The purpose of this research study is to determine if it is helpful to provide a peer-supported, health promotion intervention, known as PHOENIX, for people with spinal cord injury using telehealth. An additional purpose of this research is to test if PHOENIX has an effect on community participation, quality of life, and prevention of secondary conditions, such as pressure injuries and urinary tract infections, in people with spinal cord injury. Participants in PHOENIX will complete a 16-week spinal cord injury self-management program using iPads, provided by the study, to access online educational content and participate in video visits (weekly for the first 8 weeks, then every other week for the last 8 weeks) with a peer mentor who also has a spinal cord injury. There are 12 video visits in total and each visit will take about 1 hour. Participants will also be asked to complete a series of questionnaires several times while enrolled in the study. Participants will also be asked to take part in a group discussion or an interview to provide feedback on the PHOENIX program at the end of the study.
Reflexes are important parts of our movements. When reflexes are not working well, movements are clumsy or even impossible. Researchers have found that people can learn to increase or decrease a reflex response with training. Recently, we have found that rats with spinal cord injuries can walk better after they are trained to change a spinal cord reflex. Thus, learning to change a reflex response may help people recover after a nervous system injury. We are currently studying effects of spinal cord reflex training (e.g., a knee jerk reflex) in people in early adulthood. We hope that the results of this study will help us develop spinal reflex training as a new treatment to help people in early adulthood recover better after spinal cord injury or other damage to the nervous system.
Reflexes are important parts of our movements. When reflexes are not working well, movements are clumsy or even impossible. After spinal cord injury, reflex responses may change. Researchers have found that people can learn to increase or decrease a reflex response with training. Recently, we have found that rats with spinal cord injuries can walk better after they are trained to change a spinal reflex. Thus, learning to change a reflex response may help people recover after a nervous system injury. In this study, we aim to examine whether learning to change a spinal reflex through operant conditioning training can improve movement function recovery after spinal cord injury.
Over many years, we have learnt that the brain's connections with the spinal cord change in response to injury or training. Because brain-spinal cord (i.e., corticospinal) pathways are very important in movement control, restoring function of these pathways could help to restore useful movement after spinal cord injury (SCI). In this project, we hypothesize that operant conditioning training of the muscle response to non-invasive transcranial magnetic stimulation can strengthen the functional connectivity of corticospinal pathways and thereby alleviate movement problems in people with chronic incomplete SCI. Specifically, through this project, we will investigate the effects of strengthening the corticospinal connection to the ankle dorsiflexor muscles through operant up-conditioning of the muscle evoked response, in hope to enhance the function of corticospinal pathways and alleviate foot drop (i.e., weak ankle dorsiflexion resulting in toe drop and drag) during walking in people with chronic incomplete SCI.
Spinal reflexes take important part in our movement. After spinal cord injury (SCI), reflexes often change. For many years, researchers and doctors have assumed that abnormally acting spinal reflexes lead to movement problems, without clear scientific evidence. For example, in people who suffer spasticity, a common problem after SCI, walking is disturbed, presumably because stretch reflexes (e.g., knee jerk reflex) and some other reflexes are not working well. Yet, which reflex is causing a problem in what way has not been well understood. Such understanding is very important in developing and applying effective therapies for improving gait recovery after SCI. Therefore, in this project, we are studying spinal stretch reflexes and other reflexes during walking, to understand how these reflexes contribute to spastic gait problems in people with chronic incomplete SCI. Successful completion of this project will result in better understanding of spastic gait problems, which in turn, will help us develop more effective therapy application and improve the quality of life in people after SCI.
The purpose of this study is to identify risk and protective factors for future secondary conditions after spinal cord injury. Our goal is to increase knowledge that can be used to develop prevention strategies targeting factors most predictive of the greatest number of secondary conditions.
In this study researchers aim to improve the collaborative research efforts of the Center for Rehabilitation Research in Neurological Conditions at the Medical University of South Carolina. The Center is comprised of several laboratories, including: the Communication and Swallowing Laboratory; the Locomotor Energetics and Assessment Laboratory; the Locomotor Rehabilitation Laboratory; the Neuromuscular Assessment Laboratory; and the Upper Extremity Motor Function Laboratory. The PI and investigators will recruit for their current and future studies in the above laboratories from the Clinical Database established here. Studies utilizing the Clinical Database will not include PHI but will only link to the Clinical Database individual patient code. This study is completed by completing a simple screening form with study personnel. Medical care/treatment future participation in studies is not influenced by inclusion in this study. We are also recruiting Healthy Controls for this study.
We will be developing a statewide outcomes database, analyzing and disseminating the results, and building a resource for use by diverse investigators in South Carolina in order to gain a more comprehensive understanding of the outcomes of people with SCI in South Carolina, their access to health services, and the interrelationships between access to services and clinical outcomes.