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| ID | Type | Description | Link |
|---|---|---|---|
| URGP#51472 | Other Grant/Funding Number | University of Manitoba | |
| RGPIN-2015-05703 | Other Grant/Funding Number | NSERC |
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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.
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:
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Treadmill training combined with muscle and spinal cord stimulation | Experimental | Locomotor training is defined as walking on a treadmill with appropriate bodyweight support and augmented with muscle activation either by electrical nerve or muscle stimulation based on individual needs. Then, spinal stimulation will be integrated during training with on/off bouts alternating. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Trans-spinal electrical stimulation | Device | Trans-spinal electrical stimulation (ts-ES) at T11-L1 vertebral levels with short pulses at a set frequency (30Hz). |
|
| Measure | Description | Time Frame |
|---|---|---|
| Neurophysiological markers or stepping | Average step length, step height at ankle (cm). | Pre-training (on week 1) and within one week from end of training (on week 6) |
| Electromyography (EMG) of ankle extensor muscles | Mean RMS amplitude | Pre-training (on week 1) and within one week from end of training (on week 6) |
| Metabolic function testing | Breath-by-breath analysis of air in/out will be used to measure VO2max (mL/kg/min). | Pre-training (on week 1) and within one week from end of training (on week 6) |
| Measure | Description | Time Frame |
|---|---|---|
| 6 Min Walk Test | Measure distance (m) covered in 6 min walking, overground with device of choice (if using it at home/in community). Repeat with save device. Verbal encouragement and safety support in place during testing. | Pre-training (on week 1) and within one week from end of training (on week 6) |
| SCIM-Spinal Cord Independence Measure- Mobility scores |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Katinka Stecina | Contact | 204-789-3761 | katinka.stecina@umanitoba.ca | |
| Kristine Cowley | Contact | 204-789-3305 | kristine.cowley@umanitoba.ca |
| Name | Affiliation | Role |
|---|---|---|
| Katinka Stecina | University of Manitoba | Principal Investigator |
| Kristine Cowley | University of Manitoba | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| University of Manitoba | Recruiting | Winnipeg | Manitoba | R3E 0W2 | Canada |
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| ID | Term |
|---|---|
| D013119 | Spinal Cord Injuries |
| D013118 | Spinal Cord Diseases |
| ID | Term |
|---|---|
| D002493 | Central Nervous System Diseases |
| D009422 | Nervous System Diseases |
| D020196 | Trauma, Nervous System |
| D014947 | Wounds and Injuries |
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| Electrical muscle activation | Device | Peripheral nerve (PN) or muscle (NMES) stimulation strategy was developed for each participant to optimize stance/walk capacity based on personal needs/preferences. |
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| Treadmill walking | Other | Stepping on a treadmill with individually preferred speed. |
|
Rick Hansen Institute, Spinal Cord Independence Measure III - Mobility subsection, Questions 12-17. Scale: 0-20. Lower score means less mobility. |
| Pre-training (on week 1) and within one week from end of training (on week 6) |
| Autonomic scores | American Spinal Injury Association-Autonomic Standards assessment form-General Autonomic Function & Lower Urinary tract, bowel, and sexual function components. Scale: 0-48. Lower scores mean less autonomic function. | 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 | Borg scale from 6-20 (chart used from Heart Online open source). Scale: 6-20. Lower scores mean less exertion (less tiring). | Pre-training (on week 1) and within one week from end of training (on week 6) |