Fig. 3. Acute effects of lumbosacral transcutaneous spinal cord stimulation on segmental trunk extension in children with SCI.
Box plots of angles at each measured trunk segment averaged over 10 s of the participants’ volitional attempt (VA) to sit upright (white boxes) (average of 3 trials), prior to stimulation, baseline (BL) resting sitting (gray boxes) or during 10 s of sitting with scTS at T11 (a) and L1 (b) at the upright posture-inducing, scTS intensities optimized for each individual (blue boxes) (n = 7 participants for each stimulation site, 1 trial at each stimulation site on the third day). Change in anteroposterior and mediolateral center of pressure displacement (COP, millimeters, mm) during scTS at T11 (c) and L1 (d) relative to baseline (n = 6 for each stimulation site, the missing data point from one of the experiments occurred due to the loss of signal from the force plate). The centerline represents the group median, the left, and right box bounds represent 25th and 75th interquartile range (IQR), respectively. Box whiskers represent 1.5 times the IQR. The overlaying dots represent individual data points. Black dots are outlier points that lie outside of 1.5 times the IQR. The dotted line at 0° represents neutral vs. extended (−) or flexed (+) trunk position. Mixed linear regression models were used to assess the overall differences in trunk angles and COP changes across the timepoints of baseline sitting, volitional attempt, compared to stimulation at T11 (F16,140 = 14.41, p < 0.0001) and L1 (F16,140 = 7.75, p < 0.0001), followed by Tukey’s post hoc t test. *denotes significance for L5S1: BL vs. T11 scTS, p = 0.03, Cohen’s d = 0.97; BL vs. L1 scTS, p = 0.006, Cohen’s d = 1.18; VA vs. L1 scTS, p = 0.03, Cohen’s d = 0.97; for PelvisT8: BL vs. T11 scTS, p < 0.0001, Cohen’s d = 2.1; VA vs. T11 scTS, p < 0.0001, Cohen’s d = 2.4; BL vs. L1 scTS, p < 0.0001, Cohen’s d = 2.35; VA vs. L1 scTS, p < 0.0001, Cohen’s d = 2.76; for T8Head: BL(T11) vs. VA, p = 0.03, Cohen’s d = 0.95; BL vs. T11 scTS, p = 0.0027, Cohen’s d = 1.28; VA vs. T11 scTS, p < 0.0001, Cohen’s d = 2.23; BL (L1) vs. VA, p = 0.0002, Cohen’s d = 1.53; BL vs. L1 scTS, p < 0.002, Cohen’s d = 1.33; VA vs. L1 scTS, p < 0.0001, Cohen’s d = 2.86; for anteroposterior COP: change from BL vs. T11 scTS, p = 0.0008, Cohen’s d = 1.53, change from BL vs. L1 scTS, p < 0.0001, Cohen’s d = 2.95; VA vs. L1 scTS, p = 0.0001, Cohen’s d = 1.74; for mediolateral COP: VA vs. L1 scTS, p = 0.0023, Cohen’s d = 1.4.