Sensorimotor Integration Underlying Balance Control in Individuals With Incomplete Spinal Cord Injury
- Conditions
- Spinal Cord Injuries
- Interventions
- Other: Combined explosive strength and specific balance training group
- Registration Number
- NCT05200091
- Lead Sponsor
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal
- Brief Summary
The objectives of the study are to evaluate a 4-week mixed training paradigm consisting of explosive strength training and balance perturbation training efficacy on balance control during standing and locomotion, and to understand the mechanisms of neuroplasticity that would improve sensorimotor integration at supraspinal and spinal levels.
- Detailed Description
After obtaining their consent, participants will undertake evaluations at different times:
1. Assessment 1 week prior to training
2. Training over 4 weeks (nature of the training depends on the group)
3. Assessment 1 week after training
4. Assessment 1 month after training (follow-up)
Each assessment will be divided in 2 sessions and data will be collected over 2 days, at one session per day. Days can be consecutive or non-consecutive but will be within a given week. The assessment consists of:
* Session 1 (S1; duration: 3h) will include presentation of the Study and obtainment of consent, clinical tests, galvanic vestibular stimulation testing, postural reactions and gait assessment.
* Session 2 (S2; duration: 3h) will include muscle strength, short-afference inhibition, paired pulse and trans cranial magnetic stimulation conditioning of H reflex.
After the initial assessment, iSCI participants will be separated in 2 groups and will receive combination of explosive strength and balance training or no intervention. The training will span over 12 sessions (3 times per week for 4 weeks) and each training session will last approximately 1h (including effective training and installation periods).
Recruitment & Eligibility
- Status
- UNKNOWN
- Sex
- All
- Target Recruitment
- 36
- Have an incomplete lesion of spinal cord
- Level of spinal cord lesion between C5 and T12
- At least, 6 months post-injury
- Be considered as AIS C or D
- Be able to stand without support for 15 seconds
- Be able to provide informed consent in English or in French
- To have cognitive deficits
- To have personal or family history of epilepsy
- To have suffered moderate or severe traumatic brain injury
- To have cochlear implant
FOR CONTROL PARTICIPANTS
Exclusion Criteria:
- To have orthopedics problems
- To have cognitive deficits
- To have neurological problems
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Combined explosive strength and specific balance training group Combined explosive strength and specific balance training group This group will be formed with participants with incomplete spinal cord injury. This group will perform 4 weeks of combined explosive strength and specific balance training.
- Primary Outcome Measures
Name Time Method Change in muscles EMG responses following balance perturbation Pre-intervention, immediately after and one-month after intervention Evaluation of the latency on Soleus and Tibialis anterior muscles EMG following backward and forward perturbations will be done.
Change in center of pressure displacement following balance perturbation using a force platform Pre-intervention, immediately after and one-month after intervention Excursion of centre of pressure will be analyzed following forward and backward perturbation.
Change in ankle muscle strength using force transducer Pre-intervention, immediately after and one-month after intervention Evaluation of isometric dorsi- and planti-flexors muscle strength in Newton will be done using a force transducer attached to the participant's feet.
- Secondary Outcome Measures
Name Time Method Change in intracortical mechanisms using transcranial magnetic stimulation (TMS) Pre-intervention, immediately after and one-month after intervention A paired-pulses paradigm (two trans cranial magnetic stimulations at motor cortex level) will be used to evaluate the intracortical mechanisms
Change in the influence of peripheral afferents on cortical output using short-afference inhibition Pre-intervention, immediately after and one-month after intervention A stimulation (using TMS) at motor cortex level will be triggered just after a peripheral electrical stimulation of tibial nerve to evaluate the peripheral afferents on cortical output.
Change in the modulation of the H reflex by the corticospinal tract Pre-intervention, immediately after and one-month after intervention A stimulation (using TMS) at motor cortex level will be triggered just before a tibial nerve stimulation to evaluate the modulation of the H reflex by the corticospinal tract.
Change in EMG responses following vestibular stimulations during quiet standing Pre-intervention, immediately after and one-month after intervention Galvanic vestibular stimulation will be triggered during quiet standing. EMG responses of Soleus and Tibialis Anterior muscles will be analyzed.
Change in the excursion of the center of pressure following vestibular stimulations Pre-intervention, immediately after and one-month after intervention Galvanic vestibular stimulation will be triggered during quiet standing. The displacement of the center of pressure will be analyzed using a force platform.
Trial Locations
- Locations (1)
Neuromobility lab
🇨🇦Montréal, Quebec, Canada