Kei Masani and Dimitry Sayenko, Toronto Rehabilitation Institut, Toronto, Canada

A Novel Non-Invasive Approach for Regaining Self-Assisted Standing

Funded in: 2020, 2021, 2022

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Problem: Spinal cord injury results in muscle paralysis
Target: Induce muscle activation with two non-invasive electrical stimulation methods
Goal: Generating muscle contractions sufficiently for self-assisted standing

Spinal cord injury results in muscle paralysis. Electrical stimulation can activate the paralyzed muscles and help them to perform lost functions. There are two ways for electrical stimulation to induce muscle activations: One is “invasive” where the electrodes are surgically inserted into the body, and the other is “non-invasive” where the electrodes are placed on the skin over the muscles. The invasive approach, in general, can make stronger muscle contractions. This approach, however, is based on high-cost devices, requires invasive surgical procedures, and has been used so far in only a handful of individuals with spinal cord injury. Conversely, while the non-invasive approach can generate weaker muscle contractions in general, it is preferred by more patients and can be used on a broader population. The invasive approach has been demonstrated to be effective in generating standing posture in people with spinal cord injury. Recently, the non-invasive approach showed similar results; however, its effectiveness in generating muscle contractions that are strong enough to maintain a standing posture is less effective than the invasive approach. Thus, purpose of this work is to research the potential of two non-invasive electrical stimulation methods — (1) spinal stimulation and (2) muscle stimulation — and to develop a novel non-invasive approach combining these two stimulation methods that can help people with spinal cord injury stand without any help from canes. At first, the researchers will investigate the effect of each of the two stimulation methods on muscle activation and joint movements. Then, the scientists will investigate how much of the stable standing posture can be generated by the combination of two stimulation methods. They expect to show the effectiveness of their new method in generating muscle contractions sufficiently for self-assisted standing. This project has the potential to provide highly effective therapy for the overall health of individuals with a spinal cord injury.