Effect of transcutaneous electrical spinal cord stimulation and mechanotherapy on excitability of spinal neural networks and locomotor function in patients with cerebral circulation disorders

In recent years, much evidence was gained on the efficacy of transcutaneous electrical spinal cord stimulation (TESCS) in initiation of involuntary stepping movements and control of locomotor behaviors. The data obtained on healthy persons suggest that TESCS can affect the spinal neural networks in patients with motor disorders of various origins. The objective of the study is to examine the effect of series of transcutaneous electrical spinal cord stimulation combined with proprioceptive stimulation of the lower limbs muscles on excitability of spinal neural networks and management of locomotor functions in patient with cerebrovascular disorders. Materials and Methods. The study involved patients with cerebrovascular disorders accompanied by such clinical signs as paresis. The authors used single and multisegmental TESCS on the background of proprioceptive stimulation (compulsive stepping movements of the lower limbs) with hardware-software complex for mechanotherapy. TESCS was conducted at the level of T11-T12; the second stimulation electrode was fixed at the level of L1-L2 when multisegmental stimulation was applied. The course of treatment lasted 3 weeks and consisted of 16-18 sessions of electro- and mechanotherapy. Results and Dicussion. While assessing the excitability of neuromuscular structures before treatment the authors observed obvious asymmetry of thresholds and amplitude characteristics of motor evoked potentials (MEP) of muscles of the thigh and lower leg in healthy and paretic limbs. At the end of treatment there was a significant increase in mean amplitude and decrease in MEP threshold level of muscles of the thigh and lower leg in paretic and healthy limbs. It was found out that after TESCS and mechanotherapy most of the patients covered a distance quicker than before TESCS while bipedal walking. Conclusion. TESCS on the background of proprioceptive stimulation increase excitability of spinal neural networks and MEP amplitude characteristics of the muscle of the thigh and lower leg. Such treatment can be used to improve the locomotor capabilities in patients.