【論文摘要】Effects of Transcutaneous Spinal Cord Stimulation in Individual with Spinal Cord Injury-A Systematic Review and Meta-Analysis

【論文摘要】經皮脊髓電刺激對於脊髓損傷患者下肢療效之系統性回顧與統合分析

洪仰澤(Yang-Tze Hung) ； 劉文瑜(Wen-Yu Liu) ； 方佳瑩(Chia-Ying Fang) ； 張雅如(Ya-Ju Chang)

《物理治療》 47卷4期 (2022/12) Pp. 292-292

https://doi.org/10.6215/FJPT.202212.O19

摘要

Background and Purpose: Transcutaneous spinal cord stimulation (tSCS) is a novel intervention which was adapted from epidural spina cord stimulation to restore spinal cord circuitry function after spinal cord injury (SCI). The relevant research evidence of the treatment outcomes had not been systemically analyzed for clinical decision making. The purpose of this study was to systemically analyze the effects of tSCS on spasticity and other clinical outcomes for individuals with SCI using the International Classification of Functioning Disability and Health (ICF) model. Methods: Literature search was performed using the database including Pubmed, Scopus, Medline-OvidSP, and Web of science. The quality of the published research was appraised using PEDro scale and Oxford Centre for Evidence-Based Medicine 2011 Levels of Evidence. Meta-analysis was performed by Comprehensive Meta-Analysis (version 3). The outcomes were classified using ICF model. The effects were summarized with standardized mean differences (95% confidence intervals) by random effect models. A significant level was set at 0.05. Results: Sixteen studies screened from 600 papers were included in this study. From the ICF model, the results showed that most of the existing studies discuss the body function domain. Only limited number of studies reported the effects of tSCS on the activity and participation, or environmental factors domains. In body function domain, tSCS has the effect of preserving motor control function and improving spasticity. Meta-analysis was performed on three studies using the pendulum test to evaluate spasticity. The results showed a significant effect in favor of treatment combined with tSCS in compared to no control treatment (Z = 2.621, p = 0.009). Conclusions: tSCS added to the conventional treatment of SCI could reduce spasticity and promote motor control. However, high-quality studies with long follow-up periods across all domains of the ICF framework are needed. Clinical Relevance: The results of this study suggests that tSCS is a promising intervention that can be added to the routine therapy for individuals with SCI.