Moreover, consistent with an increase in motoneurons firing rate, we found, using spinal cord fMRI, that spinal circuits were more active during a knee extension task post than pre-study.

But how are these large improvements possible in only 4 weeks of SCS? With @Lu_borda5, we detected post-study motoneurons with much higher peak firing rate than all pre-study motoneurons. We named them rescued motoneurons.

But not only this, SCS also improved fatigue in all participants! In a clinical test of fatigue where participants have to walk as far as they can for 6 minutes, we found improvements that were completely different from the results obtained with only exercise!

See this pretty cool video!

Then we tested whether these improvements in strength could have any translation in daily life activities like walking. Again, we found immediate and long-term improvements in gait quality variables such as stride length (SL), stride height (SH) and stride velocity (SV).

Our results are completely different to the results obtained in the only single-blind randomized clinical trial testing the effect of exercise in muscle strength in the same SMA population.

Then one day that I will always remember, we noticed that the maximum force of SMA01 was improving every day even without SCS! Actually, we found long-term improvements in all participants (up to +180%)

We found that with SCS ON, our participants could produce higher forces in some but not all single joint movements at the hip and knee.

Using biophysics to simulate SCS in SMA, we found that: 1) SCS could immediately increase motoneuron firing rate and 2) The potential effects of reverting motoneuron dysfunction could be a game changer for people living with SMA.

We wanted to test whether: 1) SCS can immediately increase motoneuron firing rate and 2) SCS can, in the long term, revert motoneuron dysfunction.