Rehabilitation and Cortical Remodeling After Surgical Intervention for Spinal Cord Injury
Spinal Cord Injuries, Tetraplegia, Cervical Spinal Cord Injury
About this trial
This is an interventional treatment trial for Spinal Cord Injuries focused on measuring robotics, hand function
Eligibility Criteria
Inclusion Criteria:
- Tetraplegia (cervical lesion) with some degree of motor dysfunction in the hand
- Motor incomplete or complete lesion (measured by the ASIA Impairment Scale, A, B, C, D).
- Chronic lesion (at least 6months after the injury)
- Demonstrate stability of motor examination for at least six months.
- Retain intact innervation within paralyzed target muscles (axon recipient) as determined by electrodiagnostics.
- Have muscles innervated by the nerves to be used for the transfers (axon donors) of MRC grade 4/5 or greater and sufficient innervation as determined by electrodiagnostics.
- Have access to an at home caregiver who can assist with customary postsurgical physical therapy.
- Ability to give informed consent and understand the tasks involved.
Exclusion Criteria:
- Presence of potential risk factor for brain stimulation: history of seizures, presence of surgically implanted foreign bodies such as a pacemaker, metal plate in the skull, and metal inside the skull.
- History of head trauma and/or cognitive deficit
- Medically unstable
- Contraindicated for nerve transfer surgery.
Sites / Locations
- Burke Neurological InstituteRecruiting
Arms of the Study
Arm 1
Arm 2
Experimental
Active Comparator
Nerve transfer + robotic training
Nerve transfer + delayed robotic training
Participants will receive nerve transfer surgery at Massachusetts General Hospital in Boston, MA. One year after the surgery, participants will receive six weeks of upper limb robotic training at the Burke Neurological Institute in White Plains, NY.
Participants will receive nerve transfer surgery at Massachusetts General Hospital in Boston, MA. One year + six weeks after the surgery, participants will receive six weeks of upper limb robotic training at the Burke Neurological Institute in White Plains, NY.