Noninvasive neuromodulation as an adjunct rehabilitation strategy for respiratory dysfunction in individuals with low-level spinal cord injury

Introduction. For individuals suffering from mild spinal cord injuries (SCIs), respiratory problems continue to be a leading source of disability, mainly due to impaired ventilatory muscle performance. Conventional respiratory rehabilitation improves pulmonary function to some extent, but additional strategies are needed to optimize recovery. Noninvasive neuromodulation has recently gained attention as a promising adjunctive therapy to increase respiratory complications in cases with SCI. Aim: This study sought to assess the impact of noninvasive neuromodulation, in addition to standard respiratory rehabilitation, on pulmonary function parameters in cases with low-level SCI compared with standard rehabilitation alone. Methods: Forty patients with incomplete or complete SCI at or below T6 in chronic stage were arbitrarily partitioned into 2 equal groups. Both groups A and B received a standardized respiratory rehabilitation program while Group A received additional noninvasive neuromodulation therapy, sessions were conducted 3 times/week for 8 consecutive weeks, Pulmonary function parameters, including forced expiratory volume in the first second (FEV₁), forced vital capacity (FVC), and the FEV₁/FVC ratio were evaluated pre- and post-intervention. Results: Both populations exhibited significant intra-group enhancements in FEV₁ and FVC post-treatment (P < 0.001). However, the neuromodulation group (Group A) exhibited significantly greater post-treatment values matched to the control group (P ≤ 0.001 for both FEV₁ and FVC). The FEV₁/FVC ratio showed no statistically significant changes within or among groups. Conclusion: Noninvasive neuromodulation, when added to standard respiratory rehabilitation, provides significant improvements in pulmonary function (FEV₁ and FVC) among patients with low-level spinal cord injury. This approach may represent a valuable, and noninvasive adjunct to conventional rehabilitation strategies.