The objectives of the study are to evaluate trunk task-oriented training combined with function electrical stimulation (FES/T-TOT) efficacy on sitting balance and functional independence, and to understand the mechanisms of neuroplasticity that would improve functional independence following FES/T-TOT in individuals with spinal cord injury.
After obtaining their consent, participants will undertake evaluations at different times: 1. Assessment 3 weeks prior to training 2. Assessment 1 week prior to training 3. Training over 12 weeks 4. Assessment 1 week after training 5. 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. The assessment will consist of: * Session 1 (at Neuro-Concept clinic) will include presentation of the study and the obtention of written consent, clinical (modified Reaching test and muscle strength), quality of life and functional independence assessments. * Session 2 (at IURDPM in Dr. Barthélemy's laboratory) will include postural control, corticospinal and cortical assessments. After the initial assessment, the participants with spinal cord injury will realize 36 sessions of trunk task-oriented training alone or combined with function electrical stimulation (3 times a week for 12 weeks).
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
45
Training will consist to perform one hour of trunk task-oriented training combined with functional electrical stimulation (FES/T-TOT) specific for muscle strength and motor control. All training will be done seated without support with knees and hips flexed to 90 degrees. FES will be combined with functional and non-functional tasks to work functionality and muscle strengthening. Each training session will consist on the fulfilment of two functional tasks (as reaching) and two non-functional tasks (as push-up movement) from a battery of postural control exercises.
The SCI participants who will perform T-TOT training alone will have to perform the same exercises as explained in the previous section (two functional tasks and two non-functional tasks) but they will not receive any functional electrical stimulation. Training will consist to perform one hour of trunk task-oriented training (T-TOT) specific for muscle strength and motor control. All training will be done seated without support with knees and hips flexed to 90 degrees. Each training session will consist on the fulfilment of two functional tasks (as reaching) and two non-functional tasks (as push-up movement) from a battery of postural control exercises.
Neuro-Concept Inc
Montreal, Quebec, Canada
RECRUITINGNeuromobility lab
Montreal, Quebec, Canada
ENROLLING_BY_INVITATIONChange in Function in Sitting Test
This test evaluates the sitting balance via 14 everyday functional activities rated from 0 to 4 according to the reactions of the participants.
Time frame: Before and after the 12-week trainings and 1-month follow-up
Change in modified Functional Reach Test
This test evaluates the ability for each participant to realize a lateral and anterior trunk flexion in order to observe the maximum distance reached.
Time frame: Before and after the 12-week trainings and every 4-weeks during the training period
Change in EMG activation pattern of electromyographic activity of muscles in the trunk
during reaching and pointing tasks
Time frame: Before and after the 12-week trainings and 1-month follow-up
Change in the center of pressure excursion
during reaching and pointing tasks
Time frame: Before and after the 12-week trainings and 1-month follow-up
Modification of the excitability of the reticulospinal pathway using the acoustic startle response
A tone will be triggered just before the reaching movement. The EMG responses of trunk muscles will be analyzed.
Time frame: Before and after the 12-week trainings and 1-month follow-up
Modification of the excitability of the vestibulospinal pathway using galvanic vestibular stimulation
Vestibular responses induced by GVS will be identified in the trunk muscles
Time frame: Before and after the 12-week trainings and 1-month follow-up
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