Sensorimotor Integration Underlying Balance Control in Individuals With Incomplete Spinal Cord Injury

Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal

Status: Unknown

Conditions: Spinal Cord Injuries

Treatments: Other: Combined explosive strength and specific balance training group

Study type: Interventional

Funder types: Other

Identifiers

NCT05200091

CRIR 1325-0118

Details and patient eligibility

About

The objectives of the study are to evaluate a 4-week mixed training paradigm consisting of explosive strength training and balance perturbation training efficacy on balance control during standing and locomotion, and to understand the mechanisms of neuroplasticity that would improve sensorimotor integration at supraspinal and spinal levels.

Full description

After obtaining their consent, participants will undertake evaluations at different times:

1. Assessment 1 week prior to training
2. Training over 4 weeks (nature of the training depends on the group)
3. Assessment 1 week after training
4. Assessment 1 month after training (follow-up)

Each assessment will be divided in 2 sessions and data will be collected over 2 days, at one session per day. Days can be consecutive or non-consecutive but will be within a given week. The assessment consists of:

• Session 1 (S1; duration: 3h) will include presentation of the Study and obtainment of consent, clinical tests, galvanic vestibular stimulation testing, postural reactions and gait assessment.
• Session 2 (S2; duration: 3h) will include muscle strength, short-afference inhibition, paired pulse and trans cranial magnetic stimulation conditioning of H reflex.

After the initial assessment, iSCI participants will be separated in 2 groups and will receive combination of explosive strength and balance training or no intervention. The training will span over 12 sessions (3 times per week for 4 weeks) and each training session will last approximately 1h (including effective training and installation periods).

Enrollment: 36 estimated patients

Sex: All

Ages: 18+ years old

Volunteers: Accepts Healthy Volunteers

Inclusion and exclusion criteria

FOR PARTICIPANTS WITH SPINAL CORD INJURY

Inclusion Criteria:

• Have an incomplete lesion of spinal cord
• Level of spinal cord lesion between C5 and T12
• At least, 6 months post-injury
• Be considered as AIS C or D
• Be able to stand without support for 15 seconds
• Be able to provide informed consent in English or in French

Exclusion Criteria:

• To have cognitive deficits
• To have personal or family history of epilepsy
• To have suffered moderate or severe traumatic brain injury
• To have cochlear implant

FOR CONTROL PARTICIPANTS

Exclusion Criteria:

• To have orthopedics problems
• To have cognitive deficits
• To have neurological problems

Trial design

Primary purpose: Treatment

Allocation: Non-Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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36 participants in 3 patient groups

Combined explosive strength and specific balance training group

Experimental group

Description:

This group will be formed with participants with incomplete spinal cord injury. This group will perform 4 weeks of combined explosive strength and specific balance training.

Treatment:

Other: Combined explosive strength and specific balance training group

Spinal cord injury control group

No Intervention group

Description:

This group will be formed with participants with incomplete spinal cord injury. They will perform all the evaluation before and after a 4-week period of rest (no training).

Healthy control group

No Intervention group

Description:

Healthy participants will be recruited based on the age and sex of the participants with incomplete spinal cord injury to realize clinical and neurophysiological cortical evaluations.