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Biomedicines
Volume 14
Issue 6
10.3390/biomedicines14061214
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This is an early access version, the complete PDF, HTML, and XML versions will be available soon.
Article

Changes in Motor, Functional Independence, and Gait Recovery After Incomplete Spinal Cord Injury with Transcutaneous Spinal Cord Stimulation: A Randomized Controlled Trial with a Partial Crossover Design

by
Hatice Kumru
1,2,*,†,
Aina Ros-Alsina
1,3,†,
Agustín Hernandez-Navarro
1,2,
Eloy Opisso
1,2,
Margarita Vallès
1,2,
Jesus Benito-Penalva
1,2,
Joan Vidal
1,2,
Miquel Sarrio
1 and
Loreto García-Alén
1,2
1
Guttmann Hospital de Neurorehabilitació, Institut Universitari Adscrit a la Universitat Auntònoma de Barcelona, 08916 Badalona, Barcelona, Spain
2
Institut de Recerca Germans Trias i Pujol, 08916 Badalona, Barcelona, Spain
3
Department of Automatic Control, Escola Tècnica Superior d’Enginyeria Industrial de Barcelona (ETSEIB), Universitat Politècnica de Catalunya—BarcelonaTech (UPC), Diagonal 647, 08028 Barcelona, Spain
*
Author to whom correspondence should be addressed.
†
These authors contributed equally to this work.
Biomedicines 2026, 14(6), 1214; https://doi.org/10.3390/biomedicines14061214
Submission received: 20 April 2026 / Revised: 21 May 2026 / Accepted: 23 May 2026 / Published: 27 May 2026
(This article belongs to the Section Neurobiology and Clinical Neuroscience)
Versions Notes

Abstract

Background: Transcutaneous spinal cord stimulation (tSCS) is a promising approach to enhance functional recovery after spinal cord injury (SCI). However, evidence on repeated sessions and their effects on gait and lower-limb strength remains limited. This study evaluated the effects of multisegmental tSCS on walking ability, muscle strength, and functional independence in individuals with SCI. Methods: In this randomized controlled trial with a partial crossover design, twelve individuals received tSCS combined with gait rehabilitation, while ten underwent gait rehabilitation alone, for three weeks. Four participants crossed over to the tSCS group after a minimum one-week washout period following the control intervention. We assessed the American Spinal Injury Association Impairment Scale (AIS), Total Motor Score (TMS), Lower Extremity Motor Score (LEMS), Walking Index for Spinal Cord Injury II (WISCI-II), 10- and 6-Meter Walking Tests (10MWT, 6meterWT), Timed Up and Go (TUG) test, maximal voluntary contraction (MVC) of the quadriceps (QM) and tibialis anterior (TA), and the Spinal Cord Independence Measure (SCIM-III); tSCS was applied at three spinal segments during gait rehabilitation over 15 sessions. Results: tSCS significantly improved MVC in both muscles, as well as SCIM-III and TUG, and these improvements were maintained at follow-up, with no significant adverse events reported. Other clinical assessments also showed significant improvement in both groups. Conclusions: tSCS was well tolerated and conferred additional benefits in lower-limb muscle strength, walking ability (as assessed by TUG), and functional independence, supporting its potential as a valuable adjunct to rehabilitation.
Keywords: multisegmental transcutaneous spinal cord stimulation; repeated sessions; spinal cord injury; muscle strength; TUG; SCIM-III; gait multisegmental transcutaneous spinal cord stimulation; repeated sessions; spinal cord injury; muscle strength; TUG; SCIM-III; gait

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MDPI and ACS Style

Kumru, H.; Ros-Alsina, A.; Hernandez-Navarro, A.; Opisso, E.; Vallès, M.; Benito-Penalva, J.; Vidal, J.; Sarrio, M.; García-Alén, L. Changes in Motor, Functional Independence, and Gait Recovery After Incomplete Spinal Cord Injury with Transcutaneous Spinal Cord Stimulation: A Randomized Controlled Trial with a Partial Crossover Design. Biomedicines 2026, 14, 1214. https://doi.org/10.3390/biomedicines14061214

AMA Style

Kumru H, Ros-Alsina A, Hernandez-Navarro A, Opisso E, Vallès M, Benito-Penalva J, Vidal J, Sarrio M, García-Alén L. Changes in Motor, Functional Independence, and Gait Recovery After Incomplete Spinal Cord Injury with Transcutaneous Spinal Cord Stimulation: A Randomized Controlled Trial with a Partial Crossover Design. Biomedicines. 2026; 14(6):1214. https://doi.org/10.3390/biomedicines14061214

Chicago/Turabian Style

Kumru, Hatice, Aina Ros-Alsina, Agustín Hernandez-Navarro, Eloy Opisso, Margarita Vallès, Jesus Benito-Penalva, Joan Vidal, Miquel Sarrio, and Loreto García-Alén. 2026. "Changes in Motor, Functional Independence, and Gait Recovery After Incomplete Spinal Cord Injury with Transcutaneous Spinal Cord Stimulation: A Randomized Controlled Trial with a Partial Crossover Design" Biomedicines 14, no. 6: 1214. https://doi.org/10.3390/biomedicines14061214

APA Style

Kumru, H., Ros-Alsina, A., Hernandez-Navarro, A., Opisso, E., Vallès, M., Benito-Penalva, J., Vidal, J., Sarrio, M., & García-Alén, L. (2026). Changes in Motor, Functional Independence, and Gait Recovery After Incomplete Spinal Cord Injury with Transcutaneous Spinal Cord Stimulation: A Randomized Controlled Trial with a Partial Crossover Design. Biomedicines, 14(6), 1214. https://doi.org/10.3390/biomedicines14061214

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