~9 spots leftby Mar 2026

Reflex Training for Spinal Cord Injury

AT
Overseen byAiko Thompson, PhD
Age: 18+
Sex: Any
Travel: May Be Covered
Time Reimbursement: Varies
Trial Phase: Academic
Recruiting
Sponsor: Medical University of South Carolina
Must be taking: Antispasticity medications
Must not be taking: Antidepressants
Disqualifiers: Motoneuron injury, Cardiac condition, Neurological condition, others
No Placebo Group

Trial Summary

What is the purpose of this trial?

The purpose of this study is to validate the capacity of a reflex training system to change the size of the targeted reflex. For this, the researchers are recruiting 25 individuals with chronic incomplete SCI who have spasticity in the leg to participate in the reflex training procedure. The study involves approximately 45 visits with a total study duration of about 6 months.

Will I have to stop taking my current medications?

The trial does not require you to stop taking your current medications. However, your medications, including any for spasticity, should remain stable during the study. Changes in medication are unlikely but will be monitored and recorded.

What data supports the effectiveness of the treatment Spinal Reflex Operant Down Conditioning for spinal cord injury?

Research shows that operant conditioning of spinal reflexes can improve walking and balance in people with incomplete spinal cord injuries by targeting specific reflex pathways, leading to widespread beneficial changes in the nervous system. People have reported walking faster and farther, with less spasticity and better balance after undergoing this treatment.12345

Is reflex training for spinal cord injury safe for humans?

Studies in humans and animals suggest that operant conditioning of spinal reflexes is generally safe, with no significant safety concerns reported. This method has been used to improve motor function in people with spinal cord injuries, indicating its potential as a safe rehabilitation therapy.12367

How is the Reflex Training for Spinal Cord Injury treatment different from other treatments?

This treatment is unique because it uses operant conditioning to gradually change spinal reflexes, which can improve movement and walking in people with spinal cord injuries by promoting beneficial changes in the nervous system.12589

Research Team

AT

Aiko Thompson, PhD

Principal Investigator

Medical University of South Carolina

Eligibility Criteria

This trial is for individuals with chronic incomplete spinal cord injury who can walk at least 10 meters, have leg spasticity, and are medically stable. They must be able to consent and not expect medication changes during the study. Excluded are those with unstable health, cognitive impairments, other neurological conditions, daily use of certain electrical stimulation devices, motoneuron injuries, serious heart issues, inability to test lower limb mobility or weight bearing, recent deep vein thrombosis or pregnancy.

Inclusion Criteria

My spinal cord injury above T11 has been stable for over a year.
Medical clearance to participate
My current medications are expected to stay the same during the trial's start period.
See 4 more

Exclusion Criteria

I have a history of heart issues, like a heart attack or use a pacemaker.
I have had a deep vein thrombosis in the last 6 months.
I cannot perform tests that require walking or standing.
See 7 more

Trial Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Baseline

Participants complete 6 baseline sessions to measure initial reflex activity

2 weeks
6 visits (in-person)

Conditioning

Participants undergo 30 conditioning sessions to down-condition the soleus H-reflex

10 weeks
30 visits (in-person)

Follow-up

Participants are monitored for changes in spasticity, muscle strength, and functional independence

3 months
3 visits (in-person)

Treatment Details

Interventions

  • Spinal Reflex Operant Down Conditioning (Behavioral Intervention)
Trial OverviewThe trial tests a reflex training system designed to reduce the size of targeted muscle reflexes in people with spinal cord injuries. Participants will undergo about 45 sessions over six months to see if this method can help manage spasticity in their legs by conditioning their spinal reflexes.
Participant Groups
1Treatment groups
Experimental Treatment
Group I: Validation of the new training systemExperimental Treatment1 Intervention
The researchers will measure changes in H-reflex size achieved with the use of the new system and compare these measures with the existing results in 25 spastic individuals with chronic incomplete SCI. Each participant completes 6 baseline sessions and 30 conditioning sessions. In the 30 conditioning sessions, the soleus H-reflex will be down-conditioned to decrease the activity of the hyperactive spinal stretch reflex pathway in people with spasticity that is characterized by exaggerated reflex activity. It is anticipated that the magnitude of reflex change obtained with the use of the new system would be greater or at least the same as the bench-marked values from the previous studies that used the old prototype reflex conditioning system.

Find a Clinic Near You

Who Is Running the Clinical Trial?

Medical University of South Carolina

Lead Sponsor

Trials
994
Recruited
7,408,000+

National Institute of Neurological Disorders and Stroke (NINDS)

Collaborator

Trials
1,403
Recruited
655,000+

Findings from Research

Operant-conditioning protocols that reward specific electromyographic responses can effectively modify spinal reflex pathways, leading to changes in reflex activity and associated behaviors in both animals and humans.
In individuals with partial spinal cord injuries, these conditioning techniques can enhance locomotion and promote widespread beneficial plasticity in the nervous system, suggesting a promising therapeutic approach for rehabilitation.
Targeted neuroplasticity for rehabilitation.Thompson, AK., Wolpaw, JR.[2018]
Operant conditioning of spinal reflexes has evolved over 35 years from basic science to a promising rehabilitation therapy for spinal cord injuries, showing significant potential for enhancing nervous system plasticity.
Initial studies in both animal models and humans indicate that reflex conditioning can lead to exciting therapeutic outcomes, highlighting the importance of basic research in informing clinical applications.
Operant conditioning of spinal reflexes: from basic science to clinical therapy.Thompson, AK., Wolpaw, JR.[2022]
Operant conditioning of spinal reflexes can significantly improve motor function in individuals with incomplete spinal cord injury (SCI), as shown by down-conditioning the soleus H-reflex, which led to increased walking speed and symmetry in patients.
The study indicates that targeting specific reflex pathways not only enhances the targeted reflex but also promotes widespread recovery, resulting in noticeable improvements in daily activities such as walking, balance, and reduced spasticity.
Restoring walking after spinal cord injury: operant conditioning of spinal reflexes can help.Thompson, AK., Wolpaw, JR.[2022]

References

Targeted neuroplasticity for rehabilitation. [2018]
Operant conditioning of spinal reflexes: from basic science to clinical therapy. [2022]
Restoring walking after spinal cord injury: operant conditioning of spinal reflexes can help. [2022]
H-reflex conditioning during locomotion in people with spinal cord injury. [2022]
The simplest motor skill: mechanisms and applications of reflex operant conditioning. [2021]
Probable corticospinal tract control of spinal cord plasticity in the rat. [2017]
Plasticity in the Central Nervous System: Operant Conditioning of the Spinal Stretch Reflex. [2016]
Operant down-conditioning of the soleus H-reflex in people after stroke. [2023]
Operant conditioning of a spinal reflex can improve locomotion after spinal cord injury in humans. [2022]