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  • Transcutaneous Stimulation

    I've seen posts about this for stimulating the spinal cord, without surgery, and it leading to some voluntary movements.

    how does this differ from e-stim?
    are there any devices for home use?

  • #2
    E-STIM is done with surgery to put the device inside the body. The other one Transcutaneous Stimulation is done without the surgery on the skin. Dr. Edgerton of UCLA is trying to bring it to the market as it has been successful in his studies.

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    • #3
      Originally posted by scimike View Post
      E-STIM is done with surgery to put the device inside the body. The other one Transcutaneous Stimulation is done without the surgery on the skin. Dr. Edgerton of UCLA is trying to bring it to the market as it has been successful in his studies.
      Thanks, the one without surgery, how is that different than the regular estim device?

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      • #4
        Hey - I just wanted to say that physical therapy quality e-stim/NMES units are widely available - you can get them on amazon and all kinds of sites. Especially since Noah is so young, I strongly strongly recommend that you get his PT and/or OT involved and check with his doctor. I have had good results with e-stim preventing atrophy and so forth.

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        • #5
          Originally posted by annev308 View Post
          Hey - I just wanted to say that physical therapy quality e-stim/NMES units are widely available - you can get them on amazon and all kinds of sites. Especially since Noah is so young, I strongly strongly recommend that you get his PT and/or OT involved and check with his doctor. I have had good results with e-stim preventing atrophy and so forth.
          we already do estim at home

          ive just been reading about the stimulation of the spinal cord through the skin in recent research studies and how it has produced voluntary movement. I'm wondering how this device, or frequency is different then a regular e stim unit and where I can get one if available yet.

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          • #6
            I really do not know the regular estim device. What I am talking about is Dr Edgerton's device. He has e-stim device surgically implanted in to the patient and he has another one Transcutaneous Stimulation on the skin without surgery. His surgically implanted device is FDA approved. I believe him and his team are trying to bring both to the market as soon as possible. Dr. Harkema is also involved as she recently demonstrated that the patient who was implanted the surgical device in the first trial and now went to another long training and he could initiate movement without the the sitimulator being on. I really do not know about what annev308 is saying as I do not have much information on them.

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            • #7
              Originally posted by scimike View Post
              I really do not know the regular estim device. What I am talking about is Dr Edgerton's device. He has e-stim device surgically implanted in to the patient and he has another one Transcutaneous Stimulation on the skin without surgery. His surgically implanted device is FDA approved. I believe him and his team are trying to bring both to the market as soon as possible. Dr. Harkema is also involved as she recently demonstrated that the patient who was implanted the surgical device in the first trial and now went to another long training and he could initiate movement without the the sitimulator being on. I really do not know about what annev308 is saying as I do not have much information on them.
              the Transcutaneous Stimulation device, do you know what it does or how it works? Is there any data on it out yet?

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              • #8
                Originally posted by MomNoah View Post
                the Transcutaneous Stimulation device, do you know what it does or how it works? Is there any data on it out yet?

                http://neurorecoverytechnologies.com/
                http://spinalcordresearchandadvocacy.wordpress.com/

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                • #9
                  NRT's transcutaneous stim is not estim, TENS or FES. It's a multi-frequency, waveform-based means for stimulating the spinal cord (not muscles) through the skin. No surgery, no implants. So far it's shown efficacy in functional return in chronic spinal cord injuries, but mostly in "incomplete" (aka AIS B/C) injuries. If it doesn't work for a particular patient then the implanted version would be needed.
                  The closest existing technology is the implanted spine stimulator for pain applications but that device has neither the frequency/waveform capability of the NRT device nor the number of simultaneous channels.
                  T3 complete since Sept 2015.

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                  • #10
                    The terminology is confusing, as "e-stim" could mean any kind of electrical stimulation - Functional electrical stimulation, TENS, Neuromuscular electrical stimulaiton, wide-pulse stimulation, transcutaneous and epidural stimulation are all different forms of electrical stimulation.

                    I'm assuming you have an FES/NMES device that you use for your son - there are a multitude of devices available, as has already been described, that can be use to elicit muscle contractions and improve circulation and/or attenuate muscle atrophy.

                    Edgerton et al.'s transcutaneous stimulator is different from FES, in that it uses a specific wave form (i.e., shape) of electrical waves, as well as a multi-frequency setting as Mize pointed out.

                    Currently, Edgerton's transcutaneous stimulator is NOT FDA approved, and NOT commercially available for use by patients. There are a number of studies his lab has going on right now to keep testing safety and effectiveness of the transcutaneous device - currently, the only way to access that transcutaneous device is to be enrolled in one of those studies.

                    The way that the transcutaneous and epidural stimulation work is by exciting ALL the neurons in the spinal cord below the level of injury (or at least all the neurons that are within the electrical field). After an SCI, neurons in the spinal cord below the injury level are in a dysfunctional state - essentially, these neurons that control muscles don't "hear" voluntary intentions to move from the brain like they used to. By providing this extra excitation, the theory is that the spinal cord stimulation allows the neurons below the injury to "hear" some voluntary intention to move (created by the brain) once again.

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                    • #11
                      From the patent:

                      [0142] The transcutaneous stimulation device is non-invasive. A surface stimulation cathode electrode was attached on the dorsal aspect of the neck (C5 area) and the grounding electrode was placed on the anterior superior iliac spine. Stimulation parameters ranged from 5-30 Hz and 20-100 mA. Varying combinations of these stimulation parameters were systematically assessed to obtain optimum facilitation of voluntary hand contraction by identification of the relative activation levels of the motor pools studied (data not shown). During each of the three treatment periods (Phases 2-4) a series of nine 3.5-sec maximum hand grip strength tests were performed per treatment session. In each session of Phase 2, three contractions were performed without pcEmc, followed by three in the presence of pcEmc (twice weekly at 30 Hz and 20-40 mA), followed by three without pcEmc. The same pcEmc protocol was followed during Phases 2-4. The duration of pcEmc during each testing session was approximately 15-30 min. The total number of maximum hand contractions was 9-36 and each session lasted 1 to 2 hours. During pcEMC, the subjects reported a non-painful, tingling sensation down the arms at the higher stimulation intensities at the site of stimulation with some associated tonic paraspinal muscle contractions at the neck.

                      Could this be done using a standard TENS unit?

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                      • #12
                        Originally posted by crabbyshark View Post
                        From the patent:

                        [0142] The transcutaneous stimulation device is non-invasive. A surface stimulation cathode electrode was attached on the dorsal aspect of the neck (C5 area) and the grounding electrode was placed on the anterior superior iliac spine. Stimulation parameters ranged from 5-30 Hz and 20-100 mA. Varying combinations of these stimulation parameters were systematically assessed to obtain optimum facilitation of voluntary hand contraction by identification of the relative activation levels of the motor pools studied (data not shown). During each of the three treatment periods (Phases 2-4) a series of nine 3.5-sec maximum hand grip strength tests were performed per treatment session. In each session of Phase 2, three contractions were performed without pcEmc, followed by three in the presence of pcEmc (twice weekly at 30 Hz and 20-40 mA), followed by three without pcEmc. The same pcEmc protocol was followed during Phases 2-4. The duration of pcEmc during each testing session was approximately 15-30 min. The total number of maximum hand contractions was 9-36 and each session lasted 1 to 2 hours. During pcEMC, the subjects reported a non-painful, tingling sensation down the arms at the higher stimulation intensities at the site of stimulation with some associated tonic paraspinal muscle contractions at the neck.

                        Could this be done using a standard TENS unit?
                        What patent is this from? Do you have a link?

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                        • #13
                          https://patents.google.com/patent/WO2015048563A2/en

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