to activate the same neural structures as invasive SCS, meaning it may have the potential for functional restoration without an expensive surgical implant. Functional electrical stimulation (FES) is also used in therapy for patients with spinal cord injury to locally activate paralyzed or weakened muscles. There is evidence that combining FES and tSCS may elicit greater muscle activation than either modality alone.
The objective of this study is to quantify the torque at the ankle joint generated by tSCS, by FES, and by tSCS + FES. Additionally, ultrasound images will be collected during stimulation to provide a metric of muscle activity. The correlation between ultrasound and torque will be assessed to determine if ultrasound is a useful modality for quantifying tSCS-elicited muscle activity.
Between 18 and 60 years of age
Weight less than 220 lb
Healthy and able to walk at preferred speed without an assistive device
Able to tolerate functional electrical stimulation and tSCS.
Active infection
history of cancer,
broken skin, sores, or areas of acute eczema near the electrode sites
metal implants, such as staples or pins, near the electrode sites
Single group
Functional Electrical Stimulation
DeviceFunctional electrical stimulation will be applied to the ankle muscles. The resulting torque will be collected, and ultrasound data will be obtained during stimulation.
Transcutaneous (Non-Invasive) Spinal Cord Stimulation
DeviceNon-invasive spinal cord stimulation will be applied. The resulting torque data will be collected, and ultrasound data will be obtained during stimulation.
Ultrasound
DeviceUltrasound data will be collected from the shin muscles during FES and tSCS.
Ankle Joint Torque
Ankle joint torque will be collected during stimulation with FES, with tSCS, and with FES + tSCS. We will compare the torque elicited by each simulation case.
Ultrasound-Derived Muscle Activation
Ultrasound data will be collected from the shin muscles during FES, tSCS, and FES + tSCS. Muscle activation will be extracted from this data, and activation levels will be compared across stimulation cases.
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North Carolina State University
Lead sponsor
University of North Carolina, Chapel Hill
Collaborator
