Transcutaneous spinal cord stimulation on motor function in patients with spinal cord injury: A meta-analysis

BACKGROUND: It has been suggested that transcutaneous spinal cord stimulation (SCS) is effective in the rehabilitation of patients with spinal cord injury (SCI). However, the evidence is mainly based on case reports. OBJECTIVE: To summarize the influence of transcutaneous SCS on extremity motor function of patients with SCI in a meta-analysis. METHODS: A systematic literature search was performed in electronic databases including PubMed, Cochrane library, Embase, Web of Science, Wanfang, and CNKI to obtain relevant randomized controlled trials (RCTs). A random-effects model was used to pool the results by incorporating the impact of the potential heterogeneity. The most recent database search was conducted on December 31, 2023. RESULTS: Six small-scale open-label or single-blind RCTs were included. Transcutaneous SCS on the basis of conventional rehabilitation could significantly improve limb strength (mean difference: 4.82, p = 0.004; I-2 = 0%) and attenuate spasticity (MD: -0.40, p = 0.02; I-2 = 0%). The upper-extremity motor function was not significantly affected (p = 0.75). However, transcutaneous SCS significantly improved mobility as indicated by walking speed (MD: 0.13 m/s, p = 0.009; I-2 = 0%) and walking distance (standardized MD: 0.62, I-2 = 0%). CONCLUSION: Transcutaneous SCS is effective in improving limb strength, spasticity and mobility of patients with SCI.