Researchers at the University of Pittsburgh School of Medicine are reporting the final results of a pioneering pilot clinical trial using electrical stimulation of the spinal cord to improve arm and hand mobility in today’s chronic stroke patients. natural medicine.
The study, which primarily focused on investigating safety and preliminary efficacy, showed that seven participants with severe muscle weakness due to stroke experienced an average 32% increase in arm strength, in addition to improved overall arm mobility and reduced muscle spasms. Importantly, this intervention required less than 9 hours of movement-based training over 4 weeks and did not cause discomfort or serious adverse events.
“This approach is designed to quickly help people regain better arm movement, even years after a stroke,” said Marco Capogrosso, Ph.D., assistant professor of neurosurgery at Pitt and director of the Spinal Cord Stimulation Laboratory in the Rehabilitation Neuroengineering Laboratory at the UPMC Rehabilitation Institute, and co-senior author.
This stimulation primarily serves as an assistive technique. People can move better when stimulation is on. Stimulating the spinal cord allows the remaining connections between the brain and spinal cord to function more efficiently, allowing for better movement. ”
Dr. Marco Capogrosso, University of Pittsburgh
Stroke is the leading cause of arm paralysis in adults in the United States, with approximately 400,000 people developing chronic arm and hand weakness each year. Many stroke survivors rank restoring arm function at the top of their list of unmet clinical needs, yet standard rehabilitation rarely results in meaningful improvement.
To address this gap, Pitt researchers have launched a first-of-its-kind pilot clinical study to test whether epidural spinal cord stimulation, delivered to the areas that control arm and hand movement, can help stroke survivors regain arm function. The project, named one of the most important innovations supported by the National Institute of Neurological Disorders and Stroke (NINDS) in its 75th anniversary report, relies on a technology called cervical epidural spinal cord stimulation, which involves implanting thin electrodes along the neck of the spinal cord.
Stimulation sends targeted electrical signals to sensory nerve fibers in the spinal cord, strengthening communication between the brain and weakened muscles. Similar devices have been used for decades to treat chronic pain, but this is the first time they have been used to restore arm function after a stroke. The newly published study expands on previous findings reported by the team in 2023 and confirms that the approach is safe and viable across participants of different ages, genders, and ethnic backgrounds.
Researchers observed two different types of benefits. Over the four-week study period, all seven study participants experienced an immediate increase in muscle strength when stimulation was turned on, regardless of their level of impairment at baseline. Additionally, spasticity, which is abnormal muscle stiffness caused by nerve pathways damaged by the stroke, was also reduced in all seven participants.
“From a clinical perspective, even small improvements in arm strength and arm control can make a meaningful difference in the daily lives of stroke survivors,” said study co-author George Wittenberg, MD, professor of neurology, physical therapy, and rehabilitation at Pitt School of Medicine. “Some of the improvements we measured may seem small from the outside, but many stroke survivors are on the verge of being able to do something important. Even small changes in motor function can be very important if it helps them button their shirt, stretch their arms, or return to activities they care about.”
Although the improvements were immediate, the researchers found that lasting effects depended on continued use of the stimulation. Follow-up evaluations showed that motor function decreased when stimulation was discontinued, highlighting the potential of spinal cord stimulation as an adjunctive neuroprosthetic technique rather than a short-term rehabilitation aid.
“This study concludes an early feasibility stage and represents an important step toward real-world clinical application,” Capogrosso said. “Our goal is to ultimately develop a technology that can be used not only in the clinic but also in everyday life. These results give us confidence that spinal cord stimulation has the potential to be a practical implantable option to help stroke survivors regain use of their arms when it matters most.”
Based on these findings, the research team began recruiting participants for an expanded clinical trial to evaluate the effects of long-term spinal cord stimulation, alone or in combination with physical therapy.
