PTCase ReportJournal of neurologic physical therapy : JNPT2026

Transcutaneous Spinal Cord Stimulation for Spasticity in Primary Lateral Sclerosis: A Case Series.

Kayla Chomko, Lauren Tabor Gray, Alan V Boruch and 1 others

PMID 42071279

WHAT IT FOUND

All six people with PLS had lower spasticity scores after one 30-minute transcutaneous spinal cord stimulation session, and balance scores improved, but this was an uncontrolled case series, so it does not prove the treatment works.

Key findings

01After one 30-minute tSCS session, all six participants had lower summed Modified Ashworth Scale scores, but medications and usual activity were not controlled.

02Five of six participants reported lower perceived spasticity immediately after treatment, and five reported reduced spasticity 24 hours later.

03POMA scores improved by 11.1% to 38.5%, and four of six participants improved in gait speed and endurance.

STILL TO COME

How it was doneWhat they foundWhat it means for PTs

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What it does not show

The study used a convenience sample of six participants and had no control group. The same licensed physical therapist delivered the stimulation and measured outcomes, and evaluator blinding was not used. Antispasticity medications, physical activity, and orthotic use were documented but unrestricted. Only one 30-minute session was tested, so the study does not show whether repeated sessions help or how long effects last. All testing was done on the same day, which may have introduced fatigue and affected gait endurance. MAS testing used visually estimated positions rather than precise goniometric measurements. Some gait speed and endurance changes did not meet a threshold for clinically important change in neurologic populations. Participants were ambulatory and sensory intact, so results may not apply to people with more severe impairment or sensory loss. The study did not test home use or long-term effects.

Declared interests

The authors reported no funding and no conflicts of interest.

The easy way to misread this

Do not read the spasticity reductions as proof that transcutaneous spinal cord stimulation works for PLS. This was a six-person uncontrolled case series, the same therapist delivered treatment and measured outcomes, medications were not controlled, and only one session was tested.

Read it on PubMed →