{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T16:54:27Z","timestamp":1790700867080,"version":"4.1.0"},"reference-count":47,"publisher":"MDPI AG","issue":"13","license":[{"start":{"date-parts":[[2022,6,25]],"date-time":"2022-06-25T00:00:00Z","timestamp":1656115200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000065","name":"National Institutes of Health-NINDS","doi-asserted-by":"publisher","award":["R01NS102920-02"],"award-info":[{"award-number":["R01NS102920-02"]}],"id":[{"id":"10.13039\/100000065","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000065","name":"National Institutes of Health-NINDS","doi-asserted-by":"publisher","award":["075-15-2020-92"],"award-info":[{"award-number":["075-15-2020-92"]}],"id":[{"id":"10.13039\/100000065","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Ministry of Science and Higher Education of the Russian Federation","award":["R01NS102920-02"],"award-info":[{"award-number":["R01NS102920-02"]}]},{"name":"Ministry of Science and Higher Education of the Russian Federation","award":["075-15-2020-92"],"award-info":[{"award-number":["075-15-2020-92"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>It has been suggested that neuroplasticity-promoting neuromodulation can restore sensory-motor pathways after spinal cord injury (SCI), reactivating the dormant locomotor neuronal circuitry. We introduce a neuro-rehabilitative approach that leverages locomotor training with multi-segmental spinal cord transcutaneous electrical stimulation (scTS). We hypothesized that scTS neuromodulates spinal networks, complementing the neuroplastic effects of locomotor training, result in a functional progression toward recovery of locomotion. We conducted a case-study to test this approach on a 27-year-old male classified as AIS A with chronic SCI. The training regimen included task-driven non-weight-bearing training (1 month) followed by weight-bearing training (2 months). Training was paired with multi-level continuous and phase-dependent scTS targeting function-specific motor pools. Results suggest a convergence of cross-lesional networks, improving kinematics during voluntary non-weight-bearing locomotor-like stepping. After weight-bearing training, coordination during stepping improved, suggesting an important role of afferent feedback in further improvement of voluntary control and reorganization of the sensory-motor brain-spinal connectome.<\/jats:p>","DOI":"10.3390\/jcm11133670","type":"journal-article","created":{"date-parts":[[2022,6,26]],"date-time":"2022-06-26T09:00:13Z","timestamp":1656234013000},"page":"3670","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":35,"title":["Novel Noninvasive Spinal Neuromodulation Strategy Facilitates Recovery of Stepping after Motor Complete Paraplegia"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3302-5496","authenticated-orcid":false,"given":"Ricardo","family":"Siu","sequence":"first","affiliation":[{"name":"Kentucky Spinal Cord Injury Research Center, University of Louisville, Louisville, KY 40202, USA"},{"name":"Department of Neurological Surgery, University of Louisville, Louisville, KY 40202, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edward H.","family":"Brown","sequence":"additional","affiliation":[{"name":"Kentucky Spinal Cord Injury Research Center, University of Louisville, Louisville, KY 40202, USA"},{"name":"Department of Neurological Surgery, University of Louisville, Louisville, KY 40202, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samineh","family":"Mesbah","sequence":"additional","affiliation":[{"name":"Kentucky Spinal Cord Injury Research Center, University of Louisville, Louisville, KY 40202, USA"},{"name":"Department of Neurological Surgery, University of Louisville, Louisville, KY 40202, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federica","family":"Gonnelli","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Udine, 33100 Udine, Italy"},{"name":"School of Sport Sciences, University of Udine, 33100 Udine, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tanvi","family":"Pisolkar","sequence":"additional","affiliation":[{"name":"Kentucky Spinal Cord Injury Research Center, University of Louisville, Louisville, KY 40202, USA"},{"name":"Department of Neurological Surgery, University of Louisville, Louisville, KY 40202, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6534-1875","authenticated-orcid":false,"given":"V. Reggie","family":"Edgerton","sequence":"additional","affiliation":[{"name":"Department of Neurobiology, University of California, Los Angeles, CA 90095, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander V.","family":"Ovechkin","sequence":"additional","affiliation":[{"name":"Kentucky Spinal Cord Injury Research Center, University of Louisville, Louisville, KY 40202, USA"},{"name":"Department of Neurological Surgery, University of Louisville, Louisville, KY 40202, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9345-3791","authenticated-orcid":false,"given":"Yury P.","family":"Gerasimenko","sequence":"additional","affiliation":[{"name":"Kentucky Spinal Cord Injury Research Center, University of Louisville, Louisville, KY 40202, USA"},{"name":"Department of Physiology, University of Louisville, Louisville, KY 40292, USA"},{"name":"Pavlov Institute of Physiology, Russian Academy of Sciences, 199034 St. Petersburg, Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,6,25]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"3362","DOI":"10.1093\/brain\/awt265","article-title":"Use of quadrupedal step training to re-engage spinal interneuronal networks and improve locomotor function after spinal cord injury","volume":"136","author":"Shah","year":"2013","journal-title":"Brain"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1152\/jn.1999.81.1.85","article-title":"Retention of hindlimb stepping ability in adult spinal cats after the cessation of step training","volume":"81","author":"Hodgson","year":"1999","journal-title":"J. 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