Wrist Extensor MEP Up-conditioning for Individuals With Incomplete Spinal Cord Injury

Launched by MEDICAL UNIVERSITY OF SOUTH CAROLINA · Apr 8, 2022

Keywords

ClinConnect Summary

This clinical trial is studying a new way to help individuals with incomplete spinal cord injuries improve their arm movement. Researchers want to learn how training the brain and muscles can strengthen the connections that allow for better wrist movement. They use a special tool called a transcranial magnetic stimulator (TMS), which safely sends a brief magnetic pulse to stimulate the brain and help activate the wrist extensor muscle, the one that helps lift the wrist back. By training this muscle response, the hope is to enhance the ability to move the arm, which could lead to new therapy options for people with spinal cord injuries.

To participate in this study, individuals must have had a spinal cord injury at or above a specific point in the neck (C6), be stable for at least six months, and have some weakness in wrist movement. Participants will need to attend 30 visits over the course of the study, with each visit lasting about 1.5 hours. It's important to note that certain medical conditions, like having metal implants or a history of seizures, may prevent someone from joining the trial. Overall, this study aims to better understand how to support recovery and improve daily function for those living with spinal cord injuries.

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • 1. a history of injury to spinal cord at or above C6
• • 2. neurologically stable (\>6 mo post SCI)
• • 3. medical clearance to participate
• • 4. weak wrist extension at least unilaterally
• • 5. expectation that current medication will be maintained without change for at least 3 months. Stable use of anti-spasticity medication (e.g., baclofen, diazepam, tizanidine) is accepted. In participants with bilateral wrist extension weakness, the more severely impaired arm is studied.
• Exclusion Criteria:
• • 1. motoneuron injury
• • 2. medically unstable condition
• • 3. cognitive impairment
• • 4. a history of epileptic seizures
• • 5. metal implants in the cranium
• • 6. implanted biomedical device in or above the chest (e.g., a cardiac pacemaker, cochlear implant)
• • 7. no measurable MEP elicited in the ECR
• • 8. unable to produce any voluntary ECR EMG activity
• • 9. extensive use of functional electrical stimulation to the arm on a daily basis
• • 10. pregnancy (due to changes in posture and potential medical instability).