30-Second Takeaway
- tSCS added to locomotor training did not improve walking beyond sham in chronic incomplete SCI over 12 weeks.
- Action observation plus VR produced clinically meaningful gains in paretic hand dexterity versus VR alone after stroke.
- Early intraoperative photobiomodulation in acute cervical SCI accelerated early neurologic and functional recovery without clear long-term differences.
Week ending March 21, 2026
Neuromodulation, digital rehab, and dosing of common modalities in contemporary neuro- and musculoskeletal rehabilitation
tSCS adds no clinically meaningful benefit to locomotor training in chronic thoracic SCI
In this multicentre triple-blind RCT (n=50), adding 12 weeks of transcutaneous spinal cord stimulation to locomotor training did not improve walking versus sham. The between-group difference in WISCI-II at 12 weeks was −0.1/20 (95% CI −1.6 to 1.5; p=0.98), far below the 2-point minimal worthwhile effect. Both active and sham groups improved walking with and without stimulation, and gains were maintained at 16 weeks, implicating locomotor training itself. Adverse events, mainly minor skin issues, were similar across groups, indicating acceptable safety but no additive efficacy.
Action observation plus VR improves paretic hand dexterity after stroke
This multicenter assessor-blinded RCT (n=48) compared action observation plus VR-based upper limb training with VR alone in adults with poststroke hemiplegia. Both groups received 20 one-hour sessions over 5 weeks; only the experimental group observed daily goal-directed actions before VR practice. Paretic hand Box and Block Test gains were larger with action observation, with between-group differences of 7.8 blocks post-treatment and 10.8 at 6 months. Nonparetic hand dexterity and secondary measures of strength, spasticity, disability, and independence improved similarly in both groups.
Early intraoperative photobiomodulation accelerates short-term recovery after incomplete cervical SCI
This multicenter RCT enrolled adults with acute ASIA C cervical SCI undergoing posterior decompression within 24 hours and randomized them to photobiomodulation (PBM) or standard care. Daily PBM for 7 days led to higher ASIA motor scores at 0.5 months (difference 8.13) and 3 months (13.33), but no differences at 6–12 months. Independent ambulation rates and SCIM, SF-36, and EQ-5D scores favored PBM at 3 and 6 months, converging by 12 months. CSF biomarkers of neural injury at day 7 were lower with PBM, and fewer complications occurred without device-related serious events.
References
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Additional Reads
Optional additional studies from this edition.