This trial is evaluating whether Standing transspinal stimulation followed by robotic gait training will improve 2 primary outcomes and 3 secondary outcomes in patients with Spinal Cord Injuries. Measurement will happen over the course of 4 years.
This trial requires 45 total participants across 3 different treatment groups
This trial involves 3 different treatments. Standing Transspinal Stimulation Followed By Robotic Gait Training is the primary treatment being studied. Participants will be divided into 2 treatment groups. Some patients will receive a placebo treatment. The treatments being tested are not being studied for commercial purposes.
Subjects with spinal cord injuries without a history of epidural steroid injections have a similar neurologic outcome to those without spinal cord injuries on the [SF-36].
Cervical spine trauma is the most common type of traumatic [spinal cord injury](https://www.withpower.com/clinical-trials/spinal-cord-injury) and causes symptoms and disabilities in approximately 5% of traumatic spinal cord injuries. Cervical injuries usually result in paralysis, incontinence, or impotence due to damage to the motor and sensory nerves. Spinal cord injuries can be prevented by the use of seat belts and car accident prevention measures. The cervical spine has many potential sites for spinal cord injuries, so the number of cervical cord injuries is high. A cervical collar, or neck brace, may help prevent injury.
The American Spinal Injury Association estimates that in 2007, there will be an additional 539 spinal cord injury cases. All severities of the injury resulting in complete functional loss occur in a small percentage of cases in which there is no apparent spinal cord injury in advance. Although a large number of people with minor injuries do not experience the loss of function (severe disability), they may ultimately develop permanent deficits (severe disability). In the remainder of the cases, the cause of the injury appears to be identifiable. All severities of injury, even in those with no identifiable cause, are probably preventable.
The treatment of spinal cord injuries can be very varied and requires cooperation of all clinicians involved in care of patients with these injuries. Spinal cord injuries are often diagnosed during a period of relative quiescence and are difficult to anticipate until they may develop complications. The treatment of spinal cord injury is often complex and requires careful consideration of the patient's prognosis and individual needs.
The main findings were: (1) The most common signs from SCI are changes to the bladder and bowel function, especially continence problems, especially bladder dysfunction. (2) It may be possible to identify children who might develop a SCI from the absence of these basic physical findings. (3) A specific neurological assessment of children with lower limb SCI can be used more readily by health professionals.
SCI is an injury to the spinal cord. There are 5 distinct types of these injuries. They occur following a blunt, penetrating and penetrating/contingent, burns and chemical/mechanical. The injuries occur in the cervical, thoracic and lumbar regions of the spine, with the most common being cervical injuries; followed by thoracic. Most SCI patients will regain control over bodily function and sensation either partially or completely, with a chance of complete loss being uncommon. SCI is a difficult wound with long term consequences. Most disabilities last for life. There are two types of SCI, incomplete and complete.
SCI has few absolute cures and the prognosis may be dismal. Nevertheless, with good rehabilitation and adequate care it is possible to improve quality of life.
Standing TSS is increasingly used in ambulatory patients with SCI. The use of robotic gait training seems to be worthwhile in order to address several limitations observed in patients who obtain no gait improvement following TSS.
A 5 day outpatient programme, which involves a 1-month STS programme in conjunction with 1 month robot-assisted gait training (RAGT) is feasible and safe for people with SCI.
In this pilot study, TSS following RT was not demonstrated to improve patient QoL in individuals with SCI. A multidisciplinary approach, including consideration of patient functioning and QoL may be equally important in this cohort.
There were several new findings in the treatment of spinal cord injuries. They include a novel design of wheelchair which helps keep patients in an upright position and help them sit up properly; the development of an adjustable compression device for patients with paraplegia and inpatients having had decompressive surgery; and the use of the Bier's maneuver to reduce spine flexion in patients with spinal cord injuries. The authors hope that these will benefit those persons with spinal cord injuries and/or spina bifida. Future research is needed to better understand these benefits as well as the clinical relevance of these findings and future use of them on a continuous basis.
Standing TSS+RGT provided an initial short term clinical improvement that may help patients with spinal cord injuries achieve a more independent walking performance of a less dependent level. RGT induced over time an improved ambulatory function, which was sustained for at least three months after TSS ended. Recent findings suggest that patients with spinal cord injury may benefit from TSS+RGT.