Evidence map›Paper›PMID 41129698›Full record

ArticleJMIR research protocols2025

Effectiveness of Transcutaneous Spinal Cord Stimulation for Lower Limb Rehabilitation in Spinal Cord Injury: Protocol for a Systematic Review and Meta-Analysis.

Ravi Shankar, Wei Wen Kevin Sim, Gobinathan Chandran

Abstract read
In one paragraph

Article in JMIR research protocols, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors.

Ravi ShankarDepartment of Rehabilitation Medicine, Alexandra Hospital, 378 Alexandra Road, Singapore, 159964, Singapore, 65 83797930.ORCID 0009-0005-5578-3481
Wei Wen Kevin SimDepartment of Rehabilitation Medicine, Tan Tock Seng Hospital, Singapore, Singapore.ORCID 0009-0003-4243-7227
Gobinathan ChandranDepartment of Rehabilitation Medicine, Department of Medicine, National University Hospital, Singapore, Singapore.ORCID 0000-0002-5957-1719

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Spinal cord injury (SCI) affects millions of people worldwide and often results in impaired lower limb function and reduced mobility. Transcutaneous spinal cord stimulation (tSCS) has emerged as a promising neuromodulation technique for enhancing motor recovery and walking ability in individuals with SCI. Objective: This systematic review and meta-analysis will determine the effectiveness of tSCS, compared with sham stimulation, no intervention, or other active interventions, for improving lower limb motor function in individuals with SCI. Secondary objectives are to evaluate tSCS effects on walking ability, spasticity, quality of life, and safety outcomes. Methods: This systematic review will be conducted according to the Cochrane Handbook for Systematic Reviews of Interventions and reported following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 2020 statement. We will search electronic databases (PubMed, Web of Science, Embase, CINAHL, MEDLINE, Cochrane Library, Physiotherapy Evidence Database, and Scopus) from inception to August 2025, along with gray literature, trial registries, and hand-searching of key journals. We will include randomized controlled trials (RCTs), quasi-RCTs, and nonrandomized studies (case series with ≥5 participants) that evaluate the effects of tSCS applied over the spinal region on lower limb rehabilitation outcomes in adults with traumatic or nontraumatic SCI. The primary outcome will be lower limb motor function assessed by validated measures such as the Lower Extremity Motor Score. Secondary outcomes will include walking ability, balance, functional independence, spasticity, quality of life, and adverse events. Two reviewers will independently screen studies, extract data, and assess risk of bias using version 2 of the Cochrane Risk of Bias tool for RCTs and Risk of Bias in Non-randomized Studies of Interventions tool. Data will be synthesized using random-effects meta-analysis if appropriate, with subgroup analyses examining injury level, completeness, stimulation site, and cointervention effects, and sensitivity analyses. Evidence certainty will be evaluated using the Grading of Recommendations Assessment, Development, and Evaluation approach. Results: This protocol paper presents strategy development and protocol registration, with results expected by October 2025. Conclusions: This comprehensive systematic review and meta-analysis will address an important evidence gap, providing the first focused evaluation of tSCS effectiveness for lower limb rehabilitation in SCI. Results will inform clinical practice guidelines and guide future research directions.

Indexed as

Lower ExtremitySpinal Cord InjuriesSpinal Cord StimulationHumansMeta-Analysis as TopicQuality of LifeRecovery of FunctionResearch DesignSystematic Reviews as TopicTreatment OutcomeWalkinglower limb rehabilitationmotor functionneuromodulationspasticityspinal cord injurytranscutaneous spinal cord stimulationtSCSwalking ability

Identifiers

PMID41129698
PMCPMC12548825

What OpenQuestion holds

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LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.