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Terapia del cammino con stimolazione spinale controllata dal cervello dopo lesione incompleta del midollo spinale (SCI)

29 settembre 2026 aggiornato da: Matija Milosevic, University of Miami

Terapia di stimolazione spinale controllata dal cervello per il ripristino della deambulazione dopo una lesione incompleta del midollo spinale (SCI)

The purpose of this research is to test the effectiveness of a new therapy, called Brain-Computer Interface (BCI)-Transcutaneous Spinal Cord Stimulation (TSCS), for improving walking in people with an incomplete spinal cord injury (SCI).

Panoramica dello studio

Stato

Attivo, non reclutante

Condizioni

Intervento / Trattamento

Tipo di studio

Interventistico

Iscrizione (Effettivo)

6

Fase

  • Non applicabile

Contatti e Sedi

Questa sezione fornisce i recapiti di coloro che conducono lo studio e informazioni su dove viene condotto lo studio.

Luoghi di studio

    • Florida
      • Miami, Florida, Stati Uniti, 33136
        • University of Miami

Criteri di partecipazione

I ricercatori cercano persone che corrispondano a una certa descrizione, chiamata criteri di ammissibilità. Alcuni esempi di questi criteri sono le condizioni generali di salute di una persona o trattamenti precedenti.

Criteri di ammissibilità

Età idonea allo studio

Da 18 anni a 70 anni (Adulto, Adulto più anziano)

Accetta volontari sani

No

Sessi ammissibili allo studio

Tutto

Descrizione

Inclusion Criteria:

  1. At least 18 years old and no older than 70 years old at the time of enrollment.
  2. Traumatic incomplete spinal cord injury (neurological level at or above T10 spinal cord level; Abbreviated Injury Scale (AIS) C or D impairment grade for group 1, 3 and 4 and AIS B, C or D impairment grade for group 2), who are more than 6 months post-injury.
  3. Has detectable motor function in at least 2 muscles per side confirmed by voluntary Electromyography (EMG) or detectable tibialis anterior (TA) muscle motor evoked potentials (MEPs) at the baseline assessment.
  4. Able to commit to intensive training and assessment sessions over a maximum total duration of 12 months (6 months of treatment).
  5. Could effectively walk overground for at least 10 meters with some assistance of a therapist and minimal body-weight support, with functional spasticity (by participant's self-report), functional range-of-motion of lower limb joints, and acceptable bone mass to enable body-weight support, confirmed by Dual-energy X-ray absorptiometry (DXA) scan.

Exclusion Criteria:

  1. Has traumatic brain injury, stroke, multiple sclerosis, or other neuromuscular disorders that could affect neuromotor function and walking.
  2. Has severe spasticity that could prevent stepping and walking function determined by the investigator.
  3. Has major executive dysfunction, dementia, depression, neurocognitive impairments, or other major medical co-morbidities.
  4. Has other contra-indications for transcranial magnetic stimulation (TMS) or Transcutaneous Spinal Cord Stimulation (TSCS).
  5. Has a history of recent seizures or poorly managed autonomic dysreflexia that could be triggered by TMS or TSCS.
  6. Has a history of prior intracranial surgery or known lesions that would limit TMS assessments and Brain-Computer Interface (BCI) recordings.
  7. Individuals with metal implants in their head and other implantable devices in the body that could be affected by TMS or TSCS.
  8. Has peripheral neuropathy (diabetic polyneuropathy, entrapment neuropathy, etc.).
  9. Has urinary tract infection, unhealed fracture, contracture, and pressure sore (Braden Scale).
  10. Has breakdown in skin area that will come into contact with electrodes.
  11. Individuals who require therapy or other care that could interfere with participation in the study.
  12. Individuals on investigational drugs or any other intervention known to have a potential impact on neuromotor function.
  13. Individuals with substance disorders, including alcoholism and drug abuse.
  14. Individuals who are pregnant, breastfeeding, or the desire to become pregnant during the study.
  15. In the opinion of the investigators, the study is not safe or appropriate for the participant.

Piano di studio

Questa sezione fornisce i dettagli del piano di studio, compreso il modo in cui lo studio è progettato e ciò che lo studio sta misurando.

Come è strutturato lo studio?

Dettagli di progettazione

  • Scopo principale: Trattamento
  • Assegnazione: N / A
  • Modello interventistico: Assegnazione di gruppo singolo
  • Mascheramento: Nessuno (etichetta aperta)

Armi e interventi

Gruppo di partecipanti / Arm
Intervento / Trattamento
Sperimentale: Brain-Computer Interface (BCI)-Transcutaneous Spinal Cord Stimulation (TSCS)

Participants will receive brain-computer interface (BCI)-triggered transcutaneous spinal cord stimulation (tSCS) combined with activity-based training 3 to 4 times per week. The BCI system detects movement attempts and triggers stimulation delivered through the Neostim 5 spinal cord stimulator. Participants will participate in the therapy for up to 12 months.

Participants will receive brain-computer interface (BCI)-triggered transcutaneous spinal cord stimulation (tSCS) using the Neostim 5 spinal cord stimulator during activity-based training sessions. The BCI system detects movement attempts and triggers delivery of transcutaneous spinal cord stimulation. Intervention sessions will occur 3 to 4 times per week throughout the study intervention period.

Altri nomi:
  • Neostim 5 Spinal Cord Stimulator

Cosa sta misurando lo studio?

Misure di risultato primarie

Misura del risultato
Misura Descrizione
Lasso di tempo
Number of related neurological deterioration (LEMS)
Lasso di tempo: up to 12 months

Lower Extremity Motor Score (LEMS) to assess lower limb muscle function following the American Spinal Injury Association Impairment Scale (ASIA) guidelines. The LEMS evaluates motor function on a scale of 0 (no motor function) to 5 (full motor function).

up to 12 months
Number of treatment related incidence of adverse events (AEs)
Lasso di tempo: up to 12 months

Safety will be reported as the incidence of treatment related AEs as assessed by the study doctor

up to 12 months
Number of subjects that complete the study
Lasso di tempo: up to 12 months

Safety will be determined by number of subjects that complete the study, as designed.

up to 12 months
Walking function using 10 meter walk test (10MWT)
Lasso di tempo: up to 12 months

This is a test of short-distance walking function. The subject will be asked to walk at a comfortable walking speed (CWS) and maximum walking speed (MWS) on a ten-meter straight walkway. Time is measured in meters per seconds.

up to 12 months
Walking function using 6 minute walk test (6MWT)
Lasso di tempo: up to 12 months

The object of the test is to walk as far as possible for 6 minutes. The subject will walk at a normal pace around a marked course for 6 minutes. The subject may stop to rest and begin again at will. The distance covered indicates aerobic fitness. The further a subject walks, the better their cardiovascular condition. Units are measured in meters.

up to 12 months

Misure di risultato secondarie

Misura del risultato
Misura Descrizione
Lasso di tempo
Mobility measured by Timed Up and Go (TUG) Test
Lasso di tempo: up to 12 months.

The Timed Up and Go test or TUG test is used to help evaluate mobility. It measures, in seconds, how long it takes subjects to stand up, walk 10 feet, turn around, walk back, and sit down.

up to 12 months.
Balance measured by the Berg Balance Scale (BBS)
Lasso di tempo: up to 12 months.

BBS is an assessment to determine balance. The BBS consists of 14 items scored on a 5-point ordinal scale, ranging from 0 to 4 (0 indicates lowest level of function; 4 indicates highest level of function), with a maximum total score of 56.

up to 12 months.
Muscular spasticity measured by the Modified Ashworth Scale (MAS)
Lasso di tempo: up to 12 months.

The Modified Ashworth Scale is a 6-point scale. Scores range from 0 to 4, where lower scores represent normal muscle tone and higher scores represent spasticity.

up to 12 months.
Muscular spasticity measured by the Pendulum Test
Lasso di tempo: up to 12 months.

The Pendulum Test will be used to measure muscular spasticity. During the pendulum test, the participant will be lying on a therapy mat with the lower leg hanging off the edge of the mat. A member of the study staff will support the participant's extended lower leg and then release the leg allowing it to swing freely. This test will be video recorded and the movement of the knee joint will be measured using software on the computer. Muscular spasticity will be calculated by the number of the Relaxation index (R1 and R2) and compared to norms.

up to 12 months.
Walking assistance measured by the Walking Index for Spinal Cord Injury Scale (WISCI II)
Lasso di tempo: up to 12 months

WISCI II is an ordinal scale using a rank ordering along a dimension of impairment, from the level of most severe impairment (0) to least severe impairment (20) based on the use of devices, braces and physical assistance of one or more persons. The order of the levels suggests each successive level is a less impaired level than the former.

up to 12 months
Independence as measured by Spinal Cord Independence Measure (SCIM III)
Lasso di tempo: up to 12 months

SCIM III assesses performance in activities of daily living Scores range from 0-100, where a score of 0 defines total dependence and a score of 100 is indicative of complete independence.

up to 12 months
Quality of Life using the International Spinal Cord Injury - Quality of Life (ISCI-QOL)
Lasso di tempo: up to 12 months

ISCI-QOL consists of three single items on satisfaction with life as a whole, physical health and psychological health using a 0-10 scale where 0=complete dissatisfaction; 10=complete satisfaction.

up to 12 months
Quality of Life measured by the Reintegration to Normal Living (RNL) questionnaires
Lasso di tempo: up to 12 months

RNL is a self-report questionnaire that assesses a person's satisfaction with performance in life activities. The RNL index assesses mobility, self-care, daily activity, recreational activity, and family roles.

The RNL includes 11 declarative statements and a composite score will be calculated. Minimum Score = 0; Maximum Score = 100. Higher scores indicate greater reintegration.

up to 12 months

Collaboratori e investigatori

Qui è dove troverai le persone e le organizzazioni coinvolte in questo studio.

Sponsor

Collaboratori

Investigatori

  • Investigatore principale: Matija Milosevic, PhD, University of Miami - MSOM

Studiare le date dei record

Queste date tengono traccia dell'avanzamento della registrazione dello studio e dell'invio dei risultati di sintesi a ClinicalTrials.gov. I record degli studi e i risultati riportati vengono esaminati dalla National Library of Medicine (NLM) per assicurarsi che soddisfino specifici standard di controllo della qualità prima di essere pubblicati sul sito Web pubblico.

Studia le date principali

Inizio studio (Effettivo)

7 maggio 2024

Completamento primario (Stimato)

31 dicembre 2026

Completamento dello studio (Stimato)

31 dicembre 2026

Date di iscrizione allo studio

Primo inviato

6 maggio 2024

Primo inviato che soddisfa i criteri di controllo qualità

6 maggio 2024

Primo Inserito (Effettivo)

9 maggio 2024

Aggiornamenti dei record di studio

Ultimo aggiornamento pubblicato (Effettivo)

2 ottobre 2026

Ultimo aggiornamento inviato che soddisfa i criteri QC

29 settembre 2026

Ultimo verificato

1 agosto 2026

Maggiori informazioni

Termini relativi a questo studio

Altri numeri di identificazione dello studio

  • 20240091

Piano per i dati dei singoli partecipanti (IPD)

Hai intenzione di condividere i dati dei singoli partecipanti (IPD)?

NO

Informazioni su farmaci e dispositivi, documenti di studio

Studia un prodotto farmaceutico regolamentato dalla FDA degli Stati Uniti

No

Studia un dispositivo regolamentato dalla FDA degli Stati Uniti

Sì

prodotto fabbricato ed esportato dagli Stati Uniti

No

Queste informazioni sono state recuperate direttamente dal sito web clinicaltrials.gov senza alcuna modifica. In caso di richieste di modifica, rimozione o aggiornamento dei dettagli dello studio, contattare register@clinicaltrials.gov. Non appena verrà implementata una modifica su clinicaltrials.gov, questa verrà aggiornata automaticamente anche sul nostro sito web .