Transspinal Stimulation Plus Locomotor Training for SCI
Spinal Cord Injuries, Paraplegia, Spinal, Tetraplegia/Tetraparesis
About this trial
This is an interventional treatment trial for Spinal Cord Injuries focused on measuring Locomotor Training, Transcutaneous Spinal Cord Stimulation, Lokomat, Peripheral Nerve Stimulation, H-Reflex, Spinal Neural Circuits, Neuroplasticity, Recovery
Eligibility Criteria
Inclusion Criteria:
- Willingness to comply with all study procedures and availability for the duration of the study.
- Ability to understand the consent form, and sign the consent form.
- Male or female, age 18-70 years old.
- In good general health as evidenced by medical history.
- Diagnosed with motor incomplete SCI (AIS C-D).
- Bone mineral density of the hip (proximal femur) T-score <3.5 SD from age- and gender-matched normative data.
- Lesion above thoracic (T) 10 to ensure absent lower motoneuron lesion.
- Presence of tendon reflexes to be able to elicit the soleus H-reflex.
- Absent permanent ankle joint contractures that prevent passive or active ankle movement because corticospinal and spinal excitability is based on the ankle angle. The ankle straps of the Lokomat require also flexible ankle joints.
- A diagnosis of first time SCI due to trauma, vascular, or orthopedic pathology.
- Time after SCI of more than 6 months.
- Stable medical condition without cardiopulmonary disease or cognitive impairment.
Exclusion Criteria:
- Supraspinal lesions.
- Significant neuropathies of the peripheral nervous system.
- Significant degenerative neurological disorders of the spine or spinal cord.
- AIS A or B.
- Presence of pressure sores.
- Advanced urinary tract infection.
- Neoplastic or vascular disorders of the spine or spinal cord.
- Participation in an ongoing research study or new rehabilitation program.
- Pregnant women or women who suspect they may be, or may become pregnant will be excluded from participation because the risks of thoracolumbar stimulation to the fetus are unknown.
- People with cochlear implants, pacemaker, implanted infusion device, and/or implanted stimulators of any type and purpose will be excluded to avoid their malfunction due to stimulation.
- People with history of seizures.
- Medical conditions that increase the possibility of seizures.
- Medications that may change the seizure threshold.
Sites / Locations
- Veterans Affairs Medical CenterRecruiting
- Department of Physical Therapy, Motor Control and NeuroRecovery LaboratoryRecruiting
Arms of the Study
Arm 1
Arm 2
Arm 3
Experimental
Experimental
Sham Comparator
Real transspinal stimulation delivered during standing followed by locomotor training
Real transspinal stimulation delivered while lying supine followed by locomotor training
Sham transspinal stimulation delivered during standing followed by locomotor training
Transspinal tonic stimulation of the thoracolumbar region will be delivered at a frequency of 30 Hz during standing with as needed body weight support (BWS) in a standing frame or in the Lokomat to ensure safety.
Transspinal tonic stimulation will be delivered at a frequency of 30 Hz while lying supine.
One sham group will be receiving transspinal stimulation during standing at an intensity where sensation is absent.