Combining spinal neuromodulation and activity based neurorehabilitation therapy improves sensorimotor function in cerebral palsy.
Rahul Sachdeva, Kristin Girshin, Yousef Shirkhani and 2 others
PMID 37565185WHAT IT FOUND
Six children with cerebral palsy showed greater motor function gains after eight weeks of spinal neuromodulation combined with therapy than after sham neuromodulation with therapy.
Gains persisted ten weeks later. This tiny study cannot separate the device's contribution from the activity-based therapy.
Key findings
01The study tested whether children with cerebral palsy improved more on the Gross Motor Function Measure 88 when given spinal neuromodulation alongside activity-based therapy than when given sham neuromodulation alongside the same therapy.
02After eight weeks, the group receiving spinal neuromodulation with therapy improved by 7.6 points on the GMFM88, compared with 2.2 points in the group receiving sham neuromodulation with therapy.
03When the sham group crossed over to receive real spinal neuromodulation with therapy, their GMFM88 scores rose by 7.13 points, matching the gains of the original treatment group.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
Only six children were enrolled, three per group, which is far too few to draw reliable conclusions about whether the device works. Every child received activity-based neurorehabilitation therapy, so the study cannot separate the contribution of spinal neuromodulation from the contribution of the therapy itself. The paper reports the results as a mean and standard deviation but does not report a p-value or confidence interval, so it is impossible to judge whether the 7.6-point and 2.2-point differences are statistically meaningful. The device manufacturer, SpineX Inc., is named as the source of the proprietary SCiP device used in the study. The authors state that the mechanism by which the combination works is incomplete, and the Discussion claims this is the first intervention to show significant improvement in eight weeks, which is an interpretation rather than a measured result.
Declared interests
The spinal neuromodulation was delivered using a proprietary device from SpineX Inc., Los Angeles, CA. The paper does not include a separate conflicts-of-interest declaration, so the authors' relationship with the device manufacturer is unclear.
The easy way to misread this
Do not read the 7.6-point gain as proof that spinal neuromodulation works. All six children also received eight weeks of activity-based neurorehabilitation therapy, and the study design cannot tell you how much of the improvement came from the device versus the therapy.