Spinal Stimulation for Chronic Complete Tetraplegia

Spinal Cord Injuries Clinical Trial

— Complete TESCS  

Official title:

Non-invasive Spinal Cord Stimulation Combined With Activity-based Therapy in Chronic Complete High Level Spinal Cord Injury

Clinical Trial Details — Status: Not yet recruiting

Administrative data

• NCT number: NCT05522920
• Other study ID #: GN20NE064
• Status: Not yet recruiting
• Phase: N/A
• Start date: August 2022
• Est. completion date: December 2024

Study information

• Verified date: August 2022
• Source: NHS Greater Glasgow and Clyde
• Contact: Mariel Purcell, Consultant
• Phone: +44 141 201 2536
• Email: margaret.purcell[@]ggc.scot.nhs.uk
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

The purpose of this study is investigate the acceptability and effectiveness of transcutaneous spinal cord stimulation in people with complete high level spinal cord injury.

Recruitment information / eligibility

• Status: Not yet recruiting
• Enrollment: 12
• Est. completion date: December 2024
• Est. primary completion date: June 2024
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

• Willing and able to give informed consent for participation in the study

• Aged =18 years

• Injury level C3-C7, American Spinal Cord injury Association Impairment Scale (ASIA) A

• =1 year post-injury

• Medically stable, cognitively intact, and able to breathe independently

• Able to attend all sessions two or three times per week, for 2 h sessions and assessments

Exclusion Criteria:

• Any implanted active metallic device including, but not limited to neurostimulators, cochlear implants, pacemakers, implantable defibrillators, or drug delivery pumps

• Possible, suspected, or confirmed pregnancy and/or lactation

• Recent history or fracture, contractures or pressure sore, deep vein thrombosis (DVT) or urinary tract, or other infection that may interfere with the intervention and training

• History of epilepsy and/or seizures

• Severe spasticity which has been unstable over the 3 months prior to enrolment and is not expected to change and/or taking varying doses of anti-spasticity medications which could not be tapered to a stable dose and are not expected to change

• Botulinum toxin injections within 6 months of participation

• Non-injury related neurological impairment

• Clinically significant severe depression in spite of treatment

• Cardiovascular disease

• Autonomic dysreflexia that is severe, ongoing, and has required medical treatment within the past month

• Skin conditions or allergies that may affect electrode placement

• Do not understand English

• Received a stem cell treatment or other treatment that could possibly promote or attenuate neuroplastic changes in spinal or cortical function, within =2 years of enrolment; beyond this period, they may be included, provided the treatment was conducted in an accredited facility with proper ethics and regulatory approval.

• Involved in any other study involving stimulation of the spinal cord within 6 months of enrolment

• Information regarding recent rehabilitation or exercise programmes that participants may currently be engaged in will be discussed with clinical staff and fully documented for each participant

Related Conditions & MeSH terms

• Spinal Cord Injuries

Intervention

Other:
• Therapy with and without spinal cord stimulation
Conventional therapy only will be followed with conventional therapy combined with electrical spinal cord stimulation.

Locations

Country	Name	City	State
n/a

Sponsors (2)

Lead Sponsor	Collaborator
NHS Greater Glasgow and Clyde	International Spinal Research Trust

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Acceptance	Whether the treatment protocol is acceptable by people with complete tetraplegia. This will be assessed using semi structured interview results of which will be analysed qualitatively to determine the number of participants who would use the therapy on an ongoing basis.	26 weeks at the end of intervention
Secondary	Clinical effectiveness of spinal cord stimulation using GRASSP tool	Effectiveness of spinal cord stimulation in inducing changes in functional outcome. This will be assessed using the Graded and Redefined Assessment of Strength, Sensibility, and Prehension (GRASSP tool). The unit is based on the GRASSP measurement scale.	26 and 38 weeks, at the end of intervention and at follow up respectively
Secondary	Neurophysiological change	Effectiveness of spinal cord stimulation in inducing changes in Neurophysiological equivalence of volitional movement. This will be assessed using changes in amplitude in mV of transcranial magnetic stimulation.	26 and 38 weeks, at the end of intervention and at follow up respectively
Secondary	Sensation	Change in sensation due to the intervention. This will be assessed using change the sensory score of the International Standards for Neurological classification of SCI (ISNCSCI)	26 weeks at the end of intervention
Secondary	Spasticity	Changes in upper limb muscle tone using change in the Modified Ashworth Scale.	26 weeks at the end of intervention
Secondary	Autonomic function	Changes in autonomic function will be assessed using changes in the AUTONOMIC STANDARDS ASSESSMENT FORM of the International Spinal Cord Injury Data Set.	26 weeks at the end of intervention
Secondary	Change in perceived health status	The effect of the study on perceived health status of the participants will be assessed using QUALITY OF LIFE BASIC DATA SET of the International Spinal Cord Injury Data Set.	26 weeks at the end of intervention