Craig Hospital
Upper extremity weakness, impaired coordination, reduced dexterity, and limited arm and hand use may continue after TBI. Repetitive, task-specific rehabilitation may improve function, but recovery can remain incomplete. taVNS is a non-invasive form of electrical stimulation delivered to part of the outer ear. The stimulation is intended to activate nerve pathways involved in learning and brain plasticity while you practice upper extremity tasks. This pilot study will evaluate safety, tolerability, feasibility, and preliminary effects on upper extremity function and cognition. Up to 40 people will take part at Craig Hospital.
Upper extremity impairments are among the most disabling long-term consequences of traumatic brain injury (TBI). Weakness, impaired motor control, reduced dexterity, spasticity, and limited functional arm and hand use can restrict independence, community participation, and return to meaningful life roles. Functional task-specific practice (FTP) is a task-oriented, activity-based rehabilitation approach that uses repeated practice to improve gross upper extremity movement, isolated finger motion, and pinch and grasp needed for daily activities. Despite rehabilitation, many individuals with mode…
Inclusion Criteria: * Age 18 years or older. * History of TBI requiring inpatient rehabilitation, with resulting upper extremity impairment in at least one limb * Passive range of motion within functional limits at the wrists, shoulders, and elbows. * Able to attend on-site training at Craig Hospital three times per week for four weeks. * No complicating physical or cognitive condition, as determined by the physician or study investigator, that would preclude safe use of taVNS. * If taking prescribed antispasticity medication, dose stable for at least four weeks before study procedures. * Abl…
Both groups will receive the same structured upper extremity rehabilitation program. Each 60-minute session will include approximately 40 minutes of upper extremity FTP and 10 minutes of functional carryover activities in a real-world or simulated context, with remaining time used for setup, monitoring, and transition. Training will target gross upper extremity movement, bilateral pinch, bilateral grasp, unilateral grasp, complex or unilateral pinch, and finger isolation. Progression may include increased repetitions or speed, resistance, reduced therapist assistance, and varied task contexts using common objects. Participants assigned to active taVNS will perform upper extremity FTP while receiving stimulation through an earbud electrode positioned on the auricular concha. Current intensity will be individually adjusted to a tolerable level. Stimulation may be reduced, paused, or stopped for discomfort or safety concerns.
Both groups will receive the same structured upper extremity rehabilitation program. Each 60-minute session will include approximately 40 minutes of upper extremity FTP and 10 minutes of functional carryover activities in a real-world or simulated context, with remaining time used for setup, monitoring, and transition. Training will target gross upper extremity movement, bilateral pinch, bilateral grasp, unilateral grasp, complex or unilateral pinch, and finger isolation. Progression may include increased repetitions or speed, resistance, reduced therapist assistance, and varied task contexts using common objects. Participants assigned to sham taVNS will complete the identical rehabilitation schedule and activities using identical device placement at the left auricular concha; however, no active stimulation will be delivered. Device setup and study interactions will otherwise be kept as similar as practical between groups.
Arctuva estimate
Verify or correct the compensation shown for this listing.