Electronic Thesis and Dissertation Repository

Thesis Format

Monograph

Degree

Master of Science

Program

Health and Rehabilitation Sciences

Supervisor

Unger, Janelle

2nd Supervisor

Schabrun, Siobhan

Co-Supervisor

Abstract

Spinal cord injury (SCI) is a neurological condition that disrupts lower extremity function, limiting mobility and independence. This dissertation explores the feasibility, acceptability, and safety of combining repetitive transcranial magnetic stimulation (rTMS) with functional electrical stimulation (FES) cycling to improve lower extremity function following motor incomplete SCI (iSCI). This study is a case series pilot study in which participants with iSCI underwent a combined protocol of rTMS and FES cycling for six weeks. The results demonstrate the preliminary feasibility, participant acceptability, and safety of combining rTMS and FES cycling. While results varied between participants, one participant showed improvements in walking speed, muscle strength, and functional tests. These findings suggest the potential of pairing rTMS with FES cycling to improve lower extremity function following iSCI. Further studies with larger sample sizes are warranted to confirm efficacy.

Summary for Lay Audience

Spinal Cord Injury (SCI) is a serious condition that happens when the spinal cord is damaged, often due to accidents, falls, violence, or tumours. This damage can cause problems like losing the ability to move your legs, walk, keep balance, and have strong muscles. Helping people with SCI regain their independence to do daily activities, like walking, is very important.

This study looked at a new way to help people with SCI using two techniques: repetitive transcranial magnetic stimulation (rTMS) and functional electrical stimulation (FES) cycling. rTMS uses magnetic pulses to stimulate the part of the brain that controls movement, while FES uses mild electrical currents to activate leg muscles, helping people pedal a bike.

We wanted to see if combining these techniques could improve leg function in people with incomplete SCI (iSCI). Three participants took part in the study. They were split into two groups: one group received real rTMS with FES cycling, and the other group received a fake (sham) rTMS with FES cycling over six weeks. We checked their leg function four times during the study to see if there were any improvements in walking speed, balance, and muscle strength.

All participants found the combined treatment to be tolerable. Additionally, there were no serious adverse events observed. While the results varied for each person, we saw some encouraging improvements, like faster walking speed, better balance, and stronger muscles. However, more research with more participants is needed to confirm these findings.

Even with the differences between individuals, these first results are promising. Combining rTMS and FES cycling might be a helpful way to improve leg function after iSCI. This could lead to better mobility, more independence, and a higher quality of life for people with this condition.

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