New approaches to spasticity management after spinal cord injury: application of multilevel magnetic stimulation

BACKGROUND: Each year, 5–6 million injuries involving the nervous system are reported worldwide, of which 5%–9% are spinal cord injuries. Although these occur less frequently, the outcomes are severe: up to 100% of affected individuals develop disability or die. Muscle spasticity is one of the most common complications after spinal cord injury, particularly if the cervical and upper thoracic spine is involved. Spasticity develops as a result of damage to descending pathways and loss of inhibitory cortical control. Severe spasticity substantially limits rehabilitation, contributes to contractures and pressure ulcers, reduces quality of life, and increases socioeconomic burden, highlighting the need for more effective treatment methods.

AIM: This work aimed to assess the effectiveness of multilevel magnetic stimulation as a method for reducing the severity of muscle spasticity in patients with spastic mono- and paraplegia due to spinal cord injury.

METHODS: A comprehensive evaluation was performed in 30 patients with spinal cord injury who were assigned to either the main group or the control group. Spasticity was assessed using the Modified Ashworth Scale. The main group received standard of care combined with multilevel magnetic stimulation, whereas the control group received standard of care alone.

RESULTS: Data from 30 patients were analyzed. Four patients in the control group and three in the intervention group were excluded due to absence of spasticity. The mean Modified Ashworth Scale score decreased from 3.73 to 2.00 points in the main group and from 3.58 to 2.08 points in the control group. Although the reduction in both groups was statistically significant, clinical improvement was more pronounced when multilevel magnetic stimulation was used (Cohen’s d: 1.45 vs 0.91, respectively). Intergroup differences did not reach statistical significance, yet the effect size indicates a clear advantage of the experimental technique. The results support the feasibility of multilevel magnetic stimulation as part of comprehensive rehabilitation in spinal cord injury patients.

CONCLUSION: Multilevel magnetic stimulation combined with standard therapy provides a more clinically meaningful reduction in spasticity on the Modified Ashworth Scale compared with standard therapy alone. This method represents a promising area in rehabilitation after spinal cord injury and warrants further investigation.