Sensorimotor Integration Underlying Balance Control in Individuals With Incomplete Spinal Cord Injury

NCT05200091 | Unknown

• 1 other identifier: CRIR 1325-0118
• Study Type: interventional
• Target: 36
• Locations: 1 country
• Sites: 1

Brief Summary

The objectives of the study are to evaluate a 4-week mixed training paradigm consisting of explosive strength training and balance perturbation training efficacy on balance control during standing and locomotion, and to understand the mechanisms of neuroplasticity that would improve sensorimotor integration at supraspinal and spinal levels.

Conditions

Spinal Cord Injuries

Keywords

Combined explosive strength and balance training; Balance control; Corticospinal tract; Intracortical mechanisms; Vestibular system

Outcome Measures

Primary Outcomes (3)

• Change in muscles EMG responses following balance perturbation

  Evaluation of the latency on Soleus and Tibialis anterior muscles EMG following backward and forward perturbations will be done.

  Pre-intervention, immediately after and one-month after intervention

• Change in center of pressure displacement following balance perturbation using a force platform

  Excursion of centre of pressure will be analyzed following forward and backward perturbation.

  Pre-intervention, immediately after and one-month after intervention

• Change in ankle muscle strength using force transducer

  Evaluation of isometric dorsi- and planti-flexors muscle strength in Newton will be done using a force transducer attached to the participant's feet.

  Pre-intervention, immediately after and one-month after intervention

Secondary Outcomes (5)

• Change in intracortical mechanisms using transcranial magnetic stimulation (TMS)

  Pre-intervention, immediately after and one-month after intervention

• Change in the influence of peripheral afferents on cortical output using short-afference inhibition

  Pre-intervention, immediately after and one-month after intervention

• Change in the modulation of the H reflex by the corticospinal tract

  Pre-intervention, immediately after and one-month after intervention

• Change in EMG responses following vestibular stimulations during quiet standing

  Pre-intervention, immediately after and one-month after intervention

• Change in the excursion of the center of pressure following vestibular stimulations

  Pre-intervention, immediately after and one-month after intervention

Other Outcomes (1)

• MOntreal Cognitive Assessment (MoCA) score

  Before enrollment

Study Arms (3)

Combined explosive strength and specific balance training group

EXPERIMENTAL

This group will be formed with participants with incomplete spinal cord injury. This group will perform 4 weeks of combined explosive strength and specific balance training.

Other: Combined explosive strength and specific balance training group

Spinal cord injury control group

NO INTERVENTION

This group will be formed with participants with incomplete spinal cord injury. They will perform all the evaluation before and after a 4-week period of rest (no training).

Healthy control group

NO INTERVENTION

Healthy participants will be recruited based on the age and sex of the participants with incomplete spinal cord injury to realize clinical and neurophysiological cortical evaluations.

Interventions

Combined explosive strength and specific balance training group OTHER

Training will consist to perform one hour of combined ankle explosive strength training and specific balance training using randomized perturbations. Explosive strength training: Participants will perform only 2 sets of 3 min (12 contractions for each set) for both lower limbs and both ankle plantar- and dorsiflexion movements. Balance specific training: Participants will be standing, secured by an adjusted harness, which do not support the weight but is strictly there to prevent a fall. They will have online visual feedback of their CoP via an avatar on the screen in front of them. Each training session will consist of 10 sequences of 3 min, including the 5 different conditions: * Forward tilt of base of support; * Backward tilt of base of support; * Translation forward; * Translation backward; * Without moving their feet, participants will have to move their avatar to reach different targets placed around them on the screen, at different distance from the center.

Combined explosive strength and specific balance training group

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Have an incomplete lesion of spinal cord
• Level of spinal cord lesion between C5 and T12
• At least, 6 months post-injury
• Be considered as AIS C or D
• Be able to stand without support for 15 seconds
• Be able to provide informed consent in English or in French

You may not qualify if:

• To have cognitive deficits
• To have personal or family history of epilepsy
• To have suffered moderate or severe traumatic brain injury
• To have cochlear implant
• FOR CONTROL PARTICIPANTS
• To have orthopedics problems
• To have cognitive deficits
• To have neurological problems

Sponsors & Collaborators

• Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal: lead

Study Sites (1)

Neuromobility lab

Montreal, Quebec, Canada

RECRUITING

MeSH Terms

Conditions

Spinal Cord Injuries

Condition Hierarchy (Ancestors)

Spinal Cord Diseases; Central Nervous System Diseases; Nervous System Diseases; Trauma, Nervous System; Wounds and Injuries

Central Study Contacts

Dorothy Barthélemy, PhD, PT

CONTACT

514-343-7712; dorothy.barthelemy@umontreal.ca

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NON RANDOMIZED
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Associate professor and researcher

Study Record Dates

• First Submitted: September 1, 2021
• First Posted: January 20, 2022
• Study Start: July 9, 2018
• Primary Completion: December 1, 2022
• Study Completion: December 1, 2022
• Last Updated: January 20, 2022

Record last verified: 2022-01

Locations

CA (1)