Non-invasive spinal cord neuromodulation enables volitional anti-gravity leg movements after motor-complete spinal cord injury: responders vs. non-responders.

The study was a small case series not powered for statistical inference. Interventions were heterogeneous, with some participants receiving concurrent robotic locomotor training, making it impossible to separate the effects of stimulation from activity-based therapy. Responder classification relied on visual confirmation and qualitative movement rather than a predefined quantitative threshold. Non-responders were purposefully selected to match responders, which may introduce selection bias. All non-responders were assessed in a seated position, while responders were observed in both seated and standing postures, potentially confounding the comparison. Outcomes were assessed only post-intervention, so longitudinal changes or training effects were not evaluated.

Funding was provided by multiple organizations including the Paralyzed Veterans of America, Rick Hansen Foundation, Michael Smith Health Research BC, Canadian Institutes for Health Research, and others. The device used was the TESCoN stimulator from SpineX Inc.

Do not interpret the return of volitional movement as permanent recovery or independent motor control. The movements occurred only during active stimulation and were not observed before the intervention or without the device. Additionally, because some participants received concurrent robotic locomotor training, the specific contribution of the stimulation alone cannot be isolated.