Operant Conditioning of the Motor Evoked Potential in Forearm Extensors of Individuals with Chronic Incomplete Cervical Spinal Cord Injury: Case Studies.
Five participants improved on at least one arm/hand test, and all five with paired self-care assessments improved. This supports further rehabilitation research.
Dellenbach BHS, Lewis AF, Cote RK, Phipps AM, Thompson AK.
Topics in spinal cord injury rehabilitation · Publication date: 2026-09-28
Added to site: 2026-10-05
DOI: 10.46292/sci25-00106
Published September 28, 2026. Added October 5, 2026.
- Modalities
- Biofeedback, TMS/rTMS
- Clinical focus
- Spinal cord injury, Upper-limb rehabilitation
- Population
- Adults with chronic incomplete cervical spinal cord injury
- Sample
- Six completed; five supplied paired self-care scores
- Intervention / method
- Six baseline and 24 feedback sessions targeting TMS-evoked forearm muscle responses
- Comparator
- Own baseline; no separate control group
Clinician summary
MEP size increased in four of six; voluntary-contraction EMG increased in all six. One participant performed worse on the Box and Block Test despite changing grasp strategy.
How to interpret the findings
Small uncontrolled series cannot establish efficacy. Two continued outpatient therapy. No adverse effects were reported, but six people cannot establish safety. EMG change is not equivalent to measured strength or independence.
Equipment and disclosures
Magstim 2002 with a 70-mm figure-eight coil and surface EMG.
Neilsen/ASIA, South Carolina SCI Research Fund, Doscher program and NIH support; authors declare no conflicts.
Related evidence
Compare findings from the same clinical area, including mixed results.
- Motor Cortex rTMS Alleviates Pain and Comorbid Depression After Spinal Cord Injury with a Correlate in M1 Intracortical Inhibition. · Positive with limitations
- Neurofeedback-Guided Motor Imagery in Chronic Stroke: A Case Series on Upper-Limb Recovery, Cortical Activation, and Brain Symmetry. · Positive with limitations
- Efficacy of combined repetitive transcranial magnetic stimulation and occupational therapy in spinal cord injury patients: a randomized controlled clinical study. · Mixed
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