Epidural Stimulation and Rehabilitation for Spinal Cord Injury

July 16, 2026 updated by: Görkem Açar, Istanbul Gelisim University

Early Functional Change After Epidural Electrical Stimulation Combined With Structured Rehabilitation in Spinal Cord Injury With Conus-Region Involvement: An Exploratory Cohort Analysis

Spinal cord injury involving the conus region often results in severe impairments in mobility, self-care, and bladder and bowel function, substantially reducing independence and quality of life. Epidural electrical stimulation (EES), combined with structured rehabilitation, has emerged as a promising neuromodulation strategy for improving functional recovery; however, evidence in patients with conus-region involvement remains limited. This exploratory cohort study aims to evaluate functional changes following EES integrated with a standardized rehabilitation program in individuals with spinal cord injury involving the conus region. Functional independence is assessed using the Spinal Cord Independence Measure (SCIM) at baseline and during follow-up. The study also evaluates changes in SCIM subdomains related to self-care, respiration and sphincter management, and mobility, while monitoring the safety of EES throughout the rehabilitation period. The findings are expected to provide preliminary evidence regarding the feasibility, safety, and potential functional benefits of combining epidural electrical stimulation with structured rehabilitation in this specific spinal cord injury population.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Study Type

Observational

Enrollment (Actual)

29

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Turkey (Türkiye)
    • Istanbul
      • Istanbul, Istanbul, Turkey (Türkiye), 34310
        • Istanbul Gelisim University

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Child
  • Adult

Accepts Healthy Volunteers

No

Sampling Method

Non-Probability Sample

Study Population

The study population consisted of individuals with chronic spinal cord injury involving the conus region (T12 and/or L1) who received epidural electrical stimulation integrated with a structured rehabilitation program. Twenty-nine participants (20 males and 9 females; age range 17-61 years) with complete baseline and follow-up assessments were included in the final analysis.

Description

Inclusion Criteria:

  • Adults and adolescents aged 17 to 61 years.
  • Diagnosis of chronic spinal cord injury involving the conus region (T12 and/or L1).
  • Underwent epidural electrical stimulation (EES) combined with a structured rehabilitation program.
  • Available baseline and follow-up Spinal Cord Independence Measure (SCIM) assessments.
  • Provided written informed consent or consent was obtained from a legally authorized representative.

Exclusion Criteria:

  • Spinal cord injury without conus-region involvement.
  • Missing baseline or follow-up functional assessment data. Incomplete clinical records preventing outcome evaluation.
  • Contraindications to epidural electrical stimulation or inability to participate in the rehabilitation program.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

Cohorts and Interventions

Group / Cohort
Intervention / Treatment
Spinal Cord Injury With Conus-Region Involvement
Participants with chronic spinal cord injury involving the conus region (T12 and/or L1) who underwent epidural electrical stimulation combined with a structured rehabilitation program. Functional outcomes were evaluated using the Spinal Cord Independence Measure (SCIM) over a 6-month follow-up period.
Device: Epidural Electrical Stimulation (EES)
Participants received individualized epidural electrical stimulation delivered through an implanted epidural stimulation system in combination with a structured rehabilitation program. Stimulation parameters were adjusted according to clinical response, and rehabilitation included task-oriented exercises, balance training, standing, gait preparation, and functional mobility exercises throughout the 6-month follow-up period.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Change in Total Spinal Cord Independence Measure (SCIM) Score
Time Frame: Baseline to 6 Months
The primary outcome is the change in total Spinal Cord Independence Measure (SCIM) score between baseline and the 6-month follow-up. The SCIM assesses functional independence in individuals with spinal cord injury, with scores ranging from 0 to 100; higher scores indicate greater functional independence.
Baseline to 6 Months

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Change in SCIM Self-Care Subscale Score
Time Frame: Baseline to 6 Months
Assessment of changes in the SCIM Self-Care subscale score.
Baseline to 6 Months
Change in SCIM Respiration and Sphincter Management Subscale Score
Time Frame: Baseline to 6 Months
Assessment of changes in the SCIM Respiration and Sphincter Management subscale score.
Baseline to 6 Months
Change in SCIM Mobility: Room and Toilet Subscale Score
Time Frame: Baseline to 6 Months
Assessment of changes in the SCIM Mobility: Room and Toilet subscale score.
Baseline to 6 Months
Change in SCIM Mobility: Indoors and Outdoors Subscale Score
Time Frame: Baseline to 6 Months
Assessment of changes in the SCIM Mobility: Indoors and Outdoors subscale score.
Baseline to 6 Months
Incidence of Device- or Procedure-Related Adverse Events
Time Frame: Baseline to 6 Months
Occurrence of major procedure- or device-related adverse events, including wound infection, cerebrospinal fluid leak, lead migration, stimulation intolerance requiring discontinuation, revision surgery, or device explantation during the follow-up period.
Baseline to 6 Months

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Istanbul Gelisim University

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

January 15, 2026

Primary Completion (Actual)

January 29, 2026

Study Completion (Actual)

January 31, 2026

Study Registration Dates

First Submitted

July 16, 2026

First Submitted That Met QC Criteria

July 16, 2026

First Posted (Actual)

July 21, 2026

Study Record Updates

Last Update Posted (Actual)

July 21, 2026

Last Update Submitted That Met QC Criteria

July 16, 2026

Last Verified

July 1, 2026

More Information

Terms related to this study

Additional Relevant MeSH Terms

Other Study ID Numbers

  • 2025-20162-179

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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