Innovative ESCS Bridging System: Enhancing Motor Task‐Specific Activation in Spinal Cord Injury

Abstract Epidural spinal cord electrical stimulation (ESCS) offers a promising therapy for restoring lower limb motor function after spinal cord injury. To enhance its efficacy for walking tasks, an advanced ESCS bridging system is developed, integrating a multi‐channel constant current stimulator, touch‐based human‐machine interface, wireless charging module, and implantable flexible multi‐electrode array. A spatiotemporal map of motor neuron activity in rat hindlimb muscles is generated to capture locomotor activation dynamics. This mapping guided the design of a biomimetic multi‐target control algorithm that modulates four stimulation channels in a coordinated temporal sequence. The micro‐electrode array ensures accurate signal transmission and addresses the challenge of electrode misplacement, improving motor output. The system utilizes intermittent burst and “peak‐shaped” modulation waveforms to mimic natural motor patterns. A 3‐month rat study confirmed that the stimulation paradigm effectively induced coordinated, locomotor‐like lower limb muscle activation, improving coordination and motor function. This ESCS system demonstrates strong potential for restoring lower limb mobility through precisely timed and localized spinal cord stimulation.