ROBERT® as an Intervention to Enhance Muscle Strength After Spinal Cord Injury
Spinal Cord InjuriesSpinal cord injury (SCI) is a devastating life event with long term consequences both physically and mentally. SCI is defined as either complete or incomplete according to the International Standards of the Neurological Classification of SCI. The primary consequence of a SCI is paralysis/partial paralysis affecting the person's ability to independently functioning in everyday life e.g. in and out of bed, sit to stand and walking. To regain the ability to transfer and walk the most important prerequisite is to rebuild as much strength as possible in the lower extremities. The optimal training paradigm to increase strength in partial paralysed muscles is unclear. Rehabilitation robots are upcoming methods to treat sensorimotor deficits after SCI. The rehabilitation robot ROBERT might contribute to enhance muscle strength for people with very weak strength following an incomplete SCI. The overall objective of this Ph.D project is to investigate the feasibility and effect size of a muscle strength training intervention assisted by ROBERT® for patients with SCI and severe paresis (muscle strength 1-3 in hip flexion).
Myosuit in Incomplete Spinal Cord Injury
Incomplete Spinal Cord InjuryThe Myosuit is a light-weighted lower extremity soft exosuit which provide assistance during walking. In this study the Myosuit will be tested in the home and community setting in patients with incomplete spinal cord injury.
Upper Limb Spinal Cord Stimulation for Rehabilitation Enhancement
Spinal Cord InjuriesIn the United Kingdom, there are more than 1000 new cases of spinal cord injury (SCI) each year, with around half of these injuries affecting the cervical spine. People who have reduced function and control affecting their upper limbs may have difficulty carrying out activities of daily living (ADLs), significantly affecting their independence. Recovering even partial upper limb function is a top priority among tetraplegics. Regaining voluntary function in the upper limb can have a huge impact on quality of life. Using TSCS in the upper limb for acute SCI can benefit patients early in their rehabilitation, and may reduce the number of patients with problematic spasticity at discharge. Transcutaneous spinal cord stimulation (TSCS) may provide a low-cost method of improving function and spasticity in this cohort. We are investigating the effect of adding non-invasive SCS to inpatient rehabilitation on upper limb function for people with acute SCI. We will test this by randomly assigning volunteers to either a control group, who will receive their normal inpatient rehabilitation only, and an intervention group, who will have non-invasive SCS added to their normal inpatient rehabilitation, targeting their upper limbs.
Respiratory Muscle Training in Adults With Spinal Cord Injury
Spinal Cord InjuriesThe purpose of this study is to investigate the effectiveness of a programme based on inspiratory and expiratory muscle training to improve respiratory muscle strength, functional capacity and avoid pulmonary complications in adults with cervical or high dorsal spinal cord injury (C5-D5) in acute phase.
Intensive Motor Rehabilitation With Technology for Patients With Central Neurological Disease
StrokeSpinal Cord Injuries1 moreThis project will consist of 1 large clinical trial with 2 core concepts: (1) Clinical benefits of an intensive rehabilitation programme using advanced technology, compared to the control group; (2) A full health economic evaluation combined with model-based estimation of costs and benefits.
Usability of the Adapted Rower for People With Spinal Cord Injury
Spinal Cord InjuriesThe goal of this clinical trial is to examine usability of a locally built adaptive rower for people with spinal cord injury using an established and tested design. The main questions it aims to answer are: What exercise intensity of activity do users achieve on the rower for steady state and interval rowing plans? What assistance is required for setup and usage of the adaptive rower? What do users think about the ease of use and what is their satisfaction with the adaptive rower? Participants will complete a one-time exercise session with two adaptive rower bouts (10-15 minutes each) with a rest period in between.
Eccentric Muscle Training, Stimulation, and Biomarkers in SCI
Spinal Cord InjuriesHealthyThe investigators are studying a new rehabilitation treatment for individuals trying to recover walking after spinal cord injury (SCI). The investigators will test conditions in the blood and spinal fluid to determine the best time to start this new training program. This will include checking for certain features called biomarkers by testing participants' spinal fluid and blood and compare these features to individuals without SCI. These features will help investigators determine when to start the new training program, either right away or waiting for 3 months. The new training program uses walking downhill on a slight slope on a treadmill while muscles that are not working normally are stimulated to contract using low levels of electricity. Adding this stimulation will allow people to practice walking and other skills even though full muscle control has not recovered. This new program will be in addition to any other rehabilitation therapy and will not replace standard rehabilitation. The hope is to see if downhill training with muscle stimulation, when delivered at the most ideal time, will improve trunk and leg movement, walking, and overall function. This recovery of movement and function will be compared to people with SCI receiving standard rehabilitation alone. Certain regions of the brain and spinal cord will also be studied using MRI scans to determine if these are affected by the training and compare to individuals without SCI. The total length of the study for SCI participants will be up to 16 weeks if in the standard of care group and up to 33 weeks if in the trained group. Healthy control participants will be involved for 1-2 visits.
Active tDCS Versus Sham tDCS for Upper Limb Recovery in Incomplete Tetraplegic Patients
Spinal Cord Injury CervicalSpinal Cord Injury (SCI) at the cervical level results in motor and sensory impairment below the lesion level and may determine a consistent loss of the use of the upper limbs, with a substantial impact on daily life activities. Therefore, functionality recovery of the upper limbs, of the hands in particular, represents a priority rehabilitation target. Studies in the literature show that the most relevant recovery occurs in the first months after SCI and that neuromodulation techniques may facilitate it. Transcranial Direct Current Stimulation (tDCS ) is a non-invasive neuromodulation technique. The present pilot, randomized controlled study aims at exploring the feasibility and efficacy of an early application of tDCS, in addition to the traditional physiotherapy treatment for the functional recovery of the upper limb, in incomplete traumatic tetraplegic subjects in the sub-acute phase after SCI occurrence. Patients hospitalized at the Montecatone Rehabilitation Institute are randomly assigned to Active tDCS or Sham tDCS.
Phase 3 Study of KP-100IT in Subjects With Acute Spinal Cord Injury
Acute Spinal Cord InjuryThis study is non-randomized, multicenter, confirmatory study by intrathecal administration of KP-100IT, code of HGF (Hepatocyte Growth Factor ) formulation for intrathecal injection, in subjects with acute spinal cord injury.
Riluzole in the Treatment of Spasticity in the Traumatic Chronic Spinal Cord Injury Condition
Spinal Cord InjuryThe study will be conducted in two steps: Determination of the Minimal Effective Dose (MED) among the four doses of the panel Estimation of the probability of response associated to the MED. Each step has a main objective: Step 1 Objective: To determine a daily dose of Riluzole that improves spasticity in patients with chronic SCI Step 2 Objective: To demonstrate, in a phase 2b trial, the efficacy of Riluzole to improve spasticity vs placebo, in patients with chronic SCI.