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An emergent method that activates similar target neural structures non-invasively is transcutaneous SCS. Its clinical value for spasticity control would depend on inducing carry-over effects, because the surface-electrode-based approach cannot be applied chronically. We evaluated single-session effects of transcutaneous lumbar SCS in 12 individuals with SCI by a test-battery approach, before, immediately after and 2\u2009h after intervention. Stimulation was applied for 30\u2009min at 50\u2009Hz with an intensity sub-threshold for eliciting reflexes in lower extremity muscles. The tests included evaluations of stretch-induced spasticity (Modified Ashworth Scale [MAS] sum score, pendulum test, electromyography-based evaluation of tonic stretch reflexes), clonus, cutaneous-input-evoked spasms, and the timed 10\u2009m walk test. Across participants, the MAS sum score, clonus, and spasms were significantly reduced immediately after SCS, and all spasticity measures were improved 2\u2009h post-intervention, with large effect sizes and including clinically meaningful improvements. The effect on walking speed varied across individuals. We further conducted a single-case multi-session study over 6 weeks to explore the applicability of transcutaneous SCS as a home-based therapy. Self-application of the intervention was successful; weekly evaluations suggested progressively improving therapeutic effects during the active period and carry-over effects for 7 days. Our results suggest that transcutaneous SCS can be a viable non-pharmacological option for managing spasticity, likely working through enhancing pre- and post-synaptic spinal inhibitory mechanisms, and may additionally serve to identify responders to treatments with epidural SCS.<\/jats:p>","DOI":"10.1089\/neu.2019.6588","type":"journal-article","created":{"date-parts":[[2019,7,23]],"date-time":"2019-07-23T07:18:42Z","timestamp":1563866322000},"page":"481-493","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":153,"title":["Transcutaneous Spinal Cord Stimulation Induces Temporary Attenuation of Spasticity in Individuals with Spinal Cord Injury"],"prefix":"10.1177","volume":"37","author":[{"given":"Ursula S.","family":"Hofstoetter","sequence":"first","affiliation":[{"name":"Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brigitta","family":"Freundl","sequence":"additional","affiliation":[{"name":"Neurological Center, SMZ Baumgartner Hoehe, Otto-Wagner-Hospital, Vienna, Austria."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simon M.","family":"Danner","sequence":"additional","affiliation":[{"name":"Department of Neurobiology and Anatomy, Drexel University College of Medicine, Philadelphia, Pennsylvania."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthias J.","family":"Krenn","sequence":"additional","affiliation":[{"name":"Department of Neurobiology and Anatomical Sciences, University of Mississippi Medical Center, Jackson, Mississippi."},{"name":"Center for Neuroscience and Neurological Recovery, Methodist Rehabilitation Center, Jackson, Mississippi."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Winfried","family":"Mayr","sequence":"additional","affiliation":[{"name":"Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heinrich","family":"Binder","sequence":"additional","affiliation":[{"name":"Neurological Center, SMZ Baumgartner Hoehe, Otto-Wagner-Hospital, Vienna, Austria."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen","family":"Minassian","sequence":"additional","affiliation":[{"name":"Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2020,1,9]]},"reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1080\/09638280400014576"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1748-1716.2006.01652.x"},{"key":"e_1_3_4_4_2","first-page":"566","article-title":"Epidemiology of spasticity following traumatic spinal cord injury","volume":"71","author":"Maynard F.M.","year":"1990","unstructured":"Maynard F.M., , Karunas R.S., , and Waring W.P. 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