Non-invasive Spinal Cord Stimulation for Improving Movement: Neuromodulation With Spinal Stimulation Methods and Individualized Locomotor Training
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Spinal Cord Injuries
- Sponsor
- University of Manitoba
- Enrollment
- 10
- Locations
- 1
- Primary Endpoint
- Metabolic function testing
- Status
- Recruiting
- Last Updated
- 2 years ago
Overview
Brief Summary
Spinal cord injury (SCI) is a central nervous system injury that often leads to motor dysfunction. Non-invasive electrical stimulation of the spinal cord has been recognized as a potential method of reactivating lost spinal neural networks to improve motor recovery and exercise response after SCI. Trans-spinal electrical stimulation (ts-ES) has been found to increase functional gains in people after SCI when applied in combination with other motor training protocols.
This project aims to evaluate the effects of non-invasive lumbar spinal cord electrical stimulation on the motor function of trunk and lower limbs in people with SCI after augmenting their locomotor training (treadmill stepping) with step-cycle-based electrical peripheral neural stimulation methods.
Detailed Description
This project will evaluate the effects of non-invasive lumbar ts-ES on locomotor function in people with incomplete motor SCI (iSCI) who retain some ability to stand or walk. This study has 3 phases: Baseline assessment - 2 sessions - week 1 -Lab visits #1-2 Locomotor training with varied electrical stimulation- 12 sessions - weeks 2-5 - Lab visits #3-14 (1hr, x3/week) End of training assessment - 2 sessions - week 6- Lab visits #15-16. Specific locomotor deficits of each participant will be evaluated, and their step-cycle-based peripheral muscle or nerve stimulation strategy will be determined accordingly to improve stance or step capacity. After augmenting their locomotor function with muscle or peripheral nerve stimulation-induced activation strategies that address particular and unique motor deficits, they will receive intermittent bouts of stance or locomotor training supplemented with ts-ES. The locomotor training will consist of standing/walking on a treadmill with appropriate bodyweight support and added muscle or peripheral nerve stimulation. Specifically, the project aims to assess the following: 1. Does combined muscle (NMES) or peripheral nerve (PN) stimulation with ts-ES during treadmill stepping facilitate locomotor performance? 2. Does four weeks of combined training as described above (1hrx3/week) facilitate exercise capacity (measured by submaximal VO2) in persons with chronic iSCI?
Investigators
Katinka Stecina
Associate Professor
University of Manitoba
Eligibility Criteria
Inclusion Criteria
- •Has spinal cord injury, 6 mo or longer since injury
- •Is between 20 and 65 years of age
- •Has difficulty with trunk and/or lower limb function
- •Stable medical condition
- •Non-progressive etiology of spinal injury
- •No ventilatory support
Exclusion Criteria
- •Genetic or degenerative etiology of spinal injury
- •Need for ventilatory or other life-sustaining medical support
- •History of cardiovascular or pulmonary complications (heart failure, severe hypertension etc.)
Outcomes
Primary Outcomes
Metabolic function testing
Time Frame: Pre-training (on week 1) and within one week from end of training (on week 6)
Breath-by-breath analysis of air in/out will be used to measure VO2max (mL/kg/min).
Electromyography (EMG) of ankle extensor muscles
Time Frame: Pre-training (on week 1) and within one week from end of training (on week 6)
Mean RMS amplitude
Neurophysiological markers or stepping
Time Frame: Pre-training (on week 1) and within one week from end of training (on week 6)
Average step length, step height at ankle (cm).
Secondary Outcomes
- 6 Min Walk Test(Pre-training (on week 1) and within one week from end of training (on week 6))
- Rate or Perceived Exertion (RPE) of Submaximal VO2 testing(Pre-training (on week 1) and within one week from end of training (on week 6))
- SCIM-Spinal Cord Independence Measure- Mobility scores(Pre-training (on week 1) and within one week from end of training (on week 6))
- Autonomic scores(Pre-training (on week 1) and within one week from end of training (on week 6))