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Spinal cord injury (SCI) leads to severe impairment in cardiovascular control, commonly manifested as a rapid, uncontrolled rise in blood pressure triggered by peripheral stimuli—a condition called autonomic dysreflexia. The objective was to demonstrate the translational potential of noninvasive transcutaneous stimulation (TCS) in mitigating autonomic dysreflexia following SCI, using pre-clinical evidence and a clinical case report. In rats with SCI, we show that TCS not only prevents the instigation of autonomic dysreflexia, but also mitigates its severity when delivered during an already-triggered episode. Furthermore, when TCS was delivered as a multisession therapy for 6 weeks post-SCI, the severity of autonomic dysreflexia was significantly reduced when tested in the absence of concurrent TCS. This treatment effect persisted for at least 1 week after the end of therapy. More importantly, we demonstrate the clinical applicability of TCS in treatment of autonomic dysreflexia in an individual with cervical, motor-complete, chronic SCI. We anticipate that TCS will offer significant therapeutic advantages, such as obviating the need for surgery resulting in reduced risk and medical expenses. Furthermore, this study provides a framework for testing the potential of TCS in improving recovery of other autonomic functions such lower urinary tract, bowel, and sexual dysfunction following SCI.

Introduction Limited access to health care services and the self‐isolation measures due to the coronavirus disease 2019 (COVID‐19) pandemic may have had additional unintended negative effects, affecting the health of individuals with spinal cord injury (SCI). Objectives To examine the perceived influence of the COVID‐19 pandemic on individuals with SCI. First, this study looked to understand how the pandemic affected the use and perception of telehealth services for these individuals. Second, it investigated the effect of COVID‐19 on mental health. Design Cross‐sectional online survey. Setting Individuals with SCI living in the community in British Columbia, Canada. Patients This survey was offered to individuals with SCI and had 71 respondents, with 34% living in a rural setting and 66% in an urban setting. Interventions Not applicable. Main Outcome Measures Telehealth utility, Patient Health Questionnaire‐9 (PHQ‐9), Generalized Anxiety Disorder 7 (GAD‐7), Fear of COVID‐19 scale (FCV‐19S), and Perceived Vulnerability to Disease (PVD). Results Telehealth use in the SCI population has increased from 9.9% to 25.4% over the pandemic, with rates of telehealth use in urban centers nearing those of rural participants. Thirty‐one percent of respondents had probable depression and 7.0% had probable generalized anxiety disorder as measured by a score of ≥10 on the PHQ‐9 and GAD‐7, respectively. The mean scores on FCV‐19S and PVD were 17.0 (6.6 SD) and 4.29 (1.02 SD), respectively. Conclusion Telehealth use during COVID‐19 has more than doubled. It is generally well regarded by respondents, although only a fourth of the SCI population has reported its use. With this in mind, it is important to understand the barriers to further adoption. In addition, higher rates of probable depression were seen than those estimated by pre‐pandemic studies in other countries.