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Mental Practice Impact on Gait and Cortical Organization in Spinal Cord Injury (SCI)

Primary Purpose

Incomplete Spinal Cord Injury

Status
Completed
Phase
Phase 2
Locations
Study Type
Interventional
Intervention
Mental practice
Sponsored by
University of Cincinnati
About
Eligibility
Locations
Outcomes
Full info

About this trial

This is an interventional treatment trial for Incomplete Spinal Cord Injury

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All Sexes

Inclusion Criteria:

  • age > 18 years old;
  • incomplete SCI (ASIA Grade C or D), experienced > 1 year prior to enrollment;
  • motor grade of > 1 < 3 in the quads, hamstrings, and hip flexors, and ability to ambulate with at least a maximal assist;
  • range of motion in the lower limbs within functional limits;
  • motor function in at least half of ASIA key lower extremity muscles with strength < or > 3/5;
  • able to ambulate at least 10 meters with 1 person assistance and/or assistive device;
  • medically stable (ie, no bladder infection; decubiti); (8) stable dosage of antispasticity medications for duration of study

Exclusion Criteria:

  • excessive spasticity in the lower limbs as measured by a score of > 3 on the Modified Ashworth Spasticity Scale;
  • excessive pain in the lower limbs as measured by a score of > 5 on a Visual Analog Scale or > 8/10 with a clarified scaled picture graph;
  • moderate to severe osteoporosis, as indicated by the patient's physician;
  • heterotropic ossification, as indicated by the patient's physician;
  • psychological conditions that would contraindicate participation in the program and no abnormalities of attention, with minimum cognitive capacity present sufficient to participate in MP;
  • fracture or fracture history in the lower limbs (individuals with a remote history of fractures may be included at discretion of the study physical therapists at each site);
  • enrolled in any form of rehabilitation;
  • for subjects to be administered fMRI, implant containing electrical circuitry, generating electrical signals, or having moving metal parts, metal pins or plates above the waist, orthodontic braces, or other positives on a standard checklist of MRI exclusion criteria used by the Radiology Department;
  • pregnant;
  • DSM-IV Major Depressive Episode symptom criteria of > 5/9 as exclusion threshold instead of CESD;

Sites / Locations

    Outcomes

    Primary Outcome Measures

    Gait velocity: The investigators are measuring the speed that people walk.

    Secondary Outcome Measures

    Full Information

    First Posted
    February 22, 2011
    Last Updated
    February 23, 2011
    Sponsor
    University of Cincinnati
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    1. Study Identification

    Unique Protocol Identification Number
    NCT01302522
    Brief Title
    Mental Practice Impact on Gait and Cortical Organization in Spinal Cord Injury (SCI)
    Official Title
    Mental Practice Impact on Gait and Cortical Organization in SCI
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    February 2011
    Overall Recruitment Status
    Completed
    Study Start Date
    September 2008 (undefined)
    Primary Completion Date
    July 2010 (Actual)
    Study Completion Date
    December 2010 (Actual)

    3. Sponsor/Collaborators

    Name of the Sponsor
    University of Cincinnati

    4. Oversight

    Data Monitoring Committee
    Yes

    5. Study Description

    Brief Summary
    Spinal cord injury (SCI) is a disabling condition that impairs fundamental abilities, such as ambulation, respiration, and toileting. Compromised ambulation is a common, devastating impairment following SCI. Yet, despite the fundamental desire to walk, no conventional rehabilitation regimen reliably improves ambulation after SCI, and many SCI patients do not have reliable transportation access, decreasing community integration and access to needed services, including rehabilitation. Little is also known about the subtle neural events that may predict motor recovery in incomplete SCI patients. This study will test a novel, safe, easy to implement technique that has shown promise in improving gait in incomplete SCI patients. The investigators expect that this study will confirm the efficacy of this technique, by showing that it increases the speed and efficiency of walking. This outcome is expected to produce a therapy that improves outcomes and health, and reduces care costs, for community dwelling patients with incomplete SCI.

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Incomplete Spinal Cord Injury

    7. Study Design

    Primary Purpose
    Treatment
    Study Phase
    Phase 2
    Masking
    Outcomes Assessor
    Allocation
    Randomized

    8. Arms, Groups, and Interventions

    Intervention Type
    Behavioral
    Intervention Name(s)
    Mental practice
    Other Intervention Name(s)
    Motor imagery
    Intervention Description
    All patients in the study will be administered a regimen of locomotor therapy (rehabilitative therapy working on walking). Half of the patients will also be administered a regimen in which they mentally rehearse the exercises that they have just physically performed.
    Primary Outcome Measure Information:
    Title
    Gait velocity: The investigators are measuring the speed that people walk.
    Time Frame
    1-3 weeks before intervention; 1 week after intervention; 3 months after intervention

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    18 Years
    Eligibility Criteria
    Inclusion Criteria: age > 18 years old; incomplete SCI (ASIA Grade C or D), experienced > 1 year prior to enrollment; motor grade of > 1 < 3 in the quads, hamstrings, and hip flexors, and ability to ambulate with at least a maximal assist; range of motion in the lower limbs within functional limits; motor function in at least half of ASIA key lower extremity muscles with strength < or > 3/5; able to ambulate at least 10 meters with 1 person assistance and/or assistive device; medically stable (ie, no bladder infection; decubiti); (8) stable dosage of antispasticity medications for duration of study Exclusion Criteria: excessive spasticity in the lower limbs as measured by a score of > 3 on the Modified Ashworth Spasticity Scale; excessive pain in the lower limbs as measured by a score of > 5 on a Visual Analog Scale or > 8/10 with a clarified scaled picture graph; moderate to severe osteoporosis, as indicated by the patient's physician; heterotropic ossification, as indicated by the patient's physician; psychological conditions that would contraindicate participation in the program and no abnormalities of attention, with minimum cognitive capacity present sufficient to participate in MP; fracture or fracture history in the lower limbs (individuals with a remote history of fractures may be included at discretion of the study physical therapists at each site); enrolled in any form of rehabilitation; for subjects to be administered fMRI, implant containing electrical circuitry, generating electrical signals, or having moving metal parts, metal pins or plates above the waist, orthodontic braces, or other positives on a standard checklist of MRI exclusion criteria used by the Radiology Department; pregnant; DSM-IV Major Depressive Episode symptom criteria of > 5/9 as exclusion threshold instead of CESD;

    12. IPD Sharing Statement

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    Mental Practice Impact on Gait and Cortical Organization in Spinal Cord Injury (SCI)

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