Cited by 574Spinal Cord Injury ResearchStroke Rehabilitation and RecoveryProsthetics and Rehabilitation Robotics

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Neuromodulation of lumbosacral spinal networks enables independent stepping after complete paraplegia

Gill, Megan L., Grahn, Peter J., Calvert, Jonathan S., Linde, Margaux B., Lavrov, Igor A., Strommen, Jeffrey A., Beck, Lisa A., Sayenko, Dimitry G., Van Straaten, Meegan G., Drubach, Dina I., Veith, Daniel D., Thoreson, Andrew R., Lopez, Cesar, Gerasimenko, Yury P., Edgerton, V. Reggie, Lee, Kendall H., Zhao, Kristin D.·2018·Nature Medicine

DOI 10.1038/s41591-018-0175-7

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Abstract

Spinal sensorimotor networks that are functionally disconnected from the brain because of spinal cord injury (SCI) can be facilitated via epidural electrical stimulation (EES) to restore robust, coordinated motor activity in humans with paralysis 1-3. Previously, we reported a clinical case of complete sensorimotor paralysis of the lower extremities in which EES restored the ability to stand and the ability to control step-like activity while side-lying or suspended vertically in a body-weight support system (BWS)4. Since then, dynamic task-specific training in the presence of EES, termed multimodal rehabilitation (MMR), was performed for 43 weeks and resulted in bilateral stepping on a treadmill, independent from trainer assistance or BWS. Additionally, MMR enabled independent stepping over ground while using a front-wheeled walker with trainer assistance at the hips to maintain balance. Furthermore, MMR engaged sensorimotor networks to achieve dynamic performance of standing and stepping. To our knowledge, this is the first report of independent stepping enabled by task-specific training in the presence of EES by a human with complete loss of lower extremity sensorimotor function due to SCI.

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Effect of epidural stimulation of the lumbosacral spinal cord on voluntary movement, standing, and assisted stepping after motor complete paraplegia: a case study
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Evidence for a Spinal Central Pattern Generator in Humans a
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A brain–spine interface alleviating gait deficits after spinal cord injury in primates
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“Activity-dependent reorganization of spinal circuits enabled by SCS may be a primary contribution towards the restoration of function [2, 4, 6], where SCS is believed to amplify residual descending voluntary motor input, increasing cortical excitability [6, 7] and supporting the excitatory drive to…”
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“There are several projects [15], [16], [17], [18] for the neurorehabilitation targeted to the motor control of subject limbs implemented as programmed neurostimulators demonstrated recently success.”
BackgroundSelf-citation
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“This method enabled those with motor-complete SCI to regain volitional leg movements [20, 21].”
Method
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Sayenko, D. G., Bazo, H. A. C., Horner, P. J., & Taccola, G. (2022) · Elsevier eBooks · doi:10.1016/b978-0-12-822427-4.00005-8 · Cited by 7
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“In an extreme case, for example, autonomous robot [7, 8] or wearable neuroprosthesis [1, 2, 13], we face the requirement of real-time”
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“This discrepancy suggests that interactions between Iaafferents, motoneurons and residual cortico-spinal inputs alone may be not sufficient to explain experimental evidence on the restoration of volitional movement during SCS after SCI [2]–[4].”
BackgroundInfluential
Supraspinal control of motoneurons after paralysis enabled by spinal cord stimulationPreprint
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“In the last two decades, a series of animal and clinical studies showed that epidural electrical spinal cord stimulation (SCS) can restore some degree of motor control of lower and upper limbs in people with spinal cord injury and stroke 1–7 .”
Background
FUNDAMENTAL LIMITATIONS OF KILOHERTZ-FREQUENCY CARRIERS IN AFFERENT FIBER RECRUITMENT WITH TRANSCUTANEOUS SPINAL CORD STIMULATIONPreprint
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“ESCS paddle leads were either positioned over low thoracic to high lumbar spinal segments [7, 10] or over high lumbar to high sacral segments [4, 8].”
BackgroundInfluential
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Gorgey, A. S., Trainer, R. J., Khalil, R. E., Deitrich, J. N., Rehman, M. U., Goetz, L. L., Lester, D. D., Klausner, A. P., Peterson, C. L., & Lavis, T. D. (2025) · Journal of Clinical Medicine · doi:10.3390/jcm14061829 · Cited by 7
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“Using only the caudal paddle array limits the rostrocaudal span accessible in this sheep, though the target neural structures underlying each array will be assessed independently.”
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“2,3 More recently, we also observed that some individuals can volitionally modulate the lower limb activation pattern while standing with Stand-scES, 6 and that the ability to achieve independent lower limb extension prior to any training with Stand-scES may be associated with the amount of spared…”
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Self-citation
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Guo, X.-J., Zhao, Z., Chang, J., He, L., Su, W.-N., Feng, T., Zhao, C., Xu, M., & Rao, J. (2023) · Frontiers in Neuroscience · doi:10.3389/fnins.2023.1282558 · Cited by 6
“Clinically, Gill et al. (2018) reported that patients with complete loss of motor function with T6 incomplete SCI could stand and walk on a treadmill after 43 weeks of rehabilitation training combined with EES.”
Background
Interleaved configurations of percutaneous epidural stimulation enhanced overground stepping in a person with chronic paraplegia
Gorgey, A. S., Venigalla, S., Rehman, M. U., George, B., Rejc, E., & Gouda, J. J. (2023) · Frontiers in Neuroscience · doi:10.3389/fnins.2023.1284581 · Cited by 7
MRI Spinal Cord Reconstruction Provides Insights into Mapping and Migration Following Percutaneous Epidural Stimulation Implantation in Spinal Cord Injury
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Bowersock, C. D., Pisolkar, T., Omofuma, I., Luna, T. D., Khan, M., Santamaria, V., Stein, J. M., Agrawal, S. K., Harkema, S. J., & Rejc, E. (2022) · Journal of Spinal Cord Medicine · doi:10.1080/10790268.2022.2069532 · Cited by 6
“40 In the present study, a robotic-enhanced standing environment was utilized in which free hands upright postural control could be practiced and investigated among individulas with SCI who were unable to stand independently.”
Method
Spectral analysis of lower limb EMG activity in individuals with motor complete SCI during standing with epidural stimulation
Mesbah, S., Gonnelli, F., El-Baz, A. S., Angeli, C., Harkema, S. J., & Rejc, E. (2018) · IEEE International Symposium on Signal Processing and Information Technology (ISSPIT) · doi:10.1109/isspit.2018.8705098 · Cited by 6
“Spinal cord epidural stimulation (scES) along with activity-based training has been proven to be effective in re-enabling independent standing, walking over ground and voluntary movements in individuals with severe spinal cord injury (SCI) [1-5].”
Background
Noninvasive spinal cord electrical stimulation in the complex rehabilitation of patients with spinal cord injury
Savenkova, A. A., Sarana, А. М., Shcherbak, S. G., Gerasimenko, Y. P., & Moshonkina, T. R. (2019) · Problems of Balneology Physiotherapy and Exercise Therapy · doi:10.17116/kurort20199605111 · Cited by 7
Self-citation
Biomimetic computer-to-brain communication restoring naturalistic touch sensations via peripheral nerve stimulationPreprint
Valle, G., Katic, N., Eggemann, D., Gorskii, O., Pavlova, N., Čvančara, P., Stieglitz, T., Евгеньевич, М. П., Bumbaširević, M., & Raspopović, S. (2023) · bioRxiv (Cold Spring Harbor Laboratory) · doi:10.1101/2023.07.15.549130 · Cited by 6
“Indeed, neural stimulation of the peripheral somatic nerves (PNS) 7–10 , spinal cord 11–15 or somatosensory cortex (S1) 16–18 showed the ability to restore missing sensations, resulting in closed-loop neuroprostheses able to establish a bidirectional link between humans and machines.”
Background
Disuse plasticity limits spinal cord injury recovery
Morioka, K., Tazoe, T., Huie, J. R., Hayakawa, K., Okazaki, R., Guandique, C. F., de Almeida, C., Haefeli, J., Hamanoue, M., Endoh, T., et al. (2025) · iScience · doi:10.1016/j.isci.2025.112180 · Cited by 6
Nanogenerator Neuromodulation to Enable Locomotion Rehabilitation for Spinal Cord Injury via Epidural Electrical Stimulation
Li, C., Shan, Y., Zheng, S., Tan, P., Bai, Y., Wang, E., Xu, L., Luo, R., Chao, S., Huang, J., et al. (2025) · Advanced Science · doi:10.1002/advs.202501425 · Cited by 6
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Wee, S. K., Ng, Z.-Y. V., Phua, M. W., Lui, W. L., Misbaah, F., Ker, R. X. J., Ng, W. H., & Wan, K. R. (2025) · Advances in Rehabilitation Science and Practice · doi:10.1177/27536351251343738 · Cited by 5
“8,10 Motor imagery is a dynamic cognitive process in which a person imagines that he/she performs a movement without any actual motor output.”
Non-invasive multimodal spinal network stimulation instantaneously recovers locomotor function after paralysis
Gerasimenko, Y., & Harkema, S. J. (2025) · National Science Review · doi:10.1093/nsr/nwaf239 · Cited by 5
Self-citation
Towards precise synthetic neural codes: high-dimensional stimulation with flexible electrodes
Kim, R., Liu, Y., Zhang, J., Xie, C., & Luan, L. (2025) · npj Flexible Electronics · doi:10.1038/s41528-025-00447-y · Cited by 7
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Xu, Y., Chen, D., Ye, Q., Zhang, P., Shi, J., Li, S., Sun, Y., Zhao, Z., Tang, Y., Zhang, P., et al. (2026) · MedComm · doi:10.1002/mco2.70739 · Cited by 6
“Finally, patients whose primary impairment is severe spasticity without voluntary motor capacity may not be ideal candidates, as ESCS is primarily designed to facilitate volitional motor control rather than directly treat spasticity [ 99, 118, 219 ].”
Integrative approaches in spinal cord stimulation: Neuropathic pain management and motor recovery in spinal cord injury. A narrative review
Bonomo, R., Bonomo, G., Rubiu, E., Iess, G., Cammarata, G., Innocenti, N., Restelli, F., Falco, J., Porto, E., Amato, A., et al. (2024) · Brain and Spine · doi:10.1016/j.bas.2024.102781 · Cited by 7
“Interestingly, in this paper the authors also explored the feasibility of epidural SCS-evoked motor responses as an intra-operative aid for the epidural lead positioning (Gill et al., 2018).”
Background
The Conformal, High‐Density SpineWrap Microelectrode Array for Focal Stimulation and Selective Muscle Recruitment
Russman, S. M., Montgomery‐Walsh, R., Vatsyayan, R., Hoi Sang, U., Diaz-Aguilar, L. D., Chang, E., Tang, Q., Lee, K., Yaksh, T. L., Ben‐Haim, S., et al. (2025) · Advanced Functional Materials · doi:10.1002/adfm.202420488 · Cited by 5
Self-citation
Personalized gait rehabilitation with spinal cord stimulation and machine learning: Recent advances and promising applications
North, K., Jones, S. T., Simpson, G. M., & Dalrymple, A. N. (2025) · Current Opinion in Biomedical Engineering · doi:10.1016/j.cobme.2025.100579 · Cited by 5
Design of an Ergonomic Prototype for Physical Rehabilitation of People with Paraplegia
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Spinal cord stimulation for spinal cord injury patients with paralysis
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Background
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Jervis-Rademeyer, H., Gauthier, C., Masani, K., Pakosh, M. T., & Musselman, K. E. (2021) · Physical Therapy Reviews · doi:10.1080/10833196.2021.1962051 · Cited by 5
“No change with ES of anterior spinal cord n¼ 8 Step-like movements with ES of posterior spinal cord at L2 n¼ 8 Not specified Not specified Gill et al. 2018§ [15] Grahn et al. 2017§ [17] n¼ 1 (M) Age: 26yrs TSI: 3 yrs AIS: A SCI: T6 Standing a. Unable to stand independently b. Absent or unorganized,…”
Background
When Spinal Neuromodulation Meets Sensorimotor Rehabilitation: Lessons Learned From Animal Models to Regain Manual Dexterity After a Spinal Cord Injury
Flores, Á., López-Santos, D., & García‐Alías, G. (2021) · Frontiers in Rehabilitation Sciences · doi:10.3389/fresc.2021.755963 · Cited by 6
Activation of human spinal locomotor circuitry using transvertebral magnetic stimulation
Kawai, K., Tazoe, T., Yanai, T., Kanosue, K., & Nishimura, Y. (2022) · Frontiers in Human Neuroscience · doi:10.3389/fnhum.2022.1016064 · Cited by 5
“We intend to investigate the input-output properties of TVMS and its neurophysiological impacts on the spinal locomotor circuitry in individuals with SCI to develop a new rehabilitation therapy.”
BackgroundMethodInfluential
Influence of transcutaneous electrical nerve stimulation on the distance walked by older adults during the 6-min test of walking endurance
Alenazy, M. S., Al-Jaafari, R., Daneshgar, S., Folkesson-Dey, A., & Enoka, R. M. (2023) · Journal of Electromyography and Kinesiology · doi:10.1016/j.jelekin.2023.102827 · Cited by 5
Synergistic effect of chemogenetic activation of corticospinal motoneurons and physical exercise in promoting functional recovery after spinal cord injury
Lin, X., Wang, X., Zhang, Y., Chu, G., Liang, J., Zhang, B., Lu, Y., Steward, O., & Luo, J. (2023) · Experimental Neurology · doi:10.1016/j.expneurol.2023.114549 · Cited by 5
Brain fMRI during orientation selective epidural spinal cord stimulation
Canna, A., Lehto, L. J., Wu, L., Sang, S. B., Laakso, H., Ma, J., Filip, P., Zhang, Y., Gröhn, O. H. J., Esposito, F., et al. (2021) · Scientific Reports · doi:10.1038/s41598-021-84873-8 · Cited by 5
Self-citation
Neuromodulation as a basic platform for neuroprotection and repair after spinal cord injury
Biktimirov, A., Pak, O., Bryukhovetskiy, I., Sharma, A., & Sharma, H. S. (2021) · Progress in brain research · doi:10.1016/bs.pbr.2021.06.012 · Cited by 4
Higher Responsiveness of Pattern Generation Circuitry to Sensory Stimulation in Healthy Humans Is Associated with a Larger Hoffmann Reflex
Solopova, I. A., Селионов, В. А., Blinov, E. O., Dolinskaya, I. Y., Zhvansky, D. S., Lacquaniti, F., & Ivanenko, Y. P. (2022) · Biology · doi:10.3390/biology11050707 · Cited by 5
Traumatic Spinal Cord Disorders: Current Topics and Future Directions
Huang, K. T., & Lu, Y. (2021) · Seminars in Neurology · doi:10.1055/s-0041-1725125 · Cited by 5
A flexible electrode array for determining regions of motor function activated by epidural spinal cord stimulation in rats with spinal cord injury
Lü, X., Wang, Z., Mao, G., Zhang, J.-J., Su, H., Zhou, Z., & Zhu, L.-S. (2021) · Neural Regeneration Research · doi:10.4103/1673-5374.320987 · Cited by 5
“Recent clinical reports (Angeli et al., 2018; Gill et al., 2018; Wagner et al., 2018; Gorgey et al., 2020) showed that, with the combination of ESCS and long-term rehabilitation training, motor functions were recovered in persons with SCI, such as standing and walking with the help of…”
Influential
Spinal stimulation and physical therapy helps paraplegic patients to walk again
Ridler, C. E. (2018) · Nature Reviews Neurology · doi:10.1038/s41582-018-0092-x · Cited by 5
Walking after Spinal Cord Injury: Current Clinical Approaches and Future Directions
Donovan, J. M., Snider, B. A., Miller, A. K., & Kirshblum, S. (2020) · Current Physical Medicine and Rehabilitation Reports · doi:10.1007/s40141-020-00277-1 · Cited by 5
Real-time brain-computer interface control of walking exoskeleton with bilateral sensory feedback
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Robotic Postural Training With Epidural Stimulation for the Recovery of Upright Postural Control in Individuals With Motor Complete Spinal Cord Injury: A Pilot Study
Rejc, E., Bowersock, C. D., Pisolkar, T., Omofuma, I., Luna, T. D., Khan, M., Santamaria, V., Ugiliweneza, B., Angeli, C., Forrest, G. F., et al. (2024) · Neurotrauma Reports · doi:10.1089/neur.2024.0013 · Cited by 4
Effects of Robotic Postural Stand Training with Epidural Stimulation on Sitting Postural Control in Individuals with Spinal Cord Injury: A Pilot Study
Rejc, E., Zaccaron, S., Bowersock, C. D., Pisolkar, T., Ugiliweneza, B., Forrest, G. F., Agrawal, S. K., Harkema, S. J., & Angeli, C. (2024) · Journal of Clinical Medicine · doi:10.3390/jcm13154309 · Cited by 4
Hotspots and Trends in Spinal Cord Stimulation Research for Spinal Cord Injury: A Bibliometric Analysis with Emphasis on Motor Recovery (2014–2024)
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Changes in muscle activation and joint motion during walking after transtibial amputation with sensory feedback from spinal cord stimulation: a case study
Bose, R., Petersen, B. A., Sarma, D., Barra, B., Nanivadekar, A. C., Madonna, T. J., Liu, M. F., Levy, I., Helm, E. R., Mièle, V., et al. (2025) · Journal of Neural Engineering · doi:10.1088/1741-2552/ae16d7 · Cited by 4
“SCS has been used to augment motor rehabilitation in several populations, including spinal cord injury, stroke, spinal muscular atrophy, and Parkinson’s disease [40–42, 44, 51–56].”
Safety and effectiveness of electromyography-induced rehabilitation treatment after epidural electrical stimulation for spinal cord injury: study protocol for a prospective, randomized, controlled trial
Sun, X.-P., Shi, J.-J., Bao, Y., Zhang, J., Pan, H.-J., Li, D.-Y., Li, D., & Xie, Q. (2022) · Neural Regeneration Research · doi:10.4103/1673-5374.353507 · Cited by 6
“Effectiveness of epidural electrical stimulation on SCI has been reported (Angeli et al., 2018; Aslan et al., 2018; Gill et al., 2018; Harkema et al., 2018; Herrity et al., 2018; Straaten et al., 2018; Wagner et al., 2018; Watrin et al., 2018).”
Tuning of motor outputs produced by spinal stimulation during voluntary control of torque directions in monkeys
Kaneshige, M., Obara, K., Suzuki, M., Tazoe, T., & Nishimura, Y. (2022) · eLife · doi:10.7554/elife.78346 · Cited by 4
Hormonal computing: a conceptual approach
Vallverdú, J., Talanov, M. O., Leukhin, A., Fatykhova, E., & Erokhin, V. V. (2023) · Frontiers in Chemistry · doi:10.3389/fchem.2023.1232949 · Cited by 5
“identifies and adjusts the most effective combination of electrodes in the implanted array connected to the implant controller (Gill et al., 2018).”
Background
Neurorehabilitation Based on Spinal Cord Stimulation and Motor Training
Stolbkov, Y. K., & Gerasimenko, Y. P. (2024) · Neuroscience and Behavioral Physiology · doi:10.1007/s11055-024-01654-2 · Cited by 3
“After similar interventions, a patient with paraplegia was able to walk independently on a treadmill, as well as walk on a level surface using a front-wheeled walker with the help of a trainer to maintain balance [42].”
InfluentialSelf-citation
Dynamics of independence and locomotor capabilities caused by powered exoskeleton-induced walk training in patients with severe chronic spinal cord injury
Shapkova, E. Y., Емельянников, Д. В., Larionova, Y. E., Kupreev, N. A., & Grigoreva, E. V. (2020) · Russian Journal of Spine Surgery (Khirurgiya Pozvonochnika) · doi:10.14531/ss2020.4.54-67 · Cited by 6
Litigation risks despite guideline adherence for acute spinal cord injury: time is spine
Rafter, D., Vasdev, R. M. S., Hurrelbrink, D., Gormley, M., Chettupally, T., Shen, F. X., & Samadani, U. (2020) · Neurosurgical FOCUS · doi:10.3171/2020.8.focus20607 · Cited by 4
Newly regenerated axons through a cell-containing biomaterial scaffold promote reorganization of spinal circuitry and restoration of motor functions with epidural electrical stimulationPreprint
Siddiqui, A. M., Islam, R., Cuellar, C. A., Silvernail, J. L., Knudsen, B. E., Curley, D. E., Strickland, T., Manske, E., Suwan, P. T., Latypov, T. H., et al. (2020) · bioRxiv (Cold Spring Harbor Laboratory) · doi:10.1101/2020.09.09.288100 · Cited by 4
Self-citation
Editorial: Advances in Spinal Cord Epidural Stimulation for Motor and Autonomic Functions Recovery After Severe Spinal Cord Injury.
Rejc, E., Angeli, C., & Ichiyama, R. M. (2022) · White Rose Research Online (University of Leeds, The University of Sheffield, University of York) · Cited by 4
Targeted transcutaneous cervical spinal cord stimulation promotes upper limb recovery in spinal cord and peripheral nerve injuryPreprint
Chandrasekaran, S., Bhagat, N. A., Ramdeo, R., Ebrahimi, S., Sharma, P., Stein, A., Griffin, D. G., Harkema, S. J., & Bouton, C. E. (2022) · medRxiv · doi:10.1101/2022.02.15.22269115 · Cited by 4
TARGETED STIMULATION OF THE SENSORY AFFERENTS IMPROVES MOTONEURON FUNCTION IN HUMANS WITH A DEGENERATIVE MOTONEURON DISEASEPreprint
Prat-Ortega, G., Ensel, S., Donadio, S., Borda, L., Boos, A., Yadav, P., Verma, N., Ho, J. C., Frazier-Kim, S., Fields, D. P., et al. (2024) · medRxiv · doi:10.1101/2024.02.14.24302709 · Cited by 4
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Interactions between descending and spinal circuits on motor output
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Self-citation
Spinal epidural electrical stimulation for the recovery of motor function in lower limbs after spinal cord injury: A pilot study
Chhabra, H. S., Kalidindi, K. K. V., Garg, N., Sharma, A., Chhibber, B., Kumar, H., Vishwakarma, G., Gupta, M., & Bhat, M. R. (2025) · Journal of Spinal Cord Medicine · doi:10.1080/10790268.2025.2517935 · Cited by 3
“Subsequently, independent stepping was also noticed in a person with SCI (7) and intentional overground walking in two persons with American Spinal Injury Association Impairment Scale B (AIS-B) SCI (8) after sEES (while stimulator is on) with locomotor training.”
Artificial nerve systems for use in bio-interactive prostheses
Kim, C. H., Seo, D., Lee, Y., & Lee, T. (2025) · Nature Reviews Electrical Engineering · doi:10.1038/s44287-025-00197-z · Cited by 4
“This technology has contributed to the rehabilitation of patients with neurological conditions such as paraplegia 28 , quadriplegia 15 and limb amputations 29 .”
Non-invasive closed-loop spinal stimulation restores leg stepping control in humans with paraplegia
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Hybrid 12-Month Exoskeleton Training with Percutaneous Epidural Stimulation After Spinal Cord Injury
Deitrich, J. N., Rehman, M. U., Trainer, R. J., Cifu, D. X., & Gorgey, A. S. (2026) · Life · doi:10.3390/life16010077 · Cited by 3
“However, our sample size is not different from other well-established clinical trials in the field [28–30].”
Spinal Cord Injury-Induced Changes in Encoding and Decoding of Bipedal Walking by Motor Cortical Ensembles
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Chronic Adaptations in the Dorsal Horn Following a Cervical Spinal Cord Injury in Primates
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Role of Epidural Electrode Stimulation in Three Patients with Incomplete AIS D Spinal Cord Injury
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“…electrodes at a sampling rate of 2000 Hz (Delsys Trigno Avanti, Delsys Inc., Boston, MA, USA); a custom-written MATLAB script (MATLAB 2019 Mathworks, Inc., Natick, MA, USA) was used for analysis. sEMG recordings included the RF, medial hamstring (MH), TA, and medial gastrocnemius (MG) [19,22].”
Reviewing Breakthroughs and Limitations of Implantable and External Medical Device Treatments for Spinal Cord Injury
Wallana, T., Banitsas, K. A., & Balachandran, W. (2025) · Applied Sciences · doi:10.3390/app15158488 · Cited by 3
“…by Gill et al. demonstrated that patients with the same complete spinal cord injury were able to initiate physical positions such as independent standing, different sensorimotor engagement between stepping and standing, as well as bilateral stepping on a treadmill with the addition of EES [27].”
Fundamental limitations of kilohertz-frequency carriers in afferent fibre recruitment with transcutaneous spinal cord stimulation
Keesey, R., Hofstoetter, U. S., Hu, Z., Lombardi, L., Hawthorn, R., Bryson, N. K., Alashqar, A., Rowald, A., Minassian, K., & Seáñez, I. (2026) · Nature Biomedical Engineering · doi:10.1038/s41551-026-01684-w · Cited by 14
Novel Activity Detection Algorithm to Characterize Spontaneous Stepping During Multimodal Spinal Neuromodulation After Mid-Thoracic Spinal Cord Injury in Rats
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Self-citation
How to Identify Responders and Nonresponders to Dorsal Root Ganglion-Stimulation Aimed at Eliciting Motor Responses in Chronic Spinal Cord Injury: Post Hoc Clinical and Neurophysiological Tests in a Case Series of Five Patients
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“Several groups have published on the potential beneficial role of techniques ranging from minimally invasive transcutaneous spinal cord stimulation (6,7) to more invasive techniques such as epidural electrical stimulation (EES), delivered either tonically (4,5) or with spatiotemporal patterns (3).”
Background
Surface electromyography to identify top-down modulation in complete chronic spinal cord injury
SIMÃO, C. R., de Holanda, L. J., URBINI, L. F., LACERDA, M. O., FERNANDES, K., SILVA, P. M. D., MORYA, E., & LINDQUIST, A. R. (2021) · European Journal of Physical and Rehabilitation Medicine · doi:10.23736/s1973-9087.21.06878-7 · Cited by 3

Authors: Gill, M. L., Grahn, P. J., Calvert, J. S., Linde, M. B., Lavrov, I. A., Strommen, J. A., Beck, L. A., Sayenko, D. G., Van Straaten, M. G., Drubach, D. I., Veith, D. D., Thoreson, A. R., Lopez, C., Gerasimenko, Y. P., Edgerton, V. R., Lee, K. H., & Zhao, K. D.
Affiliations: Mayo Clinic (US)
Houston Methodist (US)
Russian Academy of Sciences (RU)
University of California, Los Angeles (US)
Corresponding author: Lee, Kendall H.
Zhao, Kristin D.
ORCID: Grahn, Peter J.
Calvert, Jonathan S.
Linde, Margaux B.
Lavrov, Igor A.
Sayenko, Dimitry G.
Veith, Daniel D.
Thoreson, Andrew R.
Lopez, Cesar
Gerasimenko, Yury P.
Edgerton, V. Reggie
Lee, Kendall H.
Zhao, Kristin D.
Venue: Nature Medicine
Publisher: Springer Science and Business Media LLC
Published: 2018-09-24
Volume: 24
Issue: 11
Pages: 1677-1682
ISSN: 1078-8956 (ISSN-L)
1546-170X
DOI: 10.1038/s41591-018-0175-7
OpenAlex: W2892074957
Cited by: 574
References: 43
Citations by year: 2026: 51 · 2025: 63 · 2024: 58 · 2023: 81 · 2022: 87 · 2021: 94 · 2020: 72 · 2019: 50 · 2018: 16
FWCI: 44.13
Type: journal article
Language: en
Update notices: correction (2018-10-23)
Open access: closed
Licence: www.springer.com/tdm (tdm)
Locations: Nature Medicine (publishedVersion)
PubMed (publishedVersion)
Funders: Nature
Topics: Health Sciences › Medicine › Clinical Neurology › Spinal Cord Injury Research
Health Sciences › Medicine › Rehabilitation › Stroke Rehabilitation and Recovery
Physical Sciences › Engineering › Biomedical Engineering › Prosthetics and Rehabilitation Robotics
Keywords: spinal cord injury, complete paraplegia, epidural stimulation, multimodal rehabilitation, task-oriented training, body weight support, standing, paraplegia
MeSH terms: Adult, Electric Stimulation, Transcutaneous Electric Nerve Stimulation, Electromyography, Humans, Male, Motor Activity, Nerve Net, Paralysis, Paraplegia, Spinal Cord Injuries, Muscle, Skeletal

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Neuromodulation of lumbosacral spinal networks enables independent stepping after complete paraplegia

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