Combined Tibial Nerve Stimulation and Standing for People With SCI

University of British Columbia12 enrolled

Overview

The goal of this clinical trial is to understand how sensory inputs from the lower leg can influence pelvic floor muscle function and urogential function in adults with chronic spinal cord injury (SCI). The main questions it aims to answer are: 1. What is the modulatory role of load and posture on reflex activation of the pelvic floor muscles in participants with SCI? 2. What is the feasibility of combining tibial neuromodulation with standing therapy in participants with SCI? 3. What are the potential effects of combined tibial neuromodulation and standing therapy on reflex excitability and urogential symptoms and quality of life in people with SCI? Participants will be asked complete a series of assessments (questionnaires, electrophysiological testing) before and after a 12-week intervention of combined standing and tibial nerve stimulation therapy.

Study Type

INTERVENTIONAL

Allocation

Purpose

TREATMENT

Masking

NONE

Enrollment

Conditions

Spinal Cord Injury

Interventions

Eligibility

Sex: ALLMin age: 19 Years

Medical Language ↔ Plain English

Inclusion Criteria: * At least 19 years of age * Have a SCI between C7 - T10 that occurred at least 12 months previously * Have a motor-complete or incomplete SCI (AIS A, B, C, or D) * Have symptoms of neurogenic LUT dysfunction * Meet the manufacture requirements for standing frame use (will be evaluated by the research team) * Are able to speak and understand English. Exclusion Criteria: * Have changed their bladder management program in the past month * Have received an injection of Botulinum toxin-A in any LUT structure in the past 2 weeks, or intend to receive an injection while participating in the trial * Have a non-stable SCI (e.g. spinal tumor) * Have signs of a lower motoneuron injury (e.g. cauda equina syndrome) * Have other neurological injury besides SCI * Have an implanted metallic or electronic device (e.g. pace maker, nerve stimulator) * Have a condition for which exercise or transcutaneous stimulation is contraindicated * Have a severe acute medical issue that in the investigator's judgement would adversely affect the participant's participation in the study. Examples include, but are not limited to acute urinary tract infections, pressure sores, musculoskeletal injury, or unmanage blood pressure. * Are currently pregnant or have given birth within the past 12 months * Use walking as your primary means of movement around your home and the community.

Outcomes

Primary Outcomes

Pelvic Floor Muscle Reflex Excitability

We will electrically stimulate the tibial nerve and record reflexes responses from the pelvic floor muscles using perianal surface electromyography. We will examine the amplitude of the reflex response.

Time frame: At baseline to within 2 weeks of completing the study intervention

Secondary Outcomes

Feasibility - Recruitment Rate

Recruitment rate will be evaluated by number of participants approached, screened for eligibility, as well as reasons for exclusions.