Upper Extremity Muscle Recovery Profiles with Functional Electrical Stimulation Therapy in Chronic Spinal Cord Injury
Bibliographic record
Abstract
Abstract Background Spinal cord injuries (SCI) can affect muscle control, often resulting in significant functional impairments. Damage to sensorimotor pathways in the spinal cord can lead to muscle weakness, which may gradually recover during the first year post-injury. Functional electrical stimulation therapy (FEST) aims to enhance muscle strength, particularly when natural recovery diminishes. However, the recovery profiles of individual muscles treated with FEST during the chronic phase are still not well understood. The primary objective of this study was to characterize the timing and magnitude of gains in individual muscle strength during FEST. The secondary objective was to identify factors predictive of the response. Methods In this cohort study, we examined the strength recovery profiles of 136 muscles treated with FEST, from 17 participants with cervical SCI at the chronic phase of the injury. Electrophysiology was conducted at baseline to assess corticospinal tract (CST) integrity and the excitability of the lower motor neuron pools using surface electromyography (sEMG). Results Our findings reveal that 69 muscles did not respond to the treatment, while 67 muscles showed a median strength increase of one muscle motor score (MMS). Among responder muscles, achieving a 1 MMS increase required approximately 59 days (19.2 FEST sessions). A prediction model highlighted key predictors of responsiveness to FEST, including baseline MMS, characteristics of lesion location/severity, and neurophysiological indicators of CST integrity. Conclusion Our findings underscore the need for refined guidelines in rehabilitation medicine, particularly for FEST in cervical SCI. The data demonstrates that achieving a 1-point increase in muscle strength requires ≈59 days and 19 FEST sessions. Further evidence also suggest that CST integrity and the responsiveness of lower motor neuron pools may influence FEST outcomes. These insights will enable more personalized and effective rehabilitation strategies, optimizing outcomes and resource allocation for individuals living with cervical SCI.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".