{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T21:21:08Z","timestamp":1789852868396,"version":"4.0.1"},"reference-count":78,"publisher":"American Spinal Injury Association","issue":"Supplement1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>We examined the safety and feasibility of delivering a home-based transcutaneous spinal stimulation (TSS) program in persons with incomplete tetraplegia. We also explored the cardiovascular-autonomic safety during the program.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Males with chronic incomplete tetraplegia were invited to receive 4 weeks of supervised in-person education and training followed by 16 weeks of home-based training with assistance from a caregiver. Home-based training sessions (3 times weekly) were supervised by secured telehealth video-connect system that included monitoring blood pressure (BP) to ensure cardiovascular safety. Participants were randomized to either a TSS and blood flow restriction enhanced neuromuscular electrical stimulation exercise (BES) program (TSS+BES) or a sham TSS+BES group. Measurements were conducted at baseline 1 (BL1), BL2, post intervention (PI), and follow-up (Fw) including 60-degree head tilt with monitoring of blood pressure (BP) and pulmonary function tests.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Six participants completed the entire feasibility trial and were randomized into TSS+BES (\n                      <jats:italic>n<\/jats:italic>\n                      = 4) or sham TSS+BES (\n                      <jats:italic>n<\/jats:italic>\n                      = 2). Adherence rates were 80% \u00b1 15% and 95% \u00b1 7% for the TSS+BES and sham TSS+BES groups, respectively. Ten qualified participants were unable to enroll because of failure to identify a dedicated caregiver. No adverse events were reported during the trial. Home-based autonomic-cardiovascular safety of TSS+BES was ensured via reporting systolic BP during the entire session and absence of episodes of autonomic dysreflexia or orthostatic hypotension during the trial.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Home-based TSS is a feasible rehabilitation approach after incomplete tetraplegia. The feasibility trial provided evidence for the cardiovascular safety of TSS, with no participants developing autonomic adverse events over the 20-week education and training intervention period. Future clinical trials may deliver home-based TSS with caregiver assistance and telehealth supervision to increase access to neuromodulation treatment that may enhance autonomic nervous system and hemodynamic stability in persons with SCI.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.46292\/sci25-00116","type":"journal-article","created":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T02:17:19Z","timestamp":1776824239000},"page":"80-94","source":"Crossref","is-referenced-by-count":1,"title":["Feasibility of a Home-based Transcutaneous Spinal Stimulation Program on Autonomic-Cardiovascular Safety After Incomplete Tetraplegia"],"prefix":"10.46292","volume":"32","author":[{"given":"Muhammad Uzair","family":"Rehman","sequence":"first","affiliation":[{"name":"Spinal Cord Injury and Disorders Center, Richmond VA Medical Center, Richmond, Virginia"},{"name":"Department of Biomedical Engineering, Virginia Commonwealth University, Richmond, Virginia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Momal A.","family":"Wasim","sequence":"additional","affiliation":[{"name":"Spinal Cord Injury and Disorders Center, Richmond VA Medical Center, Richmond, Virginia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jakob N.","family":"Deitrich","sequence":"additional","affiliation":[{"name":"Spinal Cord Injury and Disorders Center, Richmond VA Medical Center, Richmond, Virginia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rajbir","family":"Chaggar","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation, VCU-Sheltering Arms Institute., Richmond, Virginia"},{"name":"Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University, Richmond, Virginia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy","family":"Lavis","sequence":"additional","affiliation":[{"name":"Spinal Cord Injury and Disorders Center, Richmond VA Medical Center, Richmond, Virginia"},{"name":"Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University, Richmond, Virginia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ronald T.","family":"Seel","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University, Richmond, Virginia"},{"name":"Center for Rehabilitation Science and Engineering, Virginia Commonwealth University, Richmond, Virginia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashraf S.","family":"Gorgey","sequence":"additional","affiliation":[{"name":"Spinal Cord Injury and Disorders Center, Richmond VA Medical Center, Richmond, Virginia"},{"name":"Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University, Richmond, Virginia"},{"name":"Center for Rehabilitation Science and Engineering, Virginia Commonwealth University, Richmond, Virginia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"25425","reference":[{"key":"b1","series-title":"Traumatic Spinal Cord Injury Facts and Figures at a Glance","year":"2025","unstructured":"Traumatic Spinal Cord Injury Facts and Figures at a Glance. 2025 SCI Data Sheet. 2025. https:\/\/msktc.org\/sites\/default\/files\/Facts-and-Figures-2023-Eng-508.pdf."},{"issue":"2","key":"b2","series-title":"Respir Physiol Neurobiol","first-page":"157","article-title":"Autonomic function following cervical spinal cord injury","volume":"169","author":"Krassioukov A","year":"2009","unstructured":"Krassioukov A. 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