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N/A N=8 Basic Science

Epi Stim to Facilitate Standing and Stepping

Spinal Cord Injury

Enrolled (actual)
8
Serious AEs
25.0%
Results posted
Apr 2022
Primary outcome: Primary: Change From Baseline of Lower Extremity Independence Time During 10 Min Standing Bout After 160 Sessions (1 Year) — 40.6 minutes

Study Design & Population

Study type
Interventional
Phase
N/A
Interventions
Standing and Stepping with spinal cord Epidural Stimulation (Device)
Age
Adult, Older Adult · 18+ yrs
Sex
All
Sponsor
University of Louisville
Primary completion
Oct 2019

Outcome Measures

OutcomeResultp-value
PRIMARY
Change From Baseline of Lower Extremity Independence Time During 10 Min Standing Bout After 160 Sessions (1 Year)
40.6
PRIMARY
Change From Baseline of Stepping Independence Time During 6 Min Stepping Bout After 160 Sessions (1 Year)
197.13
SECONDARY
Change From Baseline of Number of Consecutive Hip Flexion Repetitions Performed Within One Minute After 160 Sessions (1 Year)
14.25

Summary

The overall aim is to assess whether task specific locomotor training and spinal cord electrical stimulation (SCES) can induce neural reorganization of the functionally isolated human spinal cord to improve standing and stepping in individuals with functionally complete SCI. The investigators propose that locomotor training will result in generation of more effective standing and stepping efferent patterns by restoring phase dependent modulation of reflexes and reciprocal inhibition, reducing clonus and mediating interlimb coordination. The investigators propose that the SCES will optimize the physiological state of the spinal cord interneuronal circuitry compromised by compensating for loss of supraspinal input for the retraining of these tasks.

Eligibility Criteria

Inclusion Criteria

  • All research participants, irrespective of age or sex, will meet the following criteria:
  • stable medical condition without cardiopulmonary disease or dysautonomia that would contraindicate standing or stepping with BWST;
  • no painful musculoskeletal dysfunction, unhealed fracture, contracture, pressure sore, or urinary tract infection that might interfere with stand or step training;
  • no clinically significant depression or ongoing drug abuse;
  • no current anti-spasticity medication regimen;
  • non-progressive SCI above T10;
  • must not have received botox injections in the prior six months;
  • be unable to stand or step independently;
  • at least one-year post injury; and
  • must be at least 18 years of age.

In addition, all subjects must satisfy each of the three conditions of the functional neurophysiological assessment described below.

Functional Neurophysiological Assessment (FNPA). We will use FNPA to screen potential research participants based on specific neurophysiological inclusion criteria. Participants must have no volitional control of movement below the level of the lesion, but must retain some brain influence on spinal reflexes. Our target population, which will be identified by FNPA, cannot be identified reliable using traditional assessments: hence individual subjects may be classified widely as Class A, B, or C on the ASIA SCI scale. We will include only subjects who fulfill the following three requirements:

  • There is no descending volitional control of movement below the lesion
  • Segmental reflexes remain functional below the lesion
  • Brain influence on spinal reflexes is retained

Exclusion Criteria

  • Ventilatory dependent
  • painful musculoskeletal function, unhealed fracture, contracture, or pressure sore that might interfere with training;
  • clinically significant depression or ongoing drug abuse;
  • cardiovascular, respiratory, bladder or renal disease unrelated to SCI;
  • severe anemia (Hgb<8 g/dL) or hypovolemia; and
  • HIV or AIDS related illness.
View full record on ClinicalTrials.gov →

Data sourced from ClinicalTrials.gov (NCT02339233). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication.

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