Patients scheduled for thoracic surgery will be identified as potential candidates and recruited by a research coordinator before surgery. Research subjects will be randomized to either early or late post-operative urinary catheter (a thin flexible tube placed into the bladder to drain urine) removal. Thoracic epidural analgesia (TEA), a thin tube placed near the spinal cord, will remain functioning after urinary catheter removal for the early group. The study group randomized to early catheter removal will have urinary catheters removed 24 hours after surgery is completed. Study subjects that are randomized to late removal of urinary catheter will have urinary catheters removed after TEA is discontinued as routine clinical care (usually 4-5 days). Determination of bladder urine volume will be made by sound wave examination (ultrasound) by appropriately-trained staff. Following indwelling urinary catheter removal, research subjects may receive a brief urine drain tube as standard clinical care. Laboratory urine analysis will be obtained from urine following removal of urinary catheter and assessed for urinary tract infection (UTI).
The main objective of this study is to evaluate if Dysport® is effective and safe for the treatment of urinary incontinence due to NDO.
Dysport® contains a toxin that is produced from bacteria. The toxin is called Botulinum toxin A and it is known that this toxin causes muscles that are contracting too much to relax once the muscles are injected with the toxin. This relaxation usually lasts for several months before treatment needs to be given again.
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.