Effects of Electrostimulation With the Laparoscopic Implantation of Neuroprosthesis Procedure Combined With Cardiorespiratory Physiotherapy on the Functional Rehabilitation of Individuals With Chronic Spinal Cord Injury: Quasirandomized Prospective Controlled Observational Study.

OBJECTIVES

This study aims to evaluate the impact of electrical stimulation through the laparoscopic implantation of neuroprosthesis (LION) procedure on cardiorespiratory function in individuals with chronic spinal cord injury.

MATERIALS AND

METHODS

This was a quasirandomized prospective controlled study with 37 individuals with chronic thoracic motor-complete spinal cord injury (American Spinal Injury Association Impairment Scale A/B), allocated to LION (n = 11), LION + cardiorespiratory physiotherapy (CRP) (n = 16), or control group (CTRL) (n = 10). All groups received standardized neuromotor rehabilitation (60 minutes, five times/week); LION+CRP added two weekly cardiorespiratory sessions. Outcomes were assessed at baseline, and at three, six, and 12 months, including cardiorespiratory, cardiac, and respiratory parameters. Data were prospectively collected, with standardized protocols and monitored adherence. Statistical analyses included analysis of variance/Kruskal-Wallis and longitudinal models (p < 0.05).

RESULTS

A study with 37 participants compared CTRL, LION, and LION+CRP interventions for 12 months. LION+CRP consistently outperformed LION and CTRL, showing earlier and sustained improvements in maximal oxygen consumption or maximal oxygen uptake, functional indices, heart rate, respiratory pressures (maximal inspiratory pressures [MIP]/maximal expiratory pressures [MEP]), and peak expiratory flow. Principal component and network analyses revealed progressive multivariate remodeling and enhanced systemic coordination, with strengthened cardiorespiratory and neuromuscular integration. LION alone yielded moderate, delayed benefits. These findings highlight cumulative, time-dependent effects of LION+CRP, supporting its superior efficacy in enhancing physiologic function and systemic interaction.

CONCLUSIONS

The combination of the LION protocol with CRP significantly improved autonomic and respiratory function in patients with chronic spinal cord injury, with a reduction in heart rate, fatigue index, and rate pressure product, in addition to an increase in peak expiratory flow, MIP, and MEP, indicating greater cardiovascular and ventilatory efficiency in rehabilitation associated with LION.