Health Outcomes After Locomotor Training in Spinal Cord Injury
Condition: Spinal Cord Injuries; Spinal Cord Trauma
MeSH terms: Spinal Cord Injuries; Wounds and Injuries
Study type: Interventional

Summary: 
      People with spinal cord injury (SCI) suffer from secondary health conditions that can result
      in undue physical challenges and impact participation in activities in everyday life.
      Locomotor Training (LT) has been shown to demonstrate improvements in balance and walking
      function in both the animal and humans by reactivating spinal circuits through intensive
      therapy of muscles below the level of the injury. However, it is not known if LT also has
      beneficial health effects and it is the focus of this study proposed to be undertaken at
      Stony Brook University (SBU) as the lead site. LT is thought to produce activation of spinal
      networks to help recover balance and walking after SCI and may correspond with improvements
      in health measures such as bladder function, breathing capacity, cholesterol and other
      cardiac risk factors markers, and the ability to stand upright without drops in blood
      pressure resulting in a sensation of dizziness. LT takes place on a treadmill with the body
      weight supported in a harness, while walking overground and with the practice of key
      exercises in the home and community. The emphasis is on loading the body through the legs
      without braces and other devices except where necessary to function at home. The overall
      objective of this study to capture and analyze health outcome data collected on 80 patients
      enrolled in the 7 NeuroRecovery Network (NRN) clinics in the USA who receive LT. The NRN is
      funded by the Christopher and Dana Reeve Foundation and the CDC to implement LT for people
      with SCI. The purpose of this application is to leverage the NRN funding, that provides
      support for LT and standardized outcome measures, to generate further knowledge on health
      outcomes after LT for individuals with SCI. The proposed project will be accomplished through
      the utilization of staff at each of the 6 NRN sites, lead by the study principal investigator
      and the lead clinical research coordinator at SBU. They will ensure the data are captured
      before and after LT in a standardized manner, at the correct time and entered into a
      de-identified database. The study hypotheses are that after LT, compared to before, patients
      with SCI will improve lipid profiles and insulin factors as measured by fasting blood tests;
      respiratory function as measured by specialized but easy to use breathing equipment; and
      blood pressure and heart rate during a maneuver to test for responses to abrupt changes in
      posture. The relevance of this proposal is that it will help to determine if there is an
      association between an intensive activity- based intervention (LT) and improvements in health
      and will be used to form the basis for a larger randomized clinical trial and clinical
      practice guidelines.
    


Intervention name(s): Locomotor Training
Intervention type(s): Behavioral
Intervention description(s): Progressive retraining in functional skills including balance, transfers, activities of daily living and ambulation. Compliance to eliminate or minimize lower limb orthotics is also expected to optimize sensory input to the spinal cord and promote optimal recovery. Intensive therapy occurs in all three environments 5 times/ week for 90 minutes
Intervention model: Single Group Assignment
Masking: None (Open Label)
Primary purpose: Treatment