Cervical-level spinal cord injuries (SCIs) account for approximately 50% of all traumatic SCIs (Alizadeh et al., 2019) and are associated with lower functional rehabilitation outcomes compared to thoracic, lumbar, and sacral-level injuries (Arsh et al., 2020). Many individuals with this diagnosis report that the most debilitating consequence is the loss of upper extremity function (Inanici et al., 2021). Although occupational therapy plays a significant role throughout the continuum of care—from acute to chronic stages—interventions for this population often lead to rapid plateaus in functional improvements (Moritz et al., 2024). This standard is being challenged by the use of neuromodulation through transcutaneous spinal cord stimulation (tSCS), a non-invasive modality demonstrating promising results. By providing electrical stimulation above and below the level of injury, tSCS can facilitate volitional movement, enhance autonomic nervous system function, and support meaningful functional gains when paired with skilled occupational therapy (Moritz et al., 2024). This presentation will explore the mechanisms of tSCS, summarize current evidence supporting its use in individuals with cervical SCI, identify areas for further research, and discuss preliminary outcomes from its first year of clinical application in a Michigan outpatient facility.
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