Transcutaneous Spinal Cord Stimulation (tSCS): What Clinicians Need to Know

Non-invasive stimulation therapies like transcutaneous spinal cord stimulation (tSCS) and cortical stimulation are making headlines and for good reason. With a growing body of research supporting their use, these interventions are beginning to reshape how clinicians approach motor and gait recovery in patients with neurological conditions.

Recent studies suggest that pairing tSCS with established therapies can lead to meaningful improvements for patients. Here’s a closer look at some key findings:

In January 2025, Natalia Comino-Suárez and colleagues published a double-blind randomized controlled trial. The study aimed to evaluate whether adding tSCS to robotic-assisted gait training could produce greater motor and functional recovery than robotic training alone.

Study details:

• Participants: 27 subacute incomplete SCI patients
• Intervention: tSCS over T11-T12 + 40 Lokomat sessions
• Control: Sham tSCS + Lokomat

Key Findings:

• +3.4 points in lower extremity motor scores (LEMS) in tSCS participants
• 37.5-second improvement in 10MWT in tSCS participants
• 3.4-point increase in WISCI-II in tSCS participants
• 85.7% of tSCS participants walked 10m at follow-up (vs 43.1% in sham)

Takeaway: Combining tSCS with robotic gait training significantly improves motor function and walking ability in subacute incomplete SCI patients.

Exploring tsDCS for Motor Recovery

Xu Zhi-Jie et al. conducted a review in January 2025 examining 16 studies on tsDCS (direct current transcutaneous spinal cord stimulation). The goal was to synthesize findings on tsDCS’s potential to enhance motor recovery and explore how it might be integrated into rehabilitation protocols.

Review Details:

• Participants: post-stroke and SCI patients from 16 different studies
• Intervention: tsDCS applied with various protocols, often paired with NMES or robotic training
• Control: N/A (literature review)

Key Findings:

• tsDCS enhances motor unit recruitment and spinal reflex modulation.
• tsDCS supports neuroplasticity when paired with adjunct therapies.

Takeaway:

tsDCS shows potential for motor recovery but requires larger, standardized trials for clinical integration.

tSCS + Activity-Based Therapy

A February 2025 pilot study by Jenny Suggitt explored tSCS combined with activity-based therapy (ABT). The study focused on assessing the feasibility and effectiveness of delivering this combined intervention in a real-world community rehabilitation setting.

Study Details:

• Participants: 10 chronic SCI patients (all ASIA levels)
• Intervention: 120 sessions of tSCS + activity-based therapy (ABT) targeting UE, trunk, and LE recovery
• Control: N/A (nonrandomized pilot study)

Key Findings:

• 40% achieved AIS classification and/or neurological level improvements
• Functional gains continued beyond 120 sessions
• Minimal improvement noted before 60 sessions

Takeaway: Long-term tSCS combined with ABT supports sustained functional gains in chronic SCI populations.

Cardiovascular Safety of tSCS in Cervical SCI

In March, 2025 a study by Soshi Samejima and colleagues evaluated the cardiovascular safety of transcutaneous spinal cord stimulation (tSCS) when combined with upper extremity rehabilitation in chronic cervical SCI patients. It aimed to determine whether tSCS affects blood pressure or heart rate, ensuring its safe integration into therapy protocols for this population.

Study Details:

• Participants: 60+ chronic cervical SCI patients
• Intervention: tSCS combined with upper extremity rehabilitation
• Control: Standard rehabilitation alone (multi-center safety study)

Key Findings:

• No significant BP or HR changes during tSCS sessions
• Safe for patients on BP medications
• No adverse cardiovascular events reported

Takeaway:
tSCS is safe for cervical SCI patients and can be confidently integrated into rehabilitation protocols.

Non-Invasive Stimulation for Motor & Gait Recovery

In March 2025, a systematic review published in Journal of NeuroEngineering and Rehabilitation analyzed 12 randomized controlled trials on non-invasive brain and spinal stimulation. The review aimed to assess the effectiveness of interventions like tDCS, rTMS, tsDCS, and tSCS in improving motor strength and gait recovery for individuals with incomplete spinal cord injuries.

Study Details:

• Participants: 341 across 12 RCTs
• Intervention: tDCS, rTMS, tsDCS, and tSCS evaluated for motor and gait recovery
• Control: Standard therapy or sham stimulation (depending on study)

Key Findings:

• tDCS (transcranial direct stimulation): Modest improvements in lower extremity strength and gait velocity
• rTMS (repetitive transcranial magnetic stimulation): Greater motor gains but limited gait impact
• tsDCS (transcutaneous spinal cord direct current stimulation): No significant gains in small samples
• tSCS (transcutaneous spinal cord stimulation): Notable gait speed improvements with thoracic biphasic stimulation

Takeaway: Non-invasive stimulation shows promising effects on motor and gait recovery but requires larger, standardized studies for broad clinical integration.

For neurorehabilitation professionals, staying at the forefront of evidence-based practice is essential. These studies highlight how non-invasive stimulation therapies like tSCS and tsDCS are expanding what’s possible in patient care.

By integrating these interventions, clinicians can:

• Enhance neuroplasticity to support motor and gait recovery.
• Offer new pathways for functional gains in patients plateauing with traditional therapies.
• Address secondary complications like muscle atrophy and cardiovascular deconditioning.
• Improve patient engagement and adherence with innovative, real-world treatment options.

As research continues to validate these therapies, they’re becoming powerful tools for clinics aiming to provide comprehensive, cutting-edge care.

At MYOLYN, we’re committed to bringing the power of non-invasive stimulation into everyday clinical practice. With innovative solutions like the MyoCycle, we help clinicians to improve patient outcomes and recovery from spinal cord injuries and other movement disorders.

Explore how the MyoCycle can complement your neurorehabilitation programs and bring cutting-edge care to your patients.