Background: Individuals with spinal cord injury (SCI) frequently experience chronic pain, trunk instability, and respiratory dysfunction. This pilot trial investigated the synergistic effects of a combined neuro-orthotic approach (thoracolumbosacral orthosis (TLSO) plus transcutaneous electrical nerve stimulation (TENS)) versus TLSO alone on pain, trunk control, and respiratory function in chronic incomplete SCI. Methods: Twelve adults with chronic incomplete SCI (T6–T12) were randomized to a combined group (TLSO + TENS) or a control group (TLSO alone) for a four-week intervention. Outcomes included pain (Visual Analogue Scale), trunk control (Trunk Assessment Scale), and respiratory function (tidal volume [VT], respiratory rate [RR], oxygen uptake [VO₂], ventilatory equivalent for oxygen [VE/VO₂], and inspiratory duty cycle [Ti/Ttot]) assessed at three time points (before intervention, immediately after intervention, and after one month). Results: The combined group demonstrated a significant reduction in pain (47.8% vs. 10.4%, p = 0.01) and an improvement in Ti/Ttot (33.3% vs. 4.9%, p = 0.008) compared to the control group. Both groups showed significant improvements in VT and RR over time (p < 0.05), reflecting the biomechanical benefits of TLSO. Conclusions: Integrating TENS with TLSO offers a non-invasive strategy for managing chronic pain and improving respiratory pattern coordination in incomplete SCI. While TLSO optimizes basic ventilatory mechanics, adding TENS significantly enhances neural drive for efficient breathing and pain gating. Future large-scale trials incorporating active task-specific training are needed to restore functional trunk control.

Background/Objectives: Chronic ankle instability (CAI) is a common sequela of lateral ankle sprain and is characterized by recurrent episodes of giving way, sensorimotor deficits, impaired postural control, and diminished functional performance. While exercise-based rehabilitation, including neuromuscular training and proprioceptive exercises, remains the gold standard for managing CAI, patients often require additional support during daily activities. Orthotic interventions predominantly address mechanical instability, yet there is a clinical gap in providing integrated solutions that simultaneously offer mechanical support and sensory feedback to enhance postural control. This study aimed to investigate the effects of a semi-rigid ankle brace combined with vibro-stimulation on tactile sensation and center of pressure excursion in individuals with CAI. Methods: A randomized clinical trial was designed with two parallel groups and repeated measurements over time. Thirty adults (n = 15 per group) aged 18–35 years, who met the International Ankle Consortium criteria for CAI, were recruited. Participants in the experimental group received a semi-rigid ankle brace integrated with a wearable vibro-stimulation system, whereas those in the comparison group used the ankle brace alone. Outcome measures were collected at baseline, after 10 min, and after 2 and 4 weeks. Primary outcomes included Vibration Detection Rate and phase plane portraits assessed using a 128 Hz tuning fork and a force plate. Results: The ankle bracing plus vibration band group demonstrated significantly greater improvement at 4 weeks than the orthosis group in Vibration Detection Rate (F (3,26) = 31.93, p < 0.001, η² = 0.78). Also, the largest effect was observed for the anteroposterior phase plane portrait at 4 weeks (MD = −2.10 ± 0.42, 95% CI: −2.96 to −1.23, p < 0.001, d = −1.79). Conclusions: The findings suggest that combining a semi-rigid ankle bracing with vibro-stimulation provides additional benefits over the use of bracing alone in individuals with CAI.