Body System Effects of a Multi-Modal Training Program Targeting Chronic, Motor Complete Thoracic Spinal Cord Injury

J Neurotrauma. 2018 Feb 1;35(3):411-423. doi: 10.1089/neu.2017.5105. Epub 2017 Oct 16.

Abstract

The safety and efficacy of pharmacological and cellular transplantation strategies are currently being evaluated in people with spinal cord injury (SCI). In studies of people with chronic SCIs, it is thought that functional recovery will be best achieved when drug or cell therapies are combined with rehabilitation protocols. However, any functional recovery attributed to the therapy may be confounded by the conditioned state of the body and by training-induced effects on neuroplasticity. For this reason, we sought to investigate the effects of a multi-modal training program on several body systems. The training program included body-weight-supported treadmill training for locomotion, circuit resistance training for upper body conditioning, functional electrical stimulation for activation of sublesional muscles, and wheelchair skills training for overall mobility. Eight participants with chronic, thoracic-level, motor-complete SCI completed the 12-week training program. After 12 weeks, upper extremity muscular strength improved significantly for all participants, and some participants experienced improvements in function, which may be explained by increased strength. Neurological function did not change. Changes in pain and spasticity were highly variable between participants. This is the first demonstration of the effect of this combination of four training modalities. However, balancing participant and study-site burden with capturing meaningful outcome measures is also an important consideration.

Keywords: clinical trials; conditioning; exercise; rehabilitation; spinal cord injury.

Publication types

  • Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Electric Stimulation Therapy / methods*
  • Exercise Therapy / methods*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Muscle Strength / physiology
  • Pilot Projects
  • Recovery of Function
  • Spinal Cord Injuries / rehabilitation*
  • Thoracic Vertebrae
  • Young Adult