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The Impact of Combining FES Cycling and rTMS on Corticospinal Excitability in People with Motor Incomplete Spinal Cord Injury

Poster Session D - Monday, March 9, 2026, 8:00 – 10:00 am PDT, Fairview/Kitsilano Ballrooms

Kushal Biswas¹ (kbiswas5@uwo.ca), Siobhan Schabrun¹, Sue Peters¹, Eldon Loh¹, Janelle Unger¹; ¹The University of Western Ontario

Spinal cord injury (SCI) can disrupt the function of the corticospinal tract, leading to motor impairments that require targeted rehabilitation strategies to promote recovery. Neuromodulation approaches, such as repetitive transcranial magnetic stimulation (rTMS) or functional electrical stimulation (FES) cycling have been used to facilitate neuroplasticity. Although both interventions have shown potential benefits individually in this population, no studies have investigated the effectiveness of utilizing rTMS as a primer to FES cycling. In this study we investigated the effects of combining rTMS and FES cycling on corticospinal excitability in individuals with motor incomplete SCI. Participants attended 12 sessions over six-weeks and were randomized to receive either active or sham rTMS prior to FES cycling. Corticospinal excitability was measured using motor evoked potential (MEP) amplitude from the right first dorsal interosseous (FDI) muscle during the first and final session. Of the six participants, four were male and two were female with an average age of 61 ± 6.78 years. Preliminary results showed that the intervention group had a mean MEP amplitude increase of 70.53 ± 191.63 uV while the sham group had a mean decrease of 14.46 ± 45.98 uV over the course of the intervention. This research cites the need for further investigation into combined neuromodulation interventions as a rehabilitation approach. Future work will focus on running a powered trial to determine the effectiveness of combining rTMS with FES cycling in this population.

Topic Area: METHODS: Other