The methods of non-invasive therapy and rehabilitation in patients with spinal cord injury

Spinal cord injury remains one of the most challenging medical and social issues, leading to long-term disability. Modern neuromodulation techniques provide new opportunities for motor function recovery, spasticity reduction, and neuropathic pain control; however, their effectiveness requires systematic evaluation.

Objective. To summarize current evidence on the use of functional electrical stimulation, transcranial magnetic stimulation, transcranial direct current stimulation, and transcutaneous spinal cord stimulation in patients with spinal cord injury.

Material and methods. A review of systematic reviews and meta-analyses published in international databases (PubMed, Scopus, Web of Science, eLibrary) between 2015 and 2025 was performed. A total of 35 sources, including results of randomized clinical trials and network meta-analyses, were analyzed.

Results. Functional electrical stimulation demonstrated a pronounced effect in improving respiratory function, endurance, and reducing spasticity. Transcranial magnetic stimulation contributed to motor function recovery, increased muscle strength, and reduced pain. Transcranial direct current stimulation showed moderate analgesic effects while maintaining a high safety profile. Transcutaneous spinal cord stimulation was effective in reducing spasticity and improving lower limb strength, particularly when combined with physical rehabilitation.

Conclusion. Non-invasive neuromodulation is a promising adjunct to standard therapy for spinal cord injury. It enhances motor function recovery, reduces spasticity and pain, and improves patients’ quality of life. Further highquality studies are needed before its integration into clinical practice.

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