Effect of Surface Spinal Stimulation on Spasticity in SCI: A Single Case Study

Abstract

Spasticity forms one of the major complications after a spinal cord injury. Various treatment approaches are used for its reduction. Surface spinal stimulation has been used in this case and its effect pre- and post-treatment have been compared. A 27-year-old male suffered a spinal cord injury of the level C4-C5 due to a bus accident, in which the bus had overturned. The patient is a follow-up case of C4-C5 discoligamentous injury with quadriparesis with bowel and bladder involvement. The patient developed spasticity in his upper and lower limbs owing to the spinal cord injury. He has been taking physiotherapy treatment for the same. Due to the spasticity, he is suffering from problems in maintaining a comfortable posture and complains of spasms. When assessed with modified Ashworth scale for spasticity, the patient scored 4 for both left and right dorsiflexors of the lower limb. The patient was given surface spinal stimulation for reduction in spasticity and at the end of 15 days, the spasticity rating was 1 and 2 for left and right limbs respectively. Surface spinal stimulation has proved to be an effective tool for reducing spasticity after spinal cord injury. It helped the patient in being more comfortable and he was able to participate in his exercises more actively. The patient was given a session for 45 minutes each day for five days a week for fifteen days and MAS and functional outcomes of spinal cord injury measure, adductor tone rating scale, spasm frequency were recorded on day 0, day 8, and day 15. The treatment session consisted of application of two pad electrodes (5 × 9 cm) at paravertebral region at the level of T10-L2 vertebrae. There was significant reduction in the score of MAS in the individual and, therefore, it can be said that spasticity was reduced.