Spinal Cord Stimulation to Augment Activity Based Therapy

Phase

N/A

Condition

Spinal Cord Injuries

Sjögren-larsson Syndrome

Limb Spasticity

Treatment

N/A

Clinical Study ID

NCT03240601

696

Ages 18-65
All Genders

Study Summary

Involuntary muscle activity, often called spasticity, is a common problem following spinal cord injury (SCI) that can make it hard to move. Many things can cause spasticity including: muscle stretch, movement, or it can happen for no reason, and it is often described as an uncontrolled muscle spasm or feeling of stiffness. Drugs are typically used to treat spasticity, but they often have side effects, like muscle weakness, which can add to movement problems. Rehabilitation therapies offer alternatives to drugs for treating involuntary muscle activity, and rehabilitation can also improve daily function and quality of life. These benefits may be greater when several rehabilitation therapies are used together.

Walking ability can be improved with a type of therapy called "locomotor training". This type of therapy may also have the benefit of decreasing spasticity. When locomotor training (LT) is combined with electrical stimulation, the benefits of training may be increased. In this study, investigators will use a kind of stimulation called transcutaneous spinal cord stimulation ("TSS") to stimulate participants' spinal cord nerves during locomotor training.

Eligibility Criteria

Inclusion

Inclusion Criteria:

Ability and willingness to consent and/or authorize use of protected healthinformation
Be between 18-65 years of age
Be enrolled in Spinal Cord Injury In-Patient or Day Program at the Shepherd Center
Be eligible for locomotor training at the Shepherd Center
Be able to take a step, with or without an assistive device
Have a spinal cord injury, completed in-patient rehabilitation, and have beendischarged to home
Have at least mild "spasticity" affecting leg muscles
You may participate if you use prescription medications, including baclofen forcontrol of spasticity

Exclusion

Exclusion Criteria:

Inability or unwillingness to consent and/or authorization for use of protected healthinformation
Progressive or potentially progressive spinal lesions, including degenerative, orprogressive vascular disorders of the spine and/or spinal cord
Neurologic level at or below spinal level T12
History of cardiovascular irregularities
Problems with following instructions
Orthopedic problems that would limit your participation in the protocol (e.g. knee orhip flexion contractures of greater than 10 degrees)
Women who are pregnant, or who have reason to believe they are or may become pregnantdue to unknown risks to the fetus associated with tcSCS
Persons who have implanted stimulators/electronic devices of any type will be excludeddue to unknown potential of tcSCS effects
Active infection of any type, as infection may exacerbate spasticity resulting ininability to identify the influence of the treatment

Study Design

July 01, 2017

September 11, 2019

Study Description

Involuntary muscle activity, often referred to as spasticity, is a common problem following spinal cord injury. Spasticity can be evoked by stimuli or occur spontaneously, and it can manifest as spasms, clonus, or the stiffness associated with hypertonia. While medications are typically used to treat the general symptoms of spasticity, they often have additional side effects, like muscle weakness, that can impede rehabilitation. Physical therapeutics offer an alternative to these drug treatments, but the most effective therapeutic strategy for managing spasticity has not yet been identified. A combination of physical therapeutics may provide the best strategy for managing spasticity while also improving general motor control for functional movements.

Walking ability can be improved through locomotor training, which has also been shown to reduce spasticity. When locomotor training is combined with electrical stimulation, the benefits of training may be increased. To investigate the potential benefits of this combinatorial treatment strategy, investigators will use a kind of electrical stimulation called transcutaneous spinal cord stimulation ("TSS") to stimulate spinal cord nerves during locomotor training.

In order to facilitate the translation of study findings into clinical practice, this study uses a pragmatic design, meaning that the study will involve the use of real world clinical settings and practices. Participants will undergo their standard physical therapist directed locomotor training program while receiving transcutaneous spinal cord stimulation (TSS) as an additional treatment. The effects of locomotor training alone will be compared to the combination of locomotor training with TSS, specifically comparing the effects of these treatments on spasticity and walking function.

Investigators expect that the combination of TSS with locomotor training will provide 1) a greater reduction in spasticity and 2) a greater improvement of walking function compared to locomotor training alone.

The findings from this study have the potential to rapidly facilitate the translation of a novel combination treatment for the management of spasticity and improvement of walking function into real world clinical practice.

Connect with a study center

Shepherd Center, Inc.
Atlanta, Georgia 30309
United States
Site Not Available

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