Uploaded June 2021 | Updated September 2026, 3 weeks ago
Hear from Dr. Rebecca Martin, OTR/L from the International Center for Spinal Cord Injury at the Kennedy Krieger Institute as she discusses recent research examining the use and feasibility of transcutaneous spinal cord stimulation (TSCS) to supplement traditional gait training rehabilitation for individuals with motor incomplete spinal cord injuries. This field of research shows exciting advances that can lead to improvements in walking speed, endurance, and gait quality, with some interesting secondary benefits including improvements in bowel and bladder function and reductions in pain.
To learn more about this web series and ReWalk Robotics, please visit us at rewalk.com
In case you missed last month's episode of Topics in NeuroRehabilitation, you can watch episode 25 here: youtube.com/watch?v=tejuUxp3Cu0&list=PLqp_VphhkIqgqWfHGtVMOca2TZU3kXLwV&index=25
To learn more about Rebecca's research and some of the resources she mentions in her talk, please follow the links below:
International Center for Spinal Cord Injury: spinalcordrecovery.org
McHugh, Liza V., et al. "Feasibility and utility of transcutaneous spinal cord stimulation combined with walking-based therapy for people with motor incomplete spinal cord injury." Spinal Cord Series and Cases 6.1 (2020): 1-9. nature.com/articles/s41394-020-00359-1
Lang, Catherine E., et al. "Observation of amounts of movement practice provided during stroke rehabilitation." Archives of physical medicine and rehabilitation 90.10 (2009): 1692-1698. sciencedirect.com/science/article/pii/S0003999309003530?casa_token=w6aGcNgpM8MAAAAA:Bl5oiA7w4L2zh0P-Dh5J0UNyDCP6iZJSb5fmoVrr9Wt5M5HNu9bfbLWEp-jtRU98vogTVBAQhS4
National Spinal Cord Injury Statistical Center. (2013). Spinal cord injury: Facts and figures at a glance. Retrieved May 23, 2013 from https://www.nscisc.uab.edu/PublicDocuments/fact_figures_docs/Facts%202013.pdf
Additional References:
Anderson KD. Targeting recovery: Priorities of the spinal cord-injured population. J Neurotrauma. 2004 Oct;21(10):1371-83
Harkema S, Behrman A, Barbeau H. Evidence-based therapy for recovery of function after spinal cord injury. Handbook for Clinical Neurology.2012;109(3):261-274.
Labruyere R, van Hedel HJ. Strength training versus robot-assisted gait training after incomplete spinal cord injury: a randomized pilot study in patients depending on walking assistance. J of Neuroeng Rehab.2014;11(4).
Behrman AL, Lawless-Dixon AR, Davis SB, Bowden MG, Nair P, Phadke C, Hannold EM, Plummer P, Harkema SJ. Locomotor training progression and outcomes after incomplete spinal cord injury. Phys Ther. 2005;85:1356-1371
Behrman AL, Harkema SJ. Locomotor training after human spinal cord injury: a series of case studies. Phys Ther. 2000; 80:688-700.
Hofstoetter US, Krenn M, Danner, SM, Hofer C, Kern H, McKay WB, Mayr W, Minassian K. Augmentation of voluntary locomotor activity by transcutaneous spinal cord stimulation in motor-incomplete spinal cord-injured individuals. Artif Organs. 2015; 39(10):176-186.
Harkema SJ. Plasticity of interneuoronal networks of the functionally isolated human spinal cord. Brain Research Review.2008;57:255-264.
Gorodnichev RM, Pivovarova EA, Puhov A, Moiseev SA, Savochin AA, Moshonkina TR, Chsherbakova NA, Kilimnik VA, Selionov VA, Kozlovskaya IB, Edgerton VR, Gerasimenko YP. Transcutaneous electrical stimulation of the spinal cord: a noninvasive tool for the activation of stepping pattern generators in humans. Human Phys. 2012;38(2):158-167.
Hofstoetter US, Mckay WB, Tansey KE, Mayr W, Kern HK. Modification of spasticity by transcutaneous spinal cord stimulation in individuals with incomplete spinal cord injury. J Spinal Cord Med. 2014;37(2):202-211.
Minassian K, Hofstoetter US, Danner SM, Mayr W, Bruce JA, McKay WB, Tansey KE. Spinal rhythm generation by step-induced feedback and transcutaneous posterior root stimulation in complete spinal cord-injured individuals. Neurorehabil and Neural Repair. 2015; 29 (5): 395-495.
Gerasimenko YP, Lu DC, Modaber M, Zdunowski S, Gad P, Sayenko DG, Morikawa E, Haakana P, Ferguson AR, Roy RR, and Edgerton VE, Noninvasive reactivation of motor descending control after paralysis. Journal of Neurotrauma. 2015.
Hear from Dr. Rebecca Martin, OTR/L from the International Center for Spinal Cord Injury at the Kennedy Krieger Institute as she discusses recent research examining the use and feasibility of transcutaneous spinal cord stimulation (TSCS) to supplement traditional gait training rehabilitation for individuals with motor incomplete spinal cord injuries. This field of research shows exciting advances that can lead to improvements in walking speed, endurance, and gait quality, with some interesting secondary benefits including improvements in bowel and bladder function and reductions in pain.
To learn more about this web series and ReWalk Robotics, please visit us at rewalk.com
In case you missed last month's episode of Topics in NeuroRehabilitation, you can watch episode 25 here: youtube.com/watch?v=tejuUxp3Cu0&list=PLqp_VphhkIqgqWfHGtVMOca2TZU3kXLwV&index=25
To learn more about Rebecca's research and some of the resources she mentions in her talk, please follow the links below:
International Center for Spinal Cord Injury: spinalcordrecovery.org
McHugh, Liza V., et al. "Feasibility and utility of transcutaneous spinal cord stimulation combined with walking-based therapy for people with motor incomplete spinal cord injury." Spinal Cord Series and Cases 6.1 (2020): 1-9. nature.com/articles/s41394-020-00359-1
Lang, Catherine E., et al. "Observation of amounts of movement practice provided during stroke rehabilitation." Archives of physical medicine and rehabilitation 90.10 (2009): 1692-1698. sciencedirect.com/science/article/pii/S0003999309003530?casa_token=w6aGcNgpM8MAAAAA:Bl5oiA7w4L2zh0P-Dh5J0UNyDCP6iZJSb5fmoVrr9Wt5M5HNu9bfbLWEp-jtRU98vogTVBAQhS4
National Spinal Cord Injury Statistical Center. (2013). Spinal cord injury: Facts and figures at a glance. Retrieved May 23, 2013 from https://www.nscisc.uab.edu/PublicDocuments/fact_figures_docs/Facts%202013.pdf
Additional References:
Anderson KD. Targeting recovery: Priorities of the spinal cord-injured population. J Neurotrauma. 2004 Oct;21(10):1371-83
Harkema S, Behrman A, Barbeau H. Evidence-based therapy for recovery of function after spinal cord injury. Handbook for Clinical Neurology.2012;109(3):261-274.
Labruyere R, van Hedel HJ. Strength training versus robot-assisted gait training after incomplete spinal cord injury: a randomized pilot study in patients depending on walking assistance. J of Neuroeng Rehab.2014;11(4).
Behrman AL, Lawless-Dixon AR, Davis SB, Bowden MG, Nair P, Phadke C, Hannold EM, Plummer P, Harkema SJ. Locomotor training progression and outcomes after incomplete spinal cord injury. Phys Ther. 2005;85:1356-1371
Behrman AL, Harkema SJ. Locomotor training after human spinal cord injury: a series of case studies. Phys Ther. 2000; 80:688-700.
Hofstoetter US, Krenn M, Danner, SM, Hofer C, Kern H, McKay WB, Mayr W, Minassian K. Augmentation of voluntary locomotor activity by transcutaneous spinal cord stimulation in motor-incomplete spinal cord-injured individuals. Artif Organs. 2015; 39(10):176-186.
Harkema SJ. Plasticity of interneuoronal networks of the functionally isolated human spinal cord. Brain Research Review.2008;57:255-264.
Gorodnichev RM, Pivovarova EA, Puhov A, Moiseev SA, Savochin AA, Moshonkina TR, Chsherbakova NA, Kilimnik VA, Selionov VA, Kozlovskaya IB, Edgerton VR, Gerasimenko YP. Transcutaneous electrical stimulation of the spinal cord: a noninvasive tool for the activation of stepping pattern generators in humans. Human Phys. 2012;38(2):158-167.
Hofstoetter US, Mckay WB, Tansey KE, Mayr W, Kern HK. Modification of spasticity by transcutaneous spinal cord stimulation in individuals with incomplete spinal cord injury. J Spinal Cord Med. 2014;37(2):202-211.
Minassian K, Hofstoetter US, Danner SM, Mayr W, Bruce JA, McKay WB, Tansey KE. Spinal rhythm generation by step-induced feedback and transcutaneous posterior root stimulation in complete spinal cord-injured individuals. Neurorehabil and Neural Repair. 2015; 29 (5): 395-495.
Gerasimenko YP, Lu DC, Modaber M, Zdunowski S, Gad P, Sayenko DG, Morikawa E, Haakana P, Ferguson AR, Roy RR, and Edgerton VE, Noninvasive reactivation of motor descending control after paralysis. Journal of Neurotrauma. 2015.





![Topics in Neuro Rehab Ep 20: Spinal Cord Stimulation for Locomotor Recovery after CVA
Topics in NeuroRehabilitation - Episode 20. Kelly McKenzie, PT, DPT, NCS, Senior Physical Therapist at the Shirley Ryan Ability Lab walks us through the use of spinal cord stimulation to facilitate gait rehabilitation. In addition to reviewing research on SCS in spinal cord injured patients, Kelly also introduces research into the use of SCS in individuals post-stroke. Kelly highlights research from her lab indicating downregulation at the spinal cord level for individuals post-stroke, and describes ongoing research from her lab to utilize transcutaneous spinal cord stimulation to promote improved gait symmetry after CVA.
To learn more about this series or to request additional information from ReWalk Robotics, please reach out to us via our contact form here: https://rewalk.com/contact/
In case you missed last months episode, be sure to check out Topics in NeuroRehabilitation Episode 19: https://www.youtube.com/watch?v=wwGNTqZD34Q
To learn more about Kellys work at the Shirley Ryan Ability Lab and the research referenced in her talk, please visit the links below:
Max Nader Center for Rehabilitation Technologies and Outcomes Research: https://www.sralab.org/research/labs/max-nader-rto
References:
Moon, Yaejin, et al. Improvement in Gait Function After Receiving Noninvasive Spinal Stimulation Combined With Gait Training in Chronic Stroke Survivors. Archives of Physical Medicine and Rehabilitation 101.11 (2020): e46.
https://www.archives-pmr.org/article/S0003-9993(20)30700-0/abstract
Rejc E, Angeli C, Harkema S. Effects of Lumbosacral Spinal Cord Epidural Stimulation for Standing after Chronic Complete Paralysis in Humans. PLoS One. 2015;10(7):e0133998. Published 2015 Jul 24. doi:10.1371/journal.pone.0133998
Rejc E, Angeli CA, Bryant N, Harkema SJ. Effects of Stand and Step Training with Epidural Stimulation on Motor Function for Standing in Chronic Complete Paraplegics. J Neurotrauma. 2017;34(9):1787–1802. doi:10.1089/neu.2016.4516
Gill ML, Grahn PJ, Calvert JS et al. Neuromodulation of lumbosacral spinal networks enables independent stepping after complete paraplegia. Nat Med. 2018;24, 1677–1682. doi:10.1038/s41591-018-0175-7
Harkema SJ, Gerasimenko Y, Hodes J, et al. Effect of epidural stimulation of the lumbosacral spinal cord on voluntary movement, standing, and assisted stepping after motor complete paraplegia: a case study. The Lancet. 2011;377(9781):1938-1947.
Angeli CA, Edgerton VR, Gerasimenko YP, Harkema SJ. Altering spinal cord excitability enables voluntary movements after chronic complete paralysis in humans [published correction appears in Brain. 2015 Feb;138(Pt 2):e330]. Brain. 2014;137(Pt 5):1394–1409. doi:10.1093/brain/awu038
Angeli CA, Boakye M, Morton RA, et al. Recovery of Over-Ground Walking after Chronic Motor Complete Spinal Cord Injury. N Engl J Med. 2018;379:1244-50. Published 2018 Sept 24. DOI: 10.1056/NEJMoa1803588
Lu DC, Edgerton VR, Modaber M, et al. Engaging Cervical Spinal Cord Networks to Reenable Volitional Control of Hand Function in Tetraplegic Patients. Neurorehabil Neural Repair. 2016;30(10):951–962. doi:10.1177/1545968316644344
Gerasimenko Y, Gorodnichev R, Puhov A, et al. Initiation and modulation of locomotor circuitry output with multisite transcutaneous electrical stimulation of the spinal cord in noninjured humans. J Neurophysiol. 2015;113:834-842.
Gerasimenko Y, Gorodnichev R, Moshonkina T, Sayenko D, Gad P, Reggie Edgerton V. Transcutaneous electrical spinal-cord stimulation in humans. Ann Phys Rehabil Med. 2015;58(4):225–231. doi:10.1016/j.rehab.2015.05.003
Gad P, Gerasimenko Y, Zdunowski S, et al. Weight bearing over-ground stepping in an exoskeleton with non-invasive spinal cord neuromodulation after motor complete paraplegia. Front Neuroci. 2017;11(333). doi: 10.3389/fnins.2017.00333
Hofstoetter US, McKay WB, Tansey KE, Mayr W, Kern H, Minassian K. Modification of spasticity by transcutaneous spinal cord stimulation in individuals with incomplete spinal cord injury. J Spinal Cord Med. 2014;37(2):202–211. doi:10.1179/2045772313Y.0000000149
Hofstoetter US, Krenn M, Danner SM, et al. Augmentation of Locomotion by tSCS in Incomplete SCI. Artificial Organs. 2015;39: E176-E186. doi:10.1111/aor.12615
Inanici F, Samejima S, Gad P, Edgerton VR, Hofstetter CP, Moritz CT. Transcutaneous Electrical Spinal Stimulation Promotes Long-Term Recovery of Upper Extremity Function in Chronic Tetraplegia. IEEE Transactions on Neural Systems and Rehabilitation Engineering. 2018;26(6):1272-1278. doi: 10.1109/TNSRE.2018.2834339
Gad P, Lee S, Terrafranca N, et al. Non-invasive activation of cervical spinal networks after severe paralysis. J Neurotrauma. 2018;35(18):2145-2158. doi: 10.1089/neu.2017.5461. Topics in Neuro Rehab Ep 20: Spinal Cord Stimulation for Locomotor Recovery after CVA](https://i.ytimg.com/vi/TmRDQ5_oym8/mqdefault.jpg)




