STIMO-Study: Efficacy of Spinal Epidural Electrical Stimulation (EES) in combination with Robot-assisted Neurorehabilitation in patients with SCI
Funded in: 2017, 2018, 2019
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Problem: Enhance functional recovery after incomplete spinal cord injury
Target: Electrical spinal cord stimulation combined with robot-assisted locomotor training in people with chronic incomplete spinal cord injury
Goal: Demonstrating safety and efficacy of the combined treatment to improve motor function and promote neural plasticity
Over the past decade, we have methodically developed innovative procedures combining electrical stimulation of the spinal cord and robot-assisted neurorehabilitation to restore leg motor control. These interventions reestablished walking in rodent and primate models of spinal cord injury (see references). The present study is our first effort to translate these pre-clinical findings into clinical applications. For this, we are applying this combined treatment in individuals with chronic incomplete spinal cord injury to evaluate its safety and efficacy in improving voluntary movement and bladder function.
We use a cutting-edge robotic device that enables overground locomotion with body-weight support in a large and safe rehabilitation environment. Electrodes are surgically implanted between the vertebral column and the spinal cord (epidural spinal cord stimulation, A). These electrodes are connected to an implantable stimulator that is controlled in real-time and wirelessly. This system allows the delivery of electrical stimulation sequences that facilitate locomotion. Specifically, an algorithm automatically adjusts the stimulation to activate distinct leg muscle groups and thus promote flexion and extension movements of the leg (closed-loop spatio-temporal neuromodulation, B).
Eight participants will follow the combined rehabilitation program for five months. Evaluations will be performed before and throughout the program on a monthly basis to quantify improvements and identify the underlying therapeutic mechanisms.
We expect that spinal cord stimulation will result in an immediate improvement of leg motor control. We also expect a reorganization of neural connections throughout training that will lead to improved motor control without stimulation, and potentially will ameliorate additional physiological functions.
This study is currently recruiting participants with chronic incomplete spinal cord injury. More information can be found here: