Transcutaneous spinal stimulation with upper extremity robotic training in chronic stroke and spinal cord injury: individual neurophysiological and clinical responses

 How close is your competent? doctor to using this? What is your doctor doing to prevent spasticity from interfering with this intervention?

Transcutaneous spinal cord stimulation (tSCS) is a non-invasive neuromodulation technique that delivers mild electrical currents through the skin to the spinal cord. It stimulates dormant nerve pathways to help restore voluntary movement, balance, and sensation, typically when paired with physical or occupational therapy.

Transcutaneous spinal stimulation with upper extremity robotic training in chronic stroke and spinal cord injury: individual neurophysiological and clinical responses

• Jeonghoon Oh,
• Michelle S. Scheffler,
• Shane T. King,
• Erin E. Mahan,
• Melissa Lee,
• Catherine Martin,
• Alexander G. Steele,
• Jony Sheynin,
• Jenny Dinh,
• Argyrios Stampas,
• Teresa Kaldis,
• Timea M. Hodics,
• Marcia K. O’Malley &
• Dimitry G. Sayenko 

We are providing an unedited version of this manuscript to give early access to its findings. Before final publication, the manuscript will undergo further editing. Please note there may be errors present which affect the content, and all legal disclaimers apply.

Abstract

Background

Damage to the corticospinal tract after stroke and spinal cord injury (SCI) often results in persistent upper extremity (UE) impairment. Transcutaneous spinal stimulation (TSS) and robotic technologies have been explored as approaches to facilitate motor training; however, their combined effects on UE sensorimotor recovery remain poorly understood. The purpose of this study was to examine the effects of TSS combined with UE robotic training in individuals with chronic stroke or SCI.

Methods

Five participants with stroke and six with SCI completed a 14-week, sham controlled, single blind crossover study consisting of four total weeks of assessments (one week each pre and post for both training phases), four weeks of UE training with sham TSS, a two-week washout period, and four weeks of UE training with active TSS. Each one-hour session (three days/week) included robotic exoskeleton-assisted UE movements and hand grip training, performed concurrently with sham or active TSS. Assessments included electrophysiological measurements and standardized rehabilitation outcomes.

Results

Descriptive analysis revealed meaningful individual improvements masked by group-level heterogeneity. In the stroke group, three participants showed grip strength improvement (assessed without stimulation) after the active phase (+ 9.4 Newtons [N] to + 23.9 N), with two-to-four-fold increases in forearm muscle activation. Mean Fugl-Meyer overall UE scores improved from 89 to 94.2. In the SCI group, two participants showed grip strength gains. One participant exhibited a six-fold immediate force increase (1.0 N to 6.2 N) during stimulation. Another participant achieved improved grip strength without stimulation (23.9 N to 36.8 N) and a three-fold increase in electromyography (EMG) activity from the flexor carpi radialis and first dorsal interosseous muscles, alongside partial pin-prick sensory recovery and self-reported restoration of previously affected perspiration during the active TSS phase.

Conclusions

Varied outcomes in participants confirm that therapeutic effects of combined TSS and robotic UE training are highly individualized. Three critical elements must be blended for the best outcomes of this combinatorial approach: residual UE function, a curated stimulation paradigm, and tailored UE training that provides appropriate challenge, intensity, and salience. The results suggest TSS with UE robotic training hold key potential when considered in the context of the physiological and functional profile of each participant.

Highlights

• Cervical TSS was applied during robotic upper extremity training in individuals with neurological impairment.

• A within-subject sham-controlled crossover design compared active and sham stimulation conditions.

• Neurophysiological responses and sensorimotor performance varied across individuals during stimulation.

• Improvements were most frequently observed during near motor-threshold stimulation combined with active task engagement.

New Device Improves Stroke Survivors’ Mobility

 For me, the main reason for doing this would be the reduction in spasticity; with less spasticity I might be able to recover movement.

New Device Improves Stroke Survivors’ Mobility

University of Pittsburgh School of Medicine researchers reported the final outcomes of a pioneering pilot clinical trial using electrical stimulation of the spinal cord to improve arm and hand mobility in people with chronic stroke. 

The study, published June 4 in Nature Medicine, focused on investigating safety and preliminary efficacy. It showed that seven participants with profound muscle weakness due to stroke experienced an average 32% increase in arm strength, along with improvement in overall arm mobility and reduction in muscle spasticity. Importantly, the intervention required fewer than nine hours of movement-based training over four weeks and did not cause discomfort or serious adverse events.  

“This approach is designed to rapidly help people move their arms better, even years after a stroke,” said cosenior author Marco Capogrosso, assistant professor of neurological surgery, Pitt, and director of the spinal cord stimulation laboratory at Rehab Neural Engineering Labs, UPMC Rehabilitation Institute. “The stimulation works mostly as an assistive technology—when it’s on, people can move better. By stimulating the spinal cord, we can immediately allow residual connections between the brain and the spinal cord to work more efficiently, enabling better movement.” 

Stroke is the leading cause of adult arm paralysis in the United States, with approximately 400,000 people developing chronic arm and hand weakness each year. Many stroke survivors rank recovery of arm function as their top unmet clinical need, yet standard rehabilitation rarely drives meaningful improvement. 

To address this gap, Pitt researchers launched a first-of-its-kind pilot clinical study to test whether epidural spinal cord stimulation delivered to the region controlling arm and hand movement could help stroke survivors regain arm function. The project, which the National Institute of Neurological Disorders and Stroke, a part of the National Institutes of Health, spotlighted as one of the most significant innovations it supported in its 75th anniversary report, relies on implanting thin electrodes along the neck.  

Stimulation sends targeted electrical signals to sensory nerve fibers in the spinal cord to enhance communication between the brain and weakened muscles. The same class of device has been used for decades to treat chronic pain, but it had not been used to restore arm function after stroke. The newly published study expands on earlier findings the team reported in 2023 and confirms that the approach is safe and feasible regardless of age, sex or race. Over the four-week study period, all seven research participants experienced immediate improvements in strength when stimulation was turned on, regardless of how severe their impairment was at baseline. Additionally, spasticity—abnormal muscle stiffness caused by stroke-damaged nerve pathways—was reduced in all seven participants.  

“From a clinical perspective, even modest improvements in arm strength or control can make a meaningful difference in daily life of stroke survivors,” said study coauthor George Wittenberg, professor of neurology and of physical medicine and rehabilitation at Pitt’s School of Medicine. “Some of the improvements we measure may look small from the outside, but many stroke survivors are just on the verge of being able to do something important. Even a small change in motor function can be very significant if it helps someone button a shirt, open their hand or return to an activity they care about. 

While improvements were immediate, the researchers found that lasting gains depended on continued use of stimulation. Follow-up assessments showed that motor function declined when stimulation was discontinued, underscoring the potential of spinal cord stimulation as an assistive neuroprosthetic technology rather than a short-term rehabilitation aid. 

“This study represents the conclusion of our initial feasibility phase and an important step toward real-world clinical application,” Capogrosso said. “Our goal is to develop a technology that could eventually be used in everyday life, not just in the clinic. These results give us confidence that spinal cord stimulation could become a practical, implantable option for helping stroke survivors use their arms when it matters most.”  

Building on these findings, the research team has begun recruiting participants for an extended clinical trial to evaluate the effects of longer-term spinal cord stimulation, both alone and in combination with physical therapy. 

University of Pittsburgh authors of this research include Roberto de Freitas, Shovan Bhatia, Erynn Sorensen, Erick Carranza, Scott Ensel, Amy Boos, Lee Fisher, Daryl Fields, Marc Powell, Jeffrey Balzer, Robert Friedlander, Peter Gerszten and Elvira Pirondini. Additional coauthors are from Carnegie Mellon University, Columbia University, the Veterans Affairs Pittsburgh Healthcare System and Johns Hopkins University. 

This research was supported by the National Institutes of Health BRAIN Initiative (grant UG3NS12313501A1), internal funding from the Departments of Neurological Surgery and Physical Medicine and Rehabilitation,  Pitt, as well as the Department of Mechanical Engineering and the Neuroscience Institute, Carnegie Mellon University. 

Media contact: HSNews@pitt.edu 

Electromyography (EMG)-triggered transcutaneous spinal cord and hip stimulation for gait rehabilitation in persons with chronic stroke: a randomized, controlled trial

 Where is the protocol located so survivors can find it and deliver it to their therapists?

Electromyography (EMG)-triggered transcutaneous spinal cord and hip stimulation for gait rehabilitation in persons with chronic stroke: a randomized, controlled trial

• Mami Tani, 
• Tomofumi Yamaguchi, 
• Kaoru Honaga, 
• Yoko Takahashi, 
• Hidemi Kono, 
• Yuhei Murakami, 
• Reina Isayama, 
• Koshiro Haruyama, 
• Yuji Fujino, 
• Tadamitsu Matsuda, 
• Issei Fukunaga, 
• Masaaki Hori, 
• Akira Tanuma, 
• Futoshi Wada, 
• Kozo Hatori & 
• Toshiyuki Fujiwara 

Journal of NeuroEngineering and Rehabilitation volume 22, Article number: 154 (2025) Cite this article

Abstract

Background

Transcutaneous spinal stimulation has been applied to gait rehabilitation for persons with neurological diseases. The authors developed electromyography-triggered transcutaneous spinal cord and hip stimulation for gait rehabilitation and called this system FAST walk. This study aimed to assess the effect of FAST walk in a randomized, controlled trial.

Methods

All participants were randomly allocated to three groups: FAST walk combined with treadmill gait training (FAST walk); spinal stimulation combined with treadmill gait training (spinal stim); and treadmill gait training (treadmill). Participants performed two sets of 15-min treadmill gait training with 5-min intervals in the FAST walk, spinal stim, and treadmill groups. Gait training was performed twice weekly for a total of 10 sessions. The primary outcome was 10-m walking time. The secondary outcomes were the time symmetry index (TSI) with gait analysis and spinal reciprocal inhibition on the conditioned-test H reflex study.

Results

Twenty persons with chronic stroke participated in this study, and 17 persons completed this study. For the primary outcome, there was no significant interaction between time and intervention in 10-m walking time on two-way analysis of covariance (ANCOVA) (P = 0.382, η2 = 0.064). For the FAST walk group, 10-m walking time improved significantly at post and post-4w (P = 0.024 and 0.022, respectively). In the other groups, no significant improvements in 10-m walking time were seen at post and post-4w compared with before. There was also no significant between-group difference in the 10-m walking time.

Conclusions

The newly developed electromyography-triggered transcutaneous spinal cord and hip stimulation, FAST walk, is safe and may improve the gait speed of persons with chronic stroke. We did not, however, find a significant between-group difference among the FAST walk, spinal stim, and treadmill gait groups.

Trial registration: Japan Registry of Clinical Trial (JRCT registration ID: jRCTs032180289).

Introduction

Most persons with stroke suffer a gait disturbance. The goal of rehabilitation medicine is to help persons acquire independence of locomotion, and improvement of gait function is one of the primary goals of stroke rehabilitation. More than 80% of persons with stroke, however, show gait impairment [1]. A cohort study reported that 22% of persons with stroke did not regain any walking function [2]. Eighty percent of persons with stroke regained gait independence, but gait speed was limited. A previous study showed that gait speed determined the ambulation category of full community, limited community, and home ambulators [3], and gait impairment determined the participation of persons with stroke.

Conventional therapist-assisted gait training, muscle strengthening, partial weight-bearing treadmill gait training, robot-assisted gait training, and functional electrical stimulation have been applied in gait rehabilitation [4, 5].

Recently, spinal cord stimulation has been applied in gait rehabilitation for spinal cord injury, Parkinson’s disease, and stroke [6,7,8,9,10]. Supra-threshold lumbosacral spinal cord stimulation generated smooth, coordinated, flexion–extension movements at the hip, knee, and ankle [11]. This finding suggested that there existed a spinal locomotor circuit in the spinal cord. Minassian et al. [12] showed that subthreshold transcutaneous spinal electrical stimulation at Th11-12 evoked posterior root muscle reflexes in bilateral quadriceps, hamstrings, tibialis anterior, and triceps surae muscles. This finding suggested that subthreshold spinal electrical stimulation might activate a large diameter of the dorsal root afferent nerves. Spinal electrical stimulation of the lumbosacral spinal cord modulates the activity of motor neurons by activating a large diameter of the dorsal root afferent nerve [13]. Continuous spinal stimulation induced rhythmic lower extremity EMG activity, and sub-threshold spinal stimulation increased muscle activities of the lower extremities in rats with spinal cord injuries [14]. It was supposed that there existed spinal locomotor circuit and this spinal locomotor circuitry consists of spinal reflexes (e.g., crossed extensor reflex, flexor reflex) and contributes to the stereotyped locomotive movement [15, 16].

Hip extension at the late stance phase may produce an initial swing of the paralyzed lower extremity [17]. The crossed extensor reflex induces the reciprocating hip movement [18]. Hip extension is a strong trigger of the crossed extensor reflex. Hip sensory afferents induced by hip movements regulate locomotion [19]. In patients with stroke, late stance assisted-hip extension decreased the primary sensorimotor cortex activity and promoted the rhythmic coordinated gait pattern [20]. It was supposed that assisted-hip extension enhances the activity of the spinal locomotor circuit and the effect of spinal stimulation in patients with stroke.

It is hypothesized that subthreshold spinal stimulation combined with hip extensor stimulation activates spinal locomotor circuitry in the spinal cord, which contributes to locomotion. We, therefore, developed a new electromyography (EMG)-triggered transcutaneous spinal and hip stimulation system called FAST walk.

This study aimed to assess the effect of FAST walk combined with treadmill training in persons with chronic stroke in a randomized, controlled trial (RCT). We hypothesized that FAST walk combined with treadmill training improves gait function compared to the spinal stimulation combined with treadmill training, and treadmill training.

More at link.

Spinal stimulation helps stroke patients hit their stride

Is this enough proof for your doctor to get this brought in to your hospital? 

 

With spasticity being improper electrical signals from your spinal cord a competent stroke researcher could test whether this could prevent such disruption. Go ask your stroke doctor to contact stroke leadership to get this research done.

Do you prefer your  doctor and hospital  incompetence NOT KNOWING? OR NOT DOING?

Spinal stimulation helps stroke patients hit their stride

Researchers combined spinal cord stimulation with walking exercises to improve stroke survivors’ balance, walking symmetry, speed, and endurance.

---

Posted on August 19, 2024 by Sciworthy

Image Credit: Photo by Miguel A Amutio on Unsplash

By Ophélie Legars-Tousignant

People have a stroke when blood flow to part of their brain is blocked, preventing brain tissue from getting oxygen and nutrients. Stroke is the main cause of disability in adults over 55. Despite advances in medical treatment and rehabilitation, 35% of stroke survivors still have difficulty with daily tasks because they struggle to walk or stand. Around 70% of stroke survivors have trouble walking, including slow speed, coordination issues, and an uneven stride.

Doctors have found these problems often occur when the routes spinal cord neurons use to transmit information from the brain to the body are disrupted. They’ve tried to reactivate neural paths that control movement by applying electrical pulses to stroke victims’ brains. Researchers have shown electrical pulses to the brain help stroke victims regain control of their fine-scale movements, but their ability to maintain a basic walking pattern relies on neural paths inside the spinal cord. So a team of scientists from the USA and Russia hypothesized that targeting the spinal cord could help stroke patients recover. 

To test whether electrical stimulation of the spinal cord could help stroke survivors walk again, the team applied electrodes to the skin over patients’ spinal cords, a method known as transcutaneous spinal cord stimulation or tSCS. Researchers in the past found that tSCS helps stroke patients walk more steadily and smoothly in the short term. However, this team wanted to test if tSCS could improve nerve and muscle functions to help patients walk better in the long term.

To measure how tSCS impacted stroke patients’ walking ability and muscle function, the researchers recruited 2 groups of 4 participants each. They minimized experimental bias by matching individuals in both groups by age, time since stroke, and walking speed. All the participants were over 18, had experienced a stroke at least 1 year ago, and could walk without support. The researchers conducted walking exercises with both groups to improve balance and movement 3 times a week for 8 weeks. They assigned only walking exercises to the first group, referred to as the control group, and combined walking exercises with tSCS for the second group, referred to as the stim group.

The researchers assessed how well each participant could walk before they did the walking exercises, immediately after the walking exercises, and 3 months later. They measured the symmetry of each participant’s steps using 2 metrics: how long their steps were and the swing time of their steps. They also measured how fast the participants walked and the distance they covered in 6 minutes. They collected these data by combining observations from a physical therapist with direct measurements from a mat with sensors. 

The team found that the stim group improved their step symmetry by 64% after walking exercises, while the control group improved their step symmetry by only 33%. The stim group also walked faster with more consistent swing time than the control group. All stim group participants and 1 control group participant could walk farther than they did before walking exercises, but only 1 participant from each group maintained this progress after 3 months. The researchers interpreted these changes to mean that combining tSCS with walking exercises helped stroke patients walk faster and longer. However, they cautioned that patients could lose these gains without continued treatment since only their step symmetry showed lasting improvement. 

The researchers also measured changes in the participants’ muscles and neurons before and after tSCS treatment and walking exercises. They explained that the more complex and numerous a person’s muscle groups are, the better control they have over their leg movements when walking. So they considered how the patients’ muscle groups worked together when walking, known as their muscle synergy. To examine muscle synergy, the researchers measured the activity of 5 leg muscles for each participant by placing sensors on their skin that detected electrical signals when the muscles contracted. They found that 2 stim group participants had better muscle coordination after walking exercises and tSCS. The researchers interpreted these results to mean that tSCS helped improve the participants’ muscle coordination during walking.

The researchers concluded that electrical stimulation of the spinal cord helped some stroke survivors walk better than before. However, they suggested personalized training and customized stimulation settings could make tSCS more effective by addressing each patient’s individual challenges. They also suggested researchers conduct longer trials with a larger number of participants to better understand the lasting effects of tSCS and to apply their findings to stroke victims more widely.

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Study Information

Original study: Noninvasive spinal stimulation improves walking in chronic stroke survivors: a proof-of-concept case series

Study was published on: April 1, 2024

Study author(s): Yaejin Moon, Chen Yang, Nicole C. Veit, Kelly A. McKenzie, Jay Kim, Shreya Aalla, Lindsey Yingling, Kristine Buchler, Jasmine Hunt, Sophia Jenz, Sung Yul Shin, Ameen Kishta, V. Reggie Edgerton, Yury P. Gerasimenko, Elliot J. Roth, Richard L. Lieber, Arun Jayaraman

The study was done at: Shirley Ryan AbilityLab (USA), Northwestern University (USA), Syracuse University (USA), Rancho Los Amigos National Rehabilitation Center (USA), University of Southern California (USA), University of Louisville (USA), Pavlov Institute of Physiology (Russia), Hines VA Medical Center (USA)

The study was funded by: National Institutes of Health (NIH), Department of Defense (DoD), Craig H. Neilsen Foundation, University of California, Los Angeles (UCLA), Shirley Ryan AbilityLab

Raw data availability: None provided

Featured image credit: Photo by Miguel A Amutio on Unsplash

This summary was edited by: Aubrey Zerkle

 

Augmenting Hand and Arm Function for Persons with Hemiparesis

So not surgery: Transcutaneous spinal cord stimulation (tSCS) is a non-invasive form of neuromodulation in which electrodes are placed on the skin and used to stimulate the spinal circuitries via an electrical current.(Why not use something similar to disrupt the spasticity signals sent from the spinal cord?)

Ask your competent? doctor if vagus nerve stimulation is better than this. 

 Augmenting Hand and Arm Function for Persons with Hemiparesis

Abstract

Background. 

 

Hand and arm dysfunction due to neural disorders significantly influences quality of life.
Activity-based training has been found to improve function. These improvements could be augmented
with transcutaneous spinal cord stimulation (tSCS) due to the modulatory effect it has on spinal and
supraspinal networks. 

 

Objective.

 

 The primary aim is to determine if a 4-week training program will improve hand and arm function. The secondary aim is to determine if the addition of tSCS to a second
4-week training session will further improve function. 

 

Design. 

 

This is a pre-posttest, controlled trial for persons 10-75 years of age, >6 months post stroke or with unilateral cerebral palsy.

 

Methods. 

 

Participants will engage in two 4-week training periods, 3x/week for 2 hours/day. The 1st period will include unimanual and bimanual training alone. The 2nd period will be augmented with low frequency tSCS to the C5-T1 spinal region. Stimulation intensity will be based on individual muscle activation during 3 tasks: 1) grip dynamometry; 2) grip-lift; and 3) target pointing. Outcome measures taken before, midway, and after training are: Canadian Occupational Performance Measure (COPM), dexterity, daylong arm use, grip/pinch strength, sensibility, questionnaires, bilateral hand/arm surface electromyography, and Upper Extremity Fugl-Meyer (UEFM). 

 

Results:

 

 Nine participants have completed the 1st 4-week training period without mtSCS. Individual data reveals improvements in the COPM, Grip strength, dexterity, and the UEFM. Findings for other measures after the 1st period are mixed or in process. 

 

Conclusion:

 

Preliminary findings from this ongoing study reveal that participants made improvements in most measures. The next phase of the study will determine if the addition of tSCS to training further augments hand and arm function.
DisciplinesDisciplines
Neurosciences | Physical Therapy
AuthorsAuthors
Brooke Stein, Susan Duff, Alison McKenzie, Bailey Advincula, Isaac An, Annie Jeon, Casey McWilliam, Will
Potter, Virginia Ruano, Paulina Vokulich, Audrey Howell, and Rahul Soangra

Reach Neuro receives FDA Breakthrough Device designation for device to restore arm and hand movement to chronic stroke patients

I can't tell how the spinal stimulation is initiated. Because if it requires any brain function to be initiated from the motor cortex then it won't work for me with my mostly dead motor cortex.  I guess I'll just be disabled for 50 years, half my life.

Reach Neuro receives FDA Breakthrough Device designation for device to restore arm and hand movement to chronic stroke patients

Reach Neuro's Avantis device delivers small electrical impulses to the spinal cord to help stroke survivors regain motion and independence

PITTSBURGH, April 10, 2023 /PRNewswire/ -- Reach Neuro, Inc., a neurotechnology company giving control and independence back to people with debilitating neurological disorders, announced today that it has been granted a Breakthrough Device designation by the U.S. Food and Drug Administration (FDA) for its Avantis platform. Avantis uses small electrical impulses delivered to the spinal cord to help restore shoulder, arm, and hand movement to individuals with impairment due to chronic stroke. The FDA Breakthrough Device designation recognizes the importance of bringing this technology to clinics quickly to address an enormous un-met need for the nearly 7.5 million Americans living with post-stroke disability.

In the US, an estimated 800,000 people per year have a stroke, and nearly half will experience some form of long-term paralysis as a result of permanent damage to the brain's ability to send signals to muscles. Today, there is no standard of care for these individuals—many of whom struggle to obtain insurance coverage for post-acute physical or occupational therapy due to a lack of evidence that such therapy provides benefit after the first 3-6 months post-stroke. Reach Neuro's Avantis system directly restores a patient's ability to control movement, not only giving immediate relief, but also making it possible to return to therapy and continue making even further improvements.

Reach Neuro was founded in 2021 as a spinout company of the University of Pittsburgh and Carnegie Mellon University, where the technology is currently being tested in an NIH funded clinical trial in collaboration with the University of Pittsburgh Medical Center (UPMC). The team recently published a manuscript in the journal Nature Medicine, describing the results from the first two study participants. In the study, subjects showed 40% and 108% improvements in grip strength respectively, and up to 124% improvement in joint strength. These improvements enabled them to perform reaching movements more quickly and smoothly than without stimulation (30-40% faster). Participants were also able to perform functional tasks like lifting objects, eating with a fork, and opening a lock. Surprisingly, the researchers observed that some improvements were retained up to one month after the study, even without stimulation. However, patients will likely benefit from having the implant chronically.

"We are excited about the FDA's recognition of our technology's potential to change the lives of millions of people living with disability," said Marc Powell, Ph.D. CEO, Co-Founder of Reach Neuro. "The Breakthrough Device designation is an incredible opportunity to work closely with FDA experts to expedite the clinical translation of the Avantis system."

Current treatments for stroke focus only on the acute phase of recovery and approximately 50% of stroke survivors are left with disabilities that are considered permanent. However, early evidence shows that the Avantis system can be effective in chronic stroke patients even up to 9 years after their stroke, which is well outside the 6 month window in which existing therapies are used. The stimulation empowers stroke patients to regain use of their arm and hand, strengthening muscle activity without imposing unintended movements.

Heather Rendulic, the first participant in the university-lead clinical study describes her experience with the device: "Having the stimulation working and being able to move my arm/hand again after 9 years was one of the most surreal experiences of my life—it was as if my brain was in control of my arm again. This technology gave me such immense hope that one day I will regain a sense of independence again. This will change the lives of millions of people!"

Reach Neuro is an alumni of SOSV's IndieBio startup development program, which mentors, scales, and invests in early-stage life sciences startups building the future of planetary and human health. With the FDA Breakthrough Device status, the company intends to accelerate the regulatory process for its Avantis platform through close collaboration with the agency, to make their shared goal—changing the narrative around chronic stroke—a reality.

About Reach Neuro

Reach Neuro develops implantable neuromodulation systems to restore upper limb motor function in people with chronic stroke and other neurological disorders. It was founded in 2021 based on work started at the University of Pittsburgh and Carnegie Mellon University with the goal of bringing advanced neurotechnologies out of the lab and into the hands of patients. Its mission is to change the way we look at physical rehabilitation and end the notion of permanent disability. For more information, visit: www.reachneuro.com.

Spine-zapping stroke breakthrough allows survivors to do everyday tasks again: Watch life-changing effects in woman left unable to use a knife and fork for almost a decade

No comments on whether the movements continue after the stimulation is turned off. So bad research because they didn't measure the right things. The mentors and senior researchers need to be retrained in stroke research. The whole point of stroke research is to get survivors 100% recovered! This fell short of that. 

Spine-zapping stroke breakthrough allows survivors to do everyday tasks again: Watch life-changing effects in woman left unable to use a knife and fork for almost a decade

• Around three-quarters of stroke survivors lose movement down one side of body
• Heather Rendulic suffered five strokes from a burst blood vessel in her brain 
• But electrical stimulation of spinal cord helped her regain movement in left arm

By Victoria Allen Science Editor For The Daily Mail

Updated: 19:40 EST, 20 February 2023

Zapping people who have had a stroke with electricity could help them to do daily tasks easily again.

Around three-quarters of people who suffer a stroke lose movement down one side of their body, severely affecting their everyday life.

But electrical stimulation of the spinal cord has helped one woman, Heather Rendulic, eat with a knife and fork for the first time in almost a decade.

Previously unable to fully close her left hand, the technology helped her to grip a fork, spear a steak, use her right hand to cut it, and lift the fork up to her mouth to eat.

The breakthrough was made in a study involving two women who had suffered strokes.

Electrical stimulation of the spinal cord has helped one woman, Heather Rendulic (hand pictured), eat with a knife and fork for the first time in almost a decade

Previously unable to fully close her left hand, the technology helped Mrs Rendulic (pictured) to grip a fork, spear a steak, use her right hand to cut it, and lift the fork up to her mouth to eat 

• 
  

The results show a 40 per cent increased grip for Mrs Rendulic after being zapped with small, continuous pulses of electricity.

A second woman, aged 47, who was left more severely weak after a stroke, saw her grip strength more than double.

Electric stimulation has previously been principally used to help people with spinal cord injuries regain movement.

How does the device work? 

A life-changing stroke breakthrough has allowed survivors to regain motion of their arm and hands.

The technology sees a pair of thin metal electrodes — resembling strands of spaghetti — placed along the neck, in line with where the spinal cord is.

These deliver pulses of electricity that activate nerve cells inside the spinal cord.

It amplifies the activity of muscles that have been weakened by stroke. 

As a result, stroke patients were fully open and close their fist and lift their arm above their head.

They could also use a fork and knife to cut a piece of steak for the first time in years.

The technology is already used to treat chronic pain. 

And previous studies showed that spinal cord stimulation can restore movement to the legs after spinal cord injury.

There was some limited evidence that it could also help people following strokes, but researchers say they have now worked out the precise position and programming for the electrodes which can provide consistent results.

The key to the therapy is boosting nerves called 'dorsal roots' at the top of the spinal cord, which can trigger muscles in the arms and hands to respond to weak signals from the brain.

Mrs Rendulic, who suffered five strokes in 11 months from a burst blood vessel in her brain, which happened in 2011, was able to pick up a can of soup and unlock a padlock.

She had a laboratory of scientists in tears after regaining movement in her left hand within minutes of the stimulation being switched on.

Dr Marco Capogrosso, senior author of the study, from the University of Pittsburgh, said: 'The first day, with the first patient, when she opened her hand after nine years, was a particularly intense moment because obviously she started crying and we all started crying.

'The whole lab was crying - I mean, we didn't really expect that this could work as fast, like that.'

On the results, Mrs Rendulic, a human resources manager, who had to relearn how to walk following her initial strokes, said: 'It's just awesome, because I can move my arm and hand in ways I haven't done in over a decade.'

The study is at an early stage, and only in two people so far, which makes it difficult to know how safe and effective the therapy would be if it were used widely.

To have the stimulation, Mrs Rendulic and a second woman aged 47 had to undergo surgery to have two wires studded with electrodes implanted, which stretch from the neck down to the top of the ribs.

• 
  

The key to the therapy is boosting nerves called 'dorsal roots' at the top of the spinal cord (shown on scan), which can trigger muscles in the arms and hands to respond to weak signals from the brain 

• 
  

Mrs Rendulic, who suffered five strokes in 11 months from a burst blood vessel in her brain, which happened in 2011, was able to pick up a can of soup (pictured) and unlock a padlock 

But over 29 days of stimulation, both women improved their abilities.

Mrs Rendulic, who was less weak on one side from her strokes, saw better results than the other volunteer, whose stroke happened more recently, three years before the study.

She was able to draw a spiral more precisely, open her hand fully, and lift her arm straight up above her head, where previously she could only raise it to shoulder height.

The effects, reported in the journal Nature Medicine, lasted longer than expected - even after the stimulation was switched off.

Mrs Rendulic still scored significantly higher on a test of arm and hand function than she had before the study.

Experts believe electrical stimulation may help to retrain the brain to perform movements again, which could help with rehabilitation.