A Pilot Study on the Cumulative Effects of Transcutaneous Spinal Cord Stimulation (tSCS) With Robotic Gait Training in Trunk Muscle Activity and Walking Index in Chronic Spinal Cord Injury
This study is aimed to evaluate whether transcutaneous spinal cord stimulation (tSCS) can augment robotic gait training (RGT) to improve functional mobility in participants with chronic spinal cord injuries. It also evaluate the impact of the tSCS+RGT on health-related quality of life (HRQOL), compared to RGT alone. This is a prospective single-arm crossover study in participants with incomplete chronic traumatic spinal cord injury. 6 subjects with paraplegia and 6 subjects with tetraplegia will be recruited. The intervention includes Phase 1 of training which consists of 16 sessions of robotic gait training (RGT) + conventional physiotherapy in 8-10 weeks, and Phase 2 of training which consists of 16 sessions of RGT training + tSCS + conventional physiotherapy in 8-10 weeks. Outcome measures including mobility function assessment and neuromuscular assessment will be collected at Baseline, Post-Phase 1 and Post-Phase 2. A satisfaction survey on the intervention RGT training + tSCS + conventional physiotherapy will be performed at week-18 assessment.
• Between 6 months to 5 years from the diagnosis of the traumatic SCI and who are not walking independently;
• Age between 21 to 65 years old;
• Incomplete spinal cord injury: ASIA Impairment Scale (AIS) Grade: B-D;
• Spinal cord injury level: T1- L1, or C2-C8;
• SCI-TCT Score \> 13;
• Capable of providing an informed consent;
• Cleared by Neurosurgeons/ Orthopeadic Surgeons for tSCS;
• Meets prerequisites for Ekso wearable robotic exoskeleton training.