Spinal Cord Injury (SCI) Clinical Trial
Official title:
Restoring Walking in Non-ambulatory Children With Severe Chronic SCI (Kids STEP Study)
The Kids STEP Study aims to
1. Determine if walking can be restored in children with incomplete SCI and little to no
leg movement
2. Identify the neural pathways that permit recovery of walking
Locomotor training (LT) is an activity-based therapy to promote plasticity and recovery of
walking. It is based on animal studies investigating walking recovery after spinal cord
injury and the nervous system's control of walking. Normal walking is achieved through the
interaction of multiple levels of the neural axis (cortex, brain stem, spinal cord).
However, a basic rhythmic walking pattern is generated by central pattern generators (CPGs)
located within the spinal cord. Investigations of central pattern generators indicate that
sensory input specific to the task of walking can enhance the firing of these spinal
neuronal centers. Thus, LT is an intensive walking program designed to provide sensory input
to the spinal cord so that the neural output from the spinal CPGs can be maximized. In
addition, LT uses a treadmill and a harness to provide partial body weight support enabling
persons with injury to repetitively practice walking in a safe, enabling environment.
Children enrolled in the study (after medical clearance and consent to participate) will
undergo extensive testing and complete 12 weeks of locomotor training. Testing will examine
the child's neurologic and functional status. Tests to examine functional status include:
ASIA evaluation of sensory and motor function, gait analysis, comprehensive strength tests,
and assessment of skills such as cycling, stepping, and kicking. Tests to examine the
child's neurologic injury include: MRI, Transcranial Magnetic Stimulation (TMS), and reflex
testing. Locomotor training will be conducted daily (5 days/ week) for a total of 60
sessions over 12 weeks. During training children will work closely with therapists,
researcher, and trainers to practice walking skills on the treadmill and over-ground.
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Endpoint Classification: Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment
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