University of Louisville
The main goal of this pilot study is to find the best ways to use transcutaneous spinal cord stimulation (scTS) to improve hand function in children with spinal cord injuries (SCI). The investigators will start by exploring the best places and strengths for applying scTS on the neck, the added benefits of applying scTS on the lower back (T11-T12), and comparing the effects of using activity based upper extremity training (a control treatment) alone versus combining it with scTS to help children with chronic SCI regain hand function.
After learning about the study and potential risks, parents/legal guardians and their eligible children with SCI will sign consent and assent forms, respectively. For the first two aims of the study, the investigators will recruit and enroll 10 participants. In the first week, participants will undergo clinical assessments from day 1 to day 4 to categorize the severity and level of their injuries and assess their current arm and hand function. On day 5, eligible participants will have experimental assessments to measure hand grip and control, both with and without spinal cord stimulation (scTS…
Inclusion Criteria: For aim 1 and 2, 10 participants with SCI: 1. age 7-12 years; 2. chronic (\>6 months), acquired upper motor neuron SCI; 3. cervical SCI at or above C8 neurological level with motor score of 1-3 for finger flexors 4. Pediatric Neurorecovery scale score of ≥2B and ≤ 4C for impaired grip For Aim 3, 4 participants with SCI who: 1. complete aim 1 and 2; 2. consent/assent for aim 3 3. demonstrate a minimum of 10% increase in HG force with scTS (aim1-2) 4. confirmed volitional activation in hand muscles during hang grip assessment without scTS Exclusion Criteria: For all 3 a…
Activity-based upper extremity training (AB-UET) will be administered 5d/week and 1 hour 30 minutes/session. For AB-UET+ stimulation (scTS), UE tasks will be repeated with and without scTS so that scTS is administered intermittently for the duration of \~ 10 minute/bouts.
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