{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T03:02:05Z","timestamp":1784602925793,"version":"3.55.0"},"reference-count":182,"publisher":"American Spinal Injury Association","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023]]},"abstract":"<jats:p>Neuromodulation via spinal stimulation is a promising therapy that can augment the neuromuscular capacity for voluntary movements, standing, stepping, and posture in individuals with spinal cord injury (SCI). The spinal locomotor-related neuronal network known as a central pattern generator (CPG) can generate a stepping-like motor output in the absence of movement-related afferent signals from the limbs. Using epidural stimulation (EP) in conjunction with activity-based locomotor training (ABLT), the neural circuits can be neuromodulated to facilitate the recovery of locomotor functions in persons with SCI. Recently, transcutaneous spinal stimulation (scTS) has been developed as a noninvasive alternative to EP. Early studies of scTS at thoracolumbar, coccygeal, and cervical regions have demonstrated its effectiveness in producing voluntary leg movements, posture control, and independent standing and improving upper extremity function in adults with chronic SCI. In pediatric studies, the technology of spinal neuromodulation is not yet widespread. There are a limited number of publications reporting on the use of scTS in children and adolescents with either cerebral palsy, spina bifida, or SCI.<\/jats:p>","DOI":"10.46292\/sci21-00084","type":"journal-article","created":{"date-parts":[[2022,12,9]],"date-time":"2022-12-09T16:00:47Z","timestamp":1670601647000},"page":"16-32","source":"Crossref","is-referenced-by-count":26,"title":["Transcutaneous Spinal Stimulation From Adults to Children: A Review"],"prefix":"10.46292","volume":"29","author":[{"given":"Goutam","family":"Singh","sequence":"first","affiliation":[{"name":"Kosair Charities School of Physical Therapy, Spalding University, Louisville, Kentucky"},{"name":"Kentucky Spinal Cord Injury Research Center, University of Louisville, Louisville, Kentucky"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathryn","family":"Lucas","sequence":"additional","affiliation":[{"name":"Kentucky Spinal Cord Injury Research Center, University of Louisville, Louisville, Kentucky"},{"name":"Department of Neurological Surgery, University of Louisville, Louisville, Kentucky"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anastasia","family":"Keller","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of California, San Francisco, San Francisco, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca","family":"Martin","sequence":"additional","affiliation":[{"name":"International Center for Spinal Cord Injury, Hugo W. Moser Research Institute at Kennedy Krieger Institute, Baltimore, Maryland"},{"name":"Department of Physical Medicine and Rehabilitation, The Johns Hopkins University School of Medicine, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Behrman","sequence":"additional","affiliation":[{"name":"Kentucky Spinal Cord Injury Research Center, University of Louisville, Louisville, Kentucky"},{"name":"Department of Neurological Surgery, University of Louisville, Louisville, Kentucky"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sergey","family":"Vissarionov","sequence":"additional","affiliation":[{"name":"Turner Scientific Research Institute for Children\u2019s Orthopedics, St. Petersburg, Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yury P.","family":"Gerasimenko","sequence":"additional","affiliation":[{"name":"Kentucky Spinal Cord Injury Research Center, University of Louisville, Louisville, Kentucky"},{"name":"Department of Physiology, University of Louisville, Louisville, Kentucky"},{"name":"Pavlov Institute of Physiology Russian Academy of Sciences, St. Petersburg, Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"25425","reference":[{"key":"i1945-5763-29-1-16-b1","series-title":"Sensorimotor Control. 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Res.\n\t\t\t\t\t2012;\n\t\t\t\t\t223(\n\t\t\t\t\t2):\n\t\t\t\t\t281\u2013\n\t\t\t\t\t289."},{"issue":"4","key":"i1945-5763-29-1-16-b64","series-title":"J Neurophysiol","first-page":"1699","article-title":"Plasticity of spinal cord reflexes after a complete transection in adult rats: Relationship to stepping ability","volume":"96","year":"2006","unstructured":"Lavrov\n              I,\n            \n            \n              Gerasimenko\n              YP,\n            \n            \n              Ichiyama\n              RM,\n            \n          \n          .\n\t\t\t\t\tPlasticity of spinal cord reflexes after a complete transection in adult rats: Relationship to stepping ability.\n\t\t\t\t\tJ Neurophysiol.\n\t\t\t\t\t2006;\n\t\t\t\t\t96(\n\t\t\t\t\t4):\n\t\t\t\t\t1699\u2013\n\t\t\t\t\t1710."},{"issue":"Pt 3","key":"i1945-5763-29-1-16-b65","series-title":"J Physiol","first-page":"1125","article-title":"Modulation of multisegmental monosynaptic responses in a variety of leg muscles during walking and running in humans","volume":"582","year":"2007","unstructured":"Courtine\n              G,\n            \n            \n              Harkema\n              SJ,\n            \n            \n              Dy\n              CJ,\n            \n            \n              Gerasimenko\n              YP,\n            \n            \n              Dyhre-Poulsen\n              P.\n            \n          \n          Modulation of multisegmental monosynaptic responses in a variety of leg muscles during walking and running in humans.\n\t\t\t\t\tJ Physiol.\n\t\t\t\t\t2007;\n\t\t\t\t\t582(\n\t\t\t\t\tPt 3):\n\t\t\t\t\t1125\u2013\n\t\t\t\t\t1139."},{"issue":"2","key":"i1945-5763-29-1-16-b66","series-title":"Neuromodulation","first-page":"63","article-title":"Epidural spinal cord stimulation: Anatomical and electrical properties of the intraspinal structures relevant to spinal cord stimulation and clinical correlations","volume":"1","year":"1998","unstructured":"Barolat\n              G.\n            \n          \n          Epidural spinal cord stimulation: Anatomical and electrical properties of the intraspinal structures relevant to spinal cord stimulation and clinical correlations.\n\t\t\t\t\tNeuromodulation.\n\t\t\t\t\t1998;\n\t\t\t\t\t1(\n\t\t\t\t\t2):\n\t\t\t\t\t63\u2013\n\t\t\t\t\t71."},{"key":"i1945-5763-29-1-16-b67","series-title":"Neurosurgery Quarterly","first-page":"98","article-title":"Current status of epidural spinal cord stimulation","volume":"5","year":"1995","unstructured":"Barolat\n              G.\n            \n          \n          Current status of epidural spinal cord stimulation.\n\t\t\t\t\tNeurosurgery Quarterly.\n\t\t\t\t\t1995;\n\t\t\t\t\t5:\n\t\t\t\t\t98\u2013\n\t\t\t\t\t124."},{"key":"i1945-5763-29-1-16-b68","series-title":"Isokinet Exerc Sci","first-page":"167","article-title":"Comparison of peak torque, intensity and discomfort generated by neuromuscular electrical stimulation of low and medium frequency","volume":"21","year":"2013","unstructured":"Fukuda\n              TY,\n            \n            \n              Marcondes\n              FB,\n            \n            \n              dos Anjos Rabelo\n              N,\n            \n            \n              de Vasconcelos\n              RA,\n            \n            \n              Junior\n              CC.\n            \n          \n          Comparison of peak torque, intensity and discomfort generated by neuromuscular electrical stimulation of low and medium frequency.\n\t\t\t\t\tIsokinet Exerc Sci.\n\t\t\t\t\t2013;\n\t\t\t\t\t21:\n\t\t\t\t\t167\u2013\n\t\t\t\t\t173."},{"issue":"8","key":"i1945-5763-29-1-16-b69","series-title":"The I Orthop Sports Phys Ther","first-page":"508","article-title":"The role of pulse duration and stimulation duration in maximizing the normalized torque during neuromuscular electrical stimulation","volume":"38","year":"2008","unstructured":"Gorgey\n              AS,\n            \n         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different waveforms.\n\t\t\t\t\tPhys Ther.\n\t\t\t\t\t2001;\n\t\t\t\t\t81(\n\t\t\t\t\t7):\n\t\t\t\t\t1307\u2013\n\t\t\t\t\t1316."},{"issue":"10","key":"i1945-5763-29-1-16-b71","series-title":"Eur J Appl Physiol","first-page":"2399","article-title":"Motor unit recruitment during neuromuscular electrical stimulation: A critical appraisal","volume":"111","year":"2011","unstructured":"Bickel\n              CS,\n            \n            \n              Gregory\n              CM,\n            \n            \n              Dean\n              JC.\n            \n          \n          Motor unit recruitment during neuromuscular electrical stimulation: A critical appraisal.\n\t\t\t\t\tEur J Appl Physiol.\n\t\t\t\t\t2011;\n\t\t\t\t\t111(\n\t\t\t\t\t10):\n\t\t\t\t\t2399."},{"issue":"5","key":"i1945-5763-29-1-16-b72","series-title":"Biomed Eng","first-page":"300","article-title":"A five-channel noninvasive electrical stimulator of the spinal cord for rehabilitation of patients with severe motor disorders","volume":"50","year":"2017","unstructured":"Grishin\n              AA,\n            \n            \n              Moshonkina\n              TR,\n            \n            \n              Solopova\n              IA,\n            \n            \n              Gorodnichev\n              RM,\n            \n            \n              Gerasimenko\n              YP.\n            \n          \n          A five-channel noninvasive electrical stimulator of the spinal cord for rehabilitation of patients with severe motor disorders.\n\t\t\t\t\tBiomed Eng.\n\t\t\t\t\t2017;\n\t\t\t\t\t50(\n\t\t\t\t\t5):\n\t\t\t\t\t300\u2013\n\t\t\t\t\t304."},{"issue":"1","key":"i1945-5763-29-1-16-b73","series-title":"Spinal Cord Series Cases","first-page":"104","article-title":"Feasibility and utility of transcutaneous spinal cord stimulation combined with walking-based therapy for people with motor incomplete spinal cord injury","volume":"6","year":"2020","unstructured":"McHugh\n              LV,\n      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cord","volume":"93","year":"2016","unstructured":"Nikityuk\n              IE,\n            \n            \n              Moshonkina\n              TR,\n            \n            \n              Gerasimenko\n              YP,\n            \n            \n              Vissarionov\n              SV,\n            \n            \n              Baindurashvili\n              AG.\n            \n          \n          The regulation of balance in the children presenting with severe cerebral palsy following the treatment with the use of the locomotor training in combination with the electrical stimulation of leg muscles and spinal cord.\n\t\t\t\t\tVopr Kurortol Fizioter Lech Fiz Kult.\n\t\t\t\t\t2016;\n\t\t\t\t\t93(\n\t\t\t\t\t5):\n\t\t\t\t\t23\u2013\n\t\t\t\t\t27."},{"key":"i1945-5763-29-1-16-b80","series-title":"Child Neurol Open","first-page":"6","article-title":"An exploratory electrical stimulation protocol in the management of an infant with spina bifida: A case report","year":"2019","unstructured":"Motavalli\n              G,\n            \n            \n              McElroy\n              J,\n            \n            \n              Alon\n              G.\n            \n          \n          An exploratory electrical stimulation protocol in the management of an infant with spina bifida: A case report.\n\t\t\t\t\tChild Neurol Open.\n\t\t\t\t\t2019;\n\t\t\t\t\t6."},{"issue":"2","key":"i1945-5763-29-1-16-b81","series-title":"Top Spinal Cord Inj Rehabil","first-page":"132","article-title":"Activity-based therapy targeting neuromuscular capacity after pediatric-onset spinal cord injury","volume":"25","year":"2019","unstructured":"Behrman\n              AL,\n            \n            \n              Argetsinger\n              LC,\n            \n            \n              Roberts\n              MT,\n            \n          \n          .\n\t\t\t\t\tActivity-based therapy targeting neuromuscular capacity after pediatric-onset spinal cord 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Cases.\n\t\t\t\t\t2020;\n\t\t\t\t\t6(\n\t\t\t\t\t1):\n\t\t\t\t\t13."},{"issue":"4","key":"i1945-5763-29-1-16-b84","series-title":"Dev Neurorehabil","first-page":"260","article-title":"Sensitivity to change and responsiveness of the Segmental Assessment of Trunk Control (SATCo) in children with spinal cord injury","volume":"22","year":"2019","unstructured":"Argetsinger\n              LC,\n            \n            \n              Trimble\n              SA,\n            \n            \n              Roberts\n              MT,\n            \n            \n              Thompson\n              JE,\n            \n            \n              Ugiliweneza\n              B,\n            \n            \n              Behrman\n              AL.\n            \n          \n          Sensitivity to change and responsiveness of the Segmental Assessment of Trunk Control (SATCo) in children with spinal cord injury.\n\t\t\t\t\tDev 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