Effectiveness of transcutaneous spinal cord stimulation for lower limb rehabilitation in spinal cord injury: a systematic review.
Ravi Shankar, Kevin Sim Wei Wen, Ziyu Goh and 2 others
PMID 41470008WHAT IT FOUND
Evidence for non-invasive spinal stimulation to improve leg function after spinal cord injury is very uncertain.
One high-quality trial showed modest gains in strength and walking speed, but most studies had mixed or null results. It appears safe, with only minor skin irritation reported.
Key findings
01A double-blind randomized trial found that transcutaneous spinal cord stimulation combined with robotic gait training improved lower limb motor scores by a mean difference of 3.37 points compared to sham stimulation.
02The same trial reported a significant improvement in 10-meter walk test times of 37.51 seconds less for the stimulation group compared to sham.
03GRADE assessment rated the certainty of evidence for all clinical outcomes, including motor function and walking, as very low due to risk of bias, inconsistency, and small sample sizes.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
The certainty of evidence for all clinical outcomes was rated as very low. Studies varied widely in stimulation parameters (frequency 15-50 Hz, intensity 10-190 mA) and treatment duration (single session to 40 weeks), making it impossible to recommend an optimal protocol. Sample sizes were small across all included studies, limiting statistical power. The minimal clinically important difference for Lower Extremity Motor Scores in spinal cord injury has not been established, so it is unclear if the observed improvements were meaningful to patients. Most studies did not report long-term follow-up, so sustained benefits are unknown.
Declared interests
The paper does not list specific funding sources or author conflicts of interest in the provided text.
The easy way to misread this
Do not interpret the positive results from the single high-quality trial as evidence that tSCS works for all patients with spinal cord injury. The overall certainty of evidence is very low, most other trials showed null results, and the improvements were modest. It is not yet a proven treatment for routine clinical use.
Summarised by AI from the full paper, without a clinician reviewing it. Check it against the source before it changes what you do. Read it on PubMed →