Mechanisms, Clinical Applications, and Future Directions of Transcutaneous Spinal Cord Stimulation on Spinal Cord Injury Recovery: A Narrative Review
DOI:
https://doi.org/10.70672/54a5fs17Keywords:
Cardiovascular regulation, motor recovery, neuropathic pain, transcutaneous spinal cord stimulation, spinal cord injury (SCI)Abstract
Transcutaneous spinal cord stimulation (TSCS) is an emerging non-invasive approach for spinal cord injury (SCI) rehabilitation. This narrative review synthesizes current evidence on its neurophysiological mechanisms and clinical applications while identifying limitations to its clinical integration. A comprehensive literature search reveals that TSCS can transiently modulate spinal excitability, facilitating improvements in motor control, autonomic regulation, and neuropathic pain. When paired with task-specific physiotherapy, TSCS appears to enhance neuroplasticity and functional recovery. However, the field is hampered by heterogeneity in patient populations, stimulation protocols, and outcome measures, leading to inconsistent therapeutic outcomes. The absence of standardized protocols and robust longitudinal data remains a major barrier. To accelerate clinical adoption, future efforts should focus on multicenter randomized controlled trials, protocol harmonization, and the development of accessible, portable TSCS systems suitable for home and community-based rehabilitation.
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