{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:50:36Z","timestamp":1787028636305,"version":"build-2736575974"},"reference-count":78,"publisher":"MDPI AG","issue":"13","license":[{"start":{"date-parts":[[2023,6,30]],"date-time":"2023-06-30T00:00:00Z","timestamp":1688083200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100007028","name":"Leona M. and Harry B. Helmsley Charitable","doi-asserted-by":"publisher","award":["2016PG-MED001"],"award-info":[{"award-number":["2016PG-MED001"]}],"id":[{"id":"10.13039\/100007028","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100007028","name":"Leona M. and Harry B. 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Helmsley Charitable","doi-asserted-by":"publisher","award":["075-15-2020-921"],"award-info":[{"award-number":["075-15-2020-921"]}],"id":[{"id":"10.13039\/100007028","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Kessler Foundation","award":["2016PG-MED001"],"award-info":[{"award-number":["2016PG-MED001"]}]},{"name":"Kessler Foundation","award":["1R01 NS102920-01A1"],"award-info":[{"award-number":["1R01 NS102920-01A1"]}]},{"name":"Kessler Foundation","award":["075-15-2020-921"],"award-info":[{"award-number":["075-15-2020-921"]}]},{"name":"National Institutes of Health","award":["2016PG-MED001"],"award-info":[{"award-number":["2016PG-MED001"]}]},{"name":"National Institutes of Health","award":["1R01 NS102920-01A1"],"award-info":[{"award-number":["1R01 NS102920-01A1"]}]},{"name":"National Institutes of Health","award":["075-15-2020-921"],"award-info":[{"award-number":["075-15-2020-921"]}]},{"name":"Program of Pavlov Scientific World-Class Center","award":["2016PG-MED001"],"award-info":[{"award-number":["2016PG-MED001"]}]},{"name":"Program of Pavlov Scientific World-Class Center","award":["1R01 NS102920-01A1"],"award-info":[{"award-number":["1R01 NS102920-01A1"]}]},{"name":"Program of Pavlov Scientific World-Class Center","award":["075-15-2020-921"],"award-info":[{"award-number":["075-15-2020-921"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Individuals with cervical spinal cord injury (SCI) rank regaining arm and hand function as their top rehabilitation priority post-injury. Cervical spinal cord transcutaneous stimulation (scTS) combined with activity-based recovery training (ABRT) is known to effectively facilitate upper extremity sensorimotor recovery in individuals with residual arm and hand function post SCI. However, scTS effectiveness in facilitating upper extremity recovery in individuals with severe SCI with minimal to no sensory and motor preservation below injury level remains largely unknown. We herein introduced a multimodal neuro-rehabilitative approach involving scTS targeting systematically identified various spinal segments combined with ABRT. We hypothesized that multi-site scTS combined with ABRT will effectively neuromodulate the spinal networks, resulting in improved integration of ascending and descending neural information required for sensory and motor recovery in individuals with severe cervical SCI. To test the hypothesis, a 53-year-old male (C2, AIS A, 8 years post-injury) received 60 ABRT sessions combined with continuous multi-site scTS. Post-training assessments revealed improved activation of previously paralyzed upper extremity muscles and sensory improvements over the dorsal and volar aspects of the hand. Most likely, altered spinal cord excitability and improved muscle activation and sensations resulted in observed sensorimotor recovery. However, despite promising neurophysiological evidence pertaining to motor re-activation, we did not observe visually appreciable functional recovery on obtained upper extremity motor assessments.<\/jats:p>","DOI":"10.3390\/jcm12134416","type":"journal-article","created":{"date-parts":[[2023,7,3]],"date-time":"2023-07-03T00:49:27Z","timestamp":1688345367000},"page":"4416","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Multi-Site Spinal Cord Transcutaneous Stimulation Facilitates Upper Limb Sensory and Motor Recovery in Severe Cervical Spinal Cord Injury: A Case Study"],"prefix":"10.3390","volume":"12","author":[{"given":"Pawan","family":"Sharma","sequence":"first","affiliation":[{"name":"Kentucky Spinal Cord Injury Research Center, University of Louisville, Louisville, KY 40202, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tudor","family":"Panta","sequence":"additional","affiliation":[{"name":"Kentucky Spinal Cord Injury Research Center, University of Louisville, Louisville, KY 40202, USA"},{"name":"Frazier Rehabilitation Institute, University of Louisville Health, Louisville, KY 40202, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beatrice","family":"Ugiliweneza","sequence":"additional","affiliation":[{"name":"Kentucky Spinal Cord Injury Research Center, University of Louisville, Louisville, KY 40202, USA"},{"name":"Department of Health Management and Systems Science, 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":"Robert J.","family":"Bert","sequence":"additional","affiliation":[{"name":"Department of Radiology, University of Louisville, Louisville, KY 40202, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yury","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 Saint Petersburg, Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gail","family":"Forrest","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine & Rehabilitation, Rutgers New Jersey Medical School, Newark, NJ 07052, USA"},{"name":"Kessler Foundation, Newark, NJ 07052, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan","family":"Harkema","sequence":"additional","affiliation":[{"name":"Kentucky Spinal Cord Injury Research Center, University of Louisville, Louisville, KY 40202, USA"},{"name":"Frazier Rehabilitation Institute, University of Louisville Health, Louisville, KY 40202, USA"},{"name":"Department of Neurological Surgery, University of Louisville, Louisville, KY 40202, USA"},{"name":"Department of Bioengineering, University of Louisville, Louisville, KY 40202, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,6,30]]},"reference":[{"key":"ref_1","unstructured":"Birmingham, U. 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