Evaluating the effect of cognitive multisensory rehabilitation to reduce or eliminate neuropathic pain in people with spinal cord injury
For this study, we will recruit up to 25 adults with spinal cord injury, who have paraplegia, who can self-transfer, and who have neuropathic pain. We will also recruit 25 age- and sex-matched healthy adults to compare brain function in adults with spinal cord injury to brain function in healthy adults.
The healthy adults will have a one-time clinical assessment and one MRI and receive $50 at the end of study completion. Participants with spinal cord injury and with neuropathic pain will receive 6 weeks of free therapist-based cognitive multisensory rehabilitation, which is similar to physical therapy and focuses on body awareness to reduce neuropathic pain.
The cognitive multisensory rehabilitation will be given by a physical therapist who is certified in this method. The therapy sessions will take place in the wheelchair-accessible Brain Body Mind Lab (the lab of principal investigator, Dr. Van de Winckel). The group of 25 adults with spinal cord injury will be randomized in a group that receives cognitive multisensory rehabilitation right away, followed by 6-weeks of observation. The other group starts with 6 weeks of observation and then receive free cognitive multisensory rehabilitation. During the observational period, Dr. Van de Winckel's team will call these participants weekly to inquire about their pain level, medication use, and health care use that week.
At 3 time points (at the beginning of the study; after the first 6 weeks; and after the second period of 6 weeks), participants will have an MRI of the brain (to look at brain function before and after training or observation period), some assessments in the wheelchair-accessible Brain Body Mind Lab, and questionnaires to fill out. Participants with spinal cord injury will receive $150 upon completion and full participation in the study.
The proposal will identify mechanisms of cognitive multisensory rehabilitation:
- We will look at brain function differences at the start of the study between healthy adults and adults with spinal cord injury who have neuropathic pain.
- We will look at changes in brain function after cognitive multisensory rehabilitation in people with spinal cord injury and neuropathic pain and look at reduction or elimination of neuropathic pain after the therapy.
The total participation period is about 4 months.
This visit will occur in the Children’s Rehabilitation Center, Brain Body Mind lab (Room 302). You will be asked to do the following:
* Consent to participate in the study
* Review your demographic information and medication history
* Complete study required clinical assessments and surveys
* Complete an MRI scan of the brain at the Center for Magnetic Resonance Imaging
The next steps will be the cognitive multisensory rehabilitation taking place at the Brain Body Mind Lab 3 times a week for 45min (per session). Dr. Van de Winckel’s team will schedule times that work for you.
You can continue any activities that you were doing beforehand. We will ask you not to start any sport or other body awareness training (martial arts, dance, TaiChi), exercise or therapy specifically for pain (e.g. acupuncture) during the study period unless medically necessary.
The mid-testing will consist of clinical assessments, surveys and an MRI. The groups will switch places: those that received cognitive multisensory rehabilitation now have 6 weeks of the observation period. The group that was in the observation period will receive 6 weeks of cognitive multisensory rehabilitation.
The final visit will consist of clinical assessments, surveys and an MRI.
From Highway I-94 take the Huron Boulevard exit and go north:
- Proceed ~3 blocks down Huron Boulevard to Washington Avenue
- Continue straight across Washington Avenue
- Continue straight across University Avenue onto SE 23rd Avenue
- Proceed ~3 blocks to SE 6th Street
- Turn left on 6th St SE
- The CMRR is the second building on the right (2021). On street parking is located on the east side of the CMRR building. Enter from 6th St SE, under skyway. Parking permits are available from the front desk.
From Highway I-94 take the Huron Boulevard exit and go north:
- Left on Fulton Street SE
- Continue straight ahead onto East River Parkway
The East River Road Garage Parking Ramp will be on your right. After parking, take the elevator to the first floor to go outside. The Coffman Memorial Union Building is in front of you, the road is Delaware Street SE. Turn right to walk on Delaware St SE and take another right on Church St SE. We will meet you at the front entrance of the Children's Rehabilitation Building. We will then go to the Brain Body Mind Lab (3rd floor, Room 302).
If stairs are not an obstacle, you can also walk out of the East River Road Garage (Level C) and walk back to the East River Road Parkway, up the hill, to the first adjacent building on your left. This is the back entrance of the Children's Rehabilitation Center. We will wait for you at this door.
Brain Body Mind Lab (Room 302)
Frequently Asked Questions
What do researchers hope to learn?
With neuropathic pain, researchers have found that some parts of the brain, related to pain and body awareness, function differently. We would like to investigate how cognitive multisensory rehabilitation helps reduce neuropathic pain but also what parts in the brain improve in function when participants receive cognitive multisensory rehabilitation for 6 weeks, 3 times a week for 45 minutes.
How will participating in this study help?
This research helps us understand how cognitive multisensory rehabilitation helps people with spinal cord injury who have neuropathic pain. Understanding the brain function could potentially also help future research in people with other types of pain (e.g. neck pain or fibromyalgia).
How do I need to be dressed?
Loose-fitting clothing would be fine. We recommend you wear clothing in which you are comfortable.
Do I have to take a break from other activities/therapies in order to participate?
You can continue any activities that you were doing beforehand. We will ask you not to start any sport or other body awareness training (martial arts, dance, TaiChi) or exercise or therapy specifically for pain (e.g. acupuncture) during the study period unless medically necessary.
What are the characteristics of the participants you are looking for?
Participants (18-70 years of age) with spinal cord injury that results in paraplegia and with various levels of neuropathic pain can participate. Participants who have cognitive problems, are unable to speak or understand instructions, who have nerve problems, fractures or infections, vision problems, or problems with imagining movements, or who do not speak English will not be recruited. If you are not sure if you are eligible, feel free to contact us.
How will I benefit from participating?
There may be no direct benefit to participating in this study, but you could benefit from the cognitive multisensory rehabilitation. In any case, the information from this study may help other people in the future.
Does this cost money to participate?
There is no charge to participate, except to cover transport. We will cover your parking and all test and therapy sessions. You will get $50 (as an able-bodied volunteer) or $150 (as an adult with paraplegia) after attending and completing all tests and therapy sessions.
I'm working full-time/in shifts. Can I come before/after my work?
While we cannot always promise a perfect match, we will do our best to plan our visits around your working schedule. Visits early in the morning, after 5pm or during the weekend can be discussed.
Principal Investigators (PI):
Ann Van de Winckel, PhD, MS, PT
Leslie Morse, DO