The purpose of this study is to examine the relationship between common clinical assessments and measurements of the function of brain-spinal cord-muscle connections, and to examine the effects of training a brain-spinal cord-muscle response in individuals with incomplete spinal cord injury. A transcranial magnetic stimulator (TMS) is used for examining brain-to-muscle pathways. This stimulator produces a magnetic field for a very short period of time and indirectly stimulates brain cells with little or no discomfort. The target muscle is the wrist extensor (extensor carpi radialis) muscle that bends the wrist back. It is hypothesized that training the wrist extensor muscle response to transcranial magnetic stimulation will increase the strength of the brain-to-muscle pathway, which will improve the ability to move the arm. It is hoped that the results of this training study will help in developing therapy strategies for individuals, promoting better understanding of clinical assessments, and understanding treatments that aim to improve function recovery in people with spinal cord injury (SCI). This study requires 30 visits, and each visit will last approximately 1.5 hours.
Age range
18 Years
Sex
ALL
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A starting point for the conversation — always confirm anything about your own eligibility, costs, and care with the study team and your doctor.
Change in the excitability/strength of the brain-spinal cord-muscle pathway at the brain level as measured by the Motor Evoked Potential
Timeframe: Baseline and final training session (approximately 2.5 months)
Change in ability to move the arm as measured by the Action Research Arm Test (ARAT). Maximum score of 57 points
Timeframe: change from baseline to immediately after completing the training protocol
Change in ability to move the arm as measured by the Fugl-Meyer Assessment (FMA)
Timeframe: change from baseline to immediately after completing the training protocol
Change in gross manual dexterity as measured by the Box and Block Test (BBT)
Timeframe: change from baseline to immediately after completing the training protocol
Change in fine motor ability and finger dexterity as measured by the Nine Hole Peg Test
Timeframe: change from baseline to immediately after completing the training protocol
Change in strength as measured by Manual Muscle Testing (MMT)
Timeframe: change from baseline to immediately after completing the training protocol
Change in sensation on the back and palm of the hand as measured by the Semmes Weinstein Monofilament Test
Timeframe: change from baseline to immediately after completing the training protocol
Change in spasticity as measured by the Modified Ashworth Scale (mAS)
Timeframe: change from baseline to immediately after completing the training protocol