{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,31]],"date-time":"2026-10-31T16:32:31Z","timestamp":1793464351439,"version":"4.5.0"},"reference-count":38,"publisher":"Elsevier BV","issue":"7","license":[{"start":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T00:00:00Z","timestamp":1759276800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T00:00:00Z","timestamp":1759276800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2025,1,17]],"date-time":"2025-01-17T00:00:00Z","timestamp":1737072000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100013947","name":"Modern Humanities Research Association","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100013947","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000334","name":"International Spinal Research Trust","doi-asserted-by":"publisher","award":["NMN008"],"award-info":[{"award-number":["NMN008"]}],"id":[{"id":"10.13039\/501100000334","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["neuromodulationjournal.org","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Neuromodulation: Technology at the Neural Interface"],"published-print":{"date-parts":[[2025,10]]},"DOI":"10.1016\/j.neurom.2025.01.005","type":"journal-article","created":{"date-parts":[[2025,2,24]],"date-time":"2025-02-24T04:25:14Z","timestamp":1740371114000},"page":"1144-1156","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":22,"title":["Safety and Effectiveness of Multisite Transcutaneous Spinal Cord Stimulation Combined With Activity-Based Therapy When Delivered in a Community Rehabilitation Setting: A Real-World Pilot Study"],"prefix":"10.1016","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8541-5584","authenticated-orcid":false,"given":"Jenny","family":"Suggitt","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jane","family":"Symonds","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica M.","family":"D\u2019Amico","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.neurom.2025.01.005_bib1","doi-asserted-by":"crossref","DOI":"10.1093\/ptj\/pzab228","article-title":"Multisite transcutaneous spinal stimulation for walking and autonomic recovery in motor-incomplete tetraplegia: a single-subject design","volume":"102","author":"Samejima","year":"2022","journal-title":"Phys Ther"},{"key":"10.1016\/j.neurom.2025.01.005_bib2","doi-asserted-by":"crossref","first-page":"385","DOI":"10.1016\/S0003-9993(99)90274-5","article-title":"Relation of disability costs to function: spinal cord injury","volume":"80","author":"Hamilton","year":"1999","journal-title":"Arch Phys Med Rehabil"},{"issue":"suppl 1","key":"10.1016\/j.neurom.2025.01.005_bib3","first-page":"1","article-title":"The conducting and processing capabilities of the human lumbar cord network and \u201cspinal brain\u201d","volume":"58","author":"Dimitrijevic","year":"2013","journal-title":"Biomed Eng Biomed Tech"},{"key":"10.1016\/j.neurom.2025.01.005_bib4","first-page":"1124","article-title":"Iron \u2018ElectriRx\u2019 man: overground stepping in an exoskeleton combined with noninvasive spinal cord stimulation after paralysis","volume":"2015","author":"Gad","year":"2015","journal-title":"Annu Int Conf IEEE Eng Med Biol Soc"},{"key":"10.1016\/j.neurom.2025.01.005_bib5","doi-asserted-by":"crossref","first-page":"1968","DOI":"10.1089\/neu.2015.4008","article-title":"Noninvasive reactivation of motor descending control after paralysis","volume":"32","author":"Gerasimenko","year":"2015","journal-title":"J Neurotrauma"},{"key":"10.1016\/j.neurom.2025.01.005_bib6","series-title":"Electrotherapy Explained: Principles and Practice","author":"Robertson","year":"2008"},{"key":"10.1016\/j.neurom.2025.01.005_bib7","doi-asserted-by":"crossref","first-page":"1394","DOI":"10.1093\/brain\/awu038","article-title":"Altering spinal cord excitability enables voluntary movements after chronic complete paralysis in humans","volume":"137","author":"Angeli","year":"2014","journal-title":"Brain"},{"key":"10.1016\/j.neurom.2025.01.005_bib8","doi-asserted-by":"crossref","first-page":"432","DOI":"10.3389\/fnins.2018.00432","article-title":"Non-invasive neuromodulation of spinal cord restores lower urinary tract function after paralysis","volume":"12","author":"Gad","year":"2018","journal-title":"Front Neurosci"},{"key":"10.1016\/j.neurom.2025.01.005_bib9","doi-asserted-by":"crossref","first-page":"2325","DOI":"10.1089\/neu.2018.6006","article-title":"Epidural spinal cord stimulation facilitates immediate restoration of dormant motor and autonomic supraspinal pathways after chronic neurologically complete spinal cord injury","volume":"36","author":"Darrow","year":"2019","journal-title":"J Neurotrauma"},{"key":"10.1016\/j.neurom.2025.01.005_bib10","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1016\/S1350-4533(02)00040-1","article-title":"Functional electrical stimulation and rehabilitation--an hypothesis","volume":"25","author":"Rushton","year":"2003","journal-title":"Med Eng Phys"},{"key":"10.1016\/j.neurom.2025.01.005_bib11","doi-asserted-by":"crossref","first-page":"1182","DOI":"10.1126\/science.1217416","article-title":"Restoring voluntary control of locomotion after paralyzing spinal cord injury","volume":"336","author":"van den Brand","year":"2012","journal-title":"Science"},{"issue":"suppl 3","key":"10.1016\/j.neurom.2025.01.005_bib12","doi-asserted-by":"crossref","first-page":"S39","DOI":"10.1097\/NPT.0000000000000184","article-title":"Activity-based therapy: from basic science to clinical application for recovery after spinal cord injury","volume":"41","author":"Behrman","year":"2017","journal-title":"J Neurol Phys Ther"},{"key":"10.1016\/j.neurom.2025.01.005_bib13","doi-asserted-by":"crossref","first-page":"64","DOI":"10.1186\/s40814-016-0105-8","article-title":"CONSORT 2010 statement: extension to randomised pilot and feasibility trials","volume":"2","author":"Eldridge","year":"2016","journal-title":"Pilot Feasibility Stud"},{"key":"10.1016\/j.neurom.2025.01.005_bib14","doi-asserted-by":"crossref","first-page":"403","DOI":"10.1089\/neu.2014.3536","article-title":"Preserved sensory-motor function despite large-scale morphological alterations in a series of patients with holocord syringomyelia","volume":"32","author":"Awai","year":"2015","journal-title":"J Neurotrauma"},{"key":"10.1016\/j.neurom.2025.01.005_bib15","doi-asserted-by":"crossref","first-page":"276","DOI":"10.1080\/02688690220148879","article-title":"Posttraumatic syringomyelia: predisposing factors","volume":"16","author":"Vannemreddy","year":"2002","journal-title":"Br J Neurosurg"},{"key":"10.1016\/j.neurom.2025.01.005_bib16","doi-asserted-by":"crossref","first-page":"265","DOI":"10.1038\/sc.2014.246","article-title":"Common data elements for spinal cord injury clinical research: a National Institute for Neurological Disorders and Stroke project","volume":"53","author":"Biering-S\u00f8rensen","year":"2015","journal-title":"Spinal Cord"},{"key":"10.1016\/j.neurom.2025.01.005_bib17","doi-asserted-by":"crossref","first-page":"528","DOI":"10.1177\/1545968315605181","article-title":"Responsiveness of the neuromuscular recovery scale during outpatient activity-dependent rehabilitation for spinal cord injury","volume":"30","author":"Tester","year":"2016","journal-title":"Neurorehabil Neural Repair"},{"key":"10.1016\/j.neurom.2025.01.005_bib18","doi-asserted-by":"crossref","first-page":"1518","DOI":"10.1016\/j.apmr.2011.04.027","article-title":"Assessment of functional improvement without compensation reduces variability of outcome measures after human spinal cord injury","volume":"93","author":"Behrman","year":"2012","journal-title":"Arch Phys Med Rehabil"},{"key":"10.1016\/j.neurom.2025.01.005_bib19","doi-asserted-by":"crossref","first-page":"505","DOI":"10.1016\/j.pmr.2014.04.001","article-title":"Updates for the international standards for neurological classification of spinal cord injury","volume":"25","author":"Kirshblum","year":"2014","journal-title":"Phys Med Rehabil Clin N Am"},{"key":"10.1016\/j.neurom.2025.01.005_bib20","doi-asserted-by":"crossref","first-page":"27","DOI":"10.2340\/1650197719952736","article-title":"The balance scale: reliability assessment with elderly residents and patients with an acute stroke","volume":"27","author":"Berg","year":"1995","journal-title":"Scand J Rehabil Med"},{"key":"10.1016\/j.neurom.2025.01.005_bib21","doi-asserted-by":"crossref","first-page":"905","DOI":"10.1089\/neu.2010.1504","article-title":"The graded redefined assessment of strength sensibility and prehension: reliability and validity","volume":"29","author":"Kalsi-Ryan","year":"2012","journal-title":"J Neurotrauma"},{"key":"10.1016\/j.neurom.2025.01.005_bib22","doi-asserted-by":"crossref","first-page":"1890","DOI":"10.1016\/j.apmr.2004.02.032","article-title":"A validity study of the WHOQOL-bref assessment in persons with traumatic spinal cord injury","volume":"85","author":"Jang","year":"2004","journal-title":"Arch Phys Med Rehabil"},{"key":"10.1016\/j.neurom.2025.01.005_bib23","doi-asserted-by":"crossref","first-page":"850","DOI":"10.1038\/sj.sc.3100504","article-title":"SCIM--spinal cord independence measure: a new disability scale for patients with spinal cord lesions","volume":"35","author":"Catz","year":"1997","journal-title":"Spinal Cord"},{"key":"10.1016\/j.neurom.2025.01.005_bib24","first-page":"1348","article-title":"The assessment of maximal respiratory mouth pressures in adults","volume":"54","author":"Evans","year":"2009","journal-title":"Respir Care"},{"key":"10.1016\/j.neurom.2025.01.005_bib25","first-page":"84","article-title":"Pulmonary function tests","volume":"80","author":"Ranu","year":"2011","journal-title":"Ulster Med J"},{"key":"10.1016\/j.neurom.2025.01.005_bib26","doi-asserted-by":"crossref","first-page":"310","DOI":"10.1109\/TNSRE.2021.3049133","article-title":"Transcutaneous spinal cord stimulation restores hand and arm function after spinal cord injury","volume":"29","author":"Inanici","year":"2021","journal-title":"IEEE Trans Neural Syst Rehabil Eng"},{"key":"10.1016\/j.neurom.2025.01.005_bib27","doi-asserted-by":"crossref","first-page":"1276","DOI":"10.1038\/s41591-024-02940-9","article-title":"Non-invasive spinal cord electrical stimulation for arm and hand function in chronic tetraplegia: a safety and efficacy trial","volume":"30","author":"Moritz","year":"2024","journal-title":"Nat Med"},{"key":"10.1016\/j.neurom.2025.01.005_bib28","doi-asserted-by":"crossref","first-page":"423","DOI":"10.1080\/10749357.2021.1943800","article-title":"The minimal clinically important difference in Berg balance scale scores among patients with early subacute stroke: a multicenter, retrospective, observational study","volume":"29","author":"Tamura","year":"2022","journal-title":"Top Stroke Rehabil"},{"key":"10.1016\/j.neurom.2025.01.005_bib29","doi-asserted-by":"crossref","first-page":"656","DOI":"10.1080\/09638280701400698","article-title":"The relative and absolute reliability of two balance performance measures in chronic stroke patients","volume":"30","author":"Liaw","year":"2008","journal-title":"Disabil Rehabil"},{"key":"10.1016\/j.neurom.2025.01.005_bib30","doi-asserted-by":"crossref","first-page":"733","DOI":"10.2522\/ptj.20070214","article-title":"Test-retest reliability and minimal detectable change on balance and ambulation tests, the 36-item short-form health survey, and the unified Parkinson disease rating scale in people with parkinsonism","volume":"88","author":"Steffen","year":"2008","journal-title":"Phys Ther"},{"key":"10.1016\/j.neurom.2025.01.005_bib31","doi-asserted-by":"crossref","first-page":"942","DOI":"10.2522\/ptj.20130032","article-title":"Reliability and minimal detectable change of physical performance measures in individuals with pre-manifest and manifest Huntington disease","volume":"93","author":"Quinn","year":"2013","journal-title":"Phys Ther"},{"key":"10.1016\/j.neurom.2025.01.005_bib32","doi-asserted-by":"crossref","first-page":"1645","DOI":"10.1089\/neu.2021.0500","article-title":"Minimal clinically important difference of graded redefined assessment of strength, sensibility, and prehension version 1 in acute cervical traumatic spinal cord injury","volume":"39","author":"Kalsi-Ryan","year":"2022","journal-title":"J Neurotrauma"},{"key":"10.1016\/j.neurom.2025.01.005_bib33","first-page":"373","article-title":"Distribution-based estimates of clinically significant changes in the international standards for neurological classification of spinal cord injury motor and sensory scores","volume":"49","author":"Scivoletto","year":"2013","journal-title":"Eur J Phys Rehabil Med"},{"key":"10.1016\/j.neurom.2025.01.005_bib34","doi-asserted-by":"crossref","first-page":"555","DOI":"10.1016\/j.apmr.2017.10.003","article-title":"Longitudinal recovery and reduced costs after 120 sessions of locomotor training for motor incomplete spinal cord injury","volume":"99","author":"Morrison","year":"2018","journal-title":"Arch Phys Med Rehabil"},{"key":"10.1016\/j.neurom.2025.01.005_bib35","doi-asserted-by":"crossref","first-page":"1389","DOI":"10.1007\/s11136-020-02724-x","article-title":"Quality of life under the COVID-19 quarantine","volume":"30","author":"Ferreira","year":"2021","journal-title":"Qual Life Res"},{"key":"10.1016\/j.neurom.2025.01.005_bib36","doi-asserted-by":"crossref","first-page":"648","DOI":"10.1002\/j.1532-2149.2011.00060.x","article-title":"Effects of sub-perception threshold spinal cord stimulation in neuropathic pain: a randomized controlled double-blind crossover study","volume":"16","author":"Wolter","year":"2012","journal-title":"Eur J Pain"},{"key":"10.1016\/j.neurom.2025.01.005_bib37","doi-asserted-by":"crossref","first-page":"108","DOI":"10.1186\/1743-0003-10-108","article-title":"Sub-threshold spinal cord stimulation facilitates spontaneous motor activity in spinal rats","volume":"10","author":"Gad","year":"2013","journal-title":"J Neuroeng Rehabil"},{"key":"10.1016\/j.neurom.2025.01.005_bib38","doi-asserted-by":"crossref","DOI":"10.1088\/1741-2552\/ab8fc4","article-title":"Anatomical and technical factors affecting the neural response to epidural spinal cord stimulation","volume":"17","author":"Zander","year":"2020","journal-title":"J Neural Eng"}],"container-title":["Neuromodulation: Technology at the Neural Interface"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1094715925000078?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1094715925000078?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2025,11,21]],"date-time":"2025-11-21T16:26:17Z","timestamp":1763742377000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S1094715925000078"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10]]},"references-count":38,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2025,10]]}},"alternative-id":["S1094715925000078"],"URL":"https:\/\/doi.org\/10.1016\/j.neurom.2025.01.005","relation":{},"ISSN":["1094-7159"],"issn-type":[{"value":"1094-7159","type":"print"}],"subject":[],"published":{"date-parts":[[2025,10]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Safety and Effectiveness of Multisite Transcutaneous Spinal Cord Stimulation Combined With Activity-Based Therapy When Delivered in a Community Rehabilitation Setting: A Real-World Pilot Study","name":"articletitle","label":"Article Title"},{"value":"Neuromodulation: Technology at the Neural Interface","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.neurom.2025.01.005","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2025 The Authors. Published by Elsevier Inc. on behalf of the International Neuromodulation Society.","name":"copyright","label":"Copyright"}]}}