Promoting Recovery Outcomes Through Precise Early Locomotor Interventions in Persons With Spinal Cord Injury

Milap Sandhu108 enrolled

Overview

The purpose of this study is to evaluate if a specific type of additional walking therapy, called body weight supported treadmill training (BWSTT) affects walking ability following a traumatic spinal cord injury. Specifically, the study will look at whether starting BWSTT, which uses a body harness to support body weight while walking on a treadmill at different times within the first 6 months after the injury, makes a difference in how effective this therapy may be, While we know that the brain re-learns patterns following an injury, there has not been a lot of prior research evaluating how starting this type of walking therapy at specific times within the first 6 months after injury may impact any effectiveness of the additional therapy. The study will randomize participants into four groups: those who start this therapy within 60 days, within 3 months, within 6 months or who do not receive this additional research therapy. Randomization means that which group you will be in as part of this study is determined by chance, like the flip of a coin. The additional walking therapy for this research study, if you are randomized for one of the three groups who receives the additional therapy, will be given on top of (meaning in addition to) any standard of care therapies that you may be receiving at that time point after your injury.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

DOUBLE

Enrollment

108

Conditions

Spinal Cord Injuries

Eligibility

Sex: ALLMin age: 16 YearsMax age: 75 Years

Medical Language ↔ Plain English

Inclusion Criteria: * History of Acute and Traumatic SCI with AIS classification of B, C, or D between the neurological levels of C5 and T12 * Between the ages of 16-74 * Weight bearing as tolerated in bilateral lower extremities * Able to tolerate a harness * Ability to provide informed consent. For minors, consent of parents or primary caregivers/guardians and assent of the minor * Able to provide informed consent within 60 days of injury onset * Able to participate in all study related activities, including 1-year follow up Exclusion Criteria: * Orthopedic injuries, fractures, surgeries, or other conditions affecting locomotor function or weight bearing * A weight over 250lbs and if so a BMI greater than 30, or deemed clinically inappropriate due to body habitus * Moderate to sever traumatic brain injury of other neurological conditions at a severity which impairs cognition * Presence of uncontrolled orthostatic hypotension that limits active participation in intense physical rehabilitation program. * Other medical complications such as severe heart failure or large/deep pelvic or lower abdominal wounds that may limit the ability to safely don and doff a harness for ambulation * Pregnancy, as confirmed by blood draw

Outcomes

Primary Outcomes

10 Meter walk test

Used to assess walking speed, time taken to walk 10 meters at fastest pace

Time frame: 1-5 days Following Intervention

Secondary Outcomes

6 Minute Walk test

Used to assess distance traveled during a 6 minute walking test at a self selected pace

Time frame: 1-5 days Following Intervention

Walking Index for spinal cord injury

Assessment to determine the physical assistance and assistive devices needed to walk 10 meters

Time frame: 1-5 days following intervention

Daily step counts

Step counts from a waist worn activity tracker

Time frame: 2 weeks following 3-, 6-, 9-, and 12- month assessments

Gait Deviation idex

A measure of gait quality by quantifying joint angles during a gait cycle. This data is recorded via a marker-less motion capture system

Time frame: Baseline, 3-, 6-, 9-, and 12- month assessments