A Clinical Trial of Cognitive Multisensory Rehabilitation for Sensory and Motor Recovery in Adults with Spinal Cord Injury

For this study, we will recruit up to 16 adults with spinal cord injury who have a reduction or complete loss of sensation and/or movement in a part of the body, but who can self-transfer and push a call button in the MRI scanner.

Participants with spinal cord injury will be randomly divided into one of two treatment groups to receive either 8 weeks of therapist-based cognitive multisensory rehabilitation, which is similar to physical therapy and focuses on body awareness to improve sensation and movement; OR to receive an 8-week gym membership in the adaptive fitness center at the Courage Kenny Institute.

You will not be charged for the rehabilitation or fitness that is part of this research study.

The Cognitive Multisensory Rehabilitation (CMR) will be given by a physical therapist who is trained in this method. Therapy sessions will take place in the wheelchair-accessible Brain Body Mind Lab (the lab of the principal investigator, Dr. Ann Van de Winckel). Examples of CMR tasks participants are asked to complete:

  • Where the legs are situated in space; where the legs are in relation to the pelvis and the upper part of the body
  • Dimensions and length of the legs, the dimension of the pelvis
  • Sensation of the pelvis as a central body reference
  • Relationship between the left and right side of the body, and the relationship between the pelvis and the feet.

The Courage Kenny Rehabilitation Institute fitness center provides access to state-of-the-art adaptive gym equipment to promote fitness and recreation. Equipment includes treadmills, elliptical, NuSteps, SciFit upper body ergometers, Ski Erg and rowing machine, upright and recumbent stationary bicycles, chest press, rear row, leg extension, leg curl, leg press, uppertone, free weights, and kettlebells. The equipment is spaced to allow for movement and is accessible for use from a wheelchair. They allow for transfers and caregiver assistance. Participants in the adapted fitness group will start with a fitness assessment and then complete a fitness program under supervision for 8 weeks, 3x/week, for 45 min. Staff at the Courage Kenny Rehabilitation Institute will monitor training adherence through a log sheet.

During the intervention period as well as the 3 month follow-up, Dr. Van de Winckel’s team will call the participants weekly to inquire about:

  • How often the gym or therapy was done that week
  • Information about the content of the intervention performed that week
  • Perceived effects of the interventions
  • Use of over-the-counter or prescribed medication for spasms
  • Recent illnesses, healthcare utilization and/or recent hospitalizations, and
  • Information related to community integration.

We will allow medication prescribed or recommended by their clinical care team throughout the trial, as well as other treatments/therapies related to standard of care.

At two time points (beginning of the study and after the 8-week intervention) participants will have an MRI of the brain to look at brain function before and after training or observation period. This part is required.

At 3 times (beginning of the study, after the 8-week intervention, and at the 3 month follow-up) we will test sensation and movement by testing with a cotton ball, testing muscle strength and use stickers on the skin to measure muscle contraction. This will be done in the wheelchair-accessible Brain Body Mind Lab (the lab of the principal investigator, Dr. Van de Winckel). Participants will also complete questionnaires over secure Zoom.

Participants with spinal cord injury will receive $100 upon completion and full participation in the study.

The proposal will identify mechanisms of cognitive multisensory rehabilitation compared to adaptive fitness. We will look at changes in brain function after cognitive multisensory rehabilitation compared to adaptive fitness in people with spinal cord injury and look at improvement of sensation and movement.

The total participation period is about 5 months.

Screening Visit

This visit will occur in the Children’s Rehabilitation Center, Brain Body Mind lab, Room 302) and over Zoom. 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 in the Center for Magnetic Resonance Research.

Rehabilitation

Then you will come to the Brain Body Mind Lab (University of Minnesota) 3 times a week for 45 minutes per session for 8 weeks. Dr. Van de Winckel’s team will schedule times that work for you.

OR Adaptive fitness gym

You will start with a fitness assessment and then complete a fitness program under supervision for 8 weeks, 3x/week, for 45 minutes.

Assessment

Post-intervention clinical assessments, surveys and MRI. 3 month-follow-up visit of clinical assessments, and surveys

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Schedule of Events

SCHEDULE OF EVENTS

  • At the Screening/Baseline
    This includes: 
    • Combined HIPAA-Informed consent
    • Medical records
    • Demographic and general health questionnaires
    • Clinical assessment tests/surveys
    • Screening for MRI compatibility
    • MRI scan

  • After 8 weeks of CMR or adaptive fitness
    This includes: 
    • Clinical assessment tests/surveys
    • Screening for MRI compatibility
    • MRI scan

  • At the 3-month follow-up assessment
    This includes:
    • Clinical assessment tests/surveys

WEEKLY EVALUATIONS

This includes: 

  • Report on adherence, information about the content of the intervention performed that week, perceived effects of the interventions, the use of over the counter or prescribed medication for spasms, recent illnesses, healthcare utilization and/or recent hospitalizations, and information relating to community integration.

Study Locations

Children's Rehabilitation Center (wheelchair accessible entrance)

Children's Rehab Building

426 Church Street SE
Room 302 - Brain Body Mind Lab
Minneapolis, MN 55455
612-625-1191

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)

Brain Body Mind Lab Room 302

Brain Body Mind Lab (Room 302)

Frequently Asked Questions

What do researchers hope to learn?

Researchers have found that some parts of the brain related sensation, movement, and body awareness, function differently in adults who have sustained a spinal cord injury. We would like to compare the effect of cognitive multisensory rehabilitation versus adaptive fitness and investigate what parts in the brain help improve sensation and movement.

How will participating in this study help?

This research helps us understand how cognitive multisensory rehabilitation or adaptive fitness help people with spinal cord injury regain function and sensation. Understanding the brain function could potentially also help future research.

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 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, Tai Chi) or exercise or therapy specifically for improving sensation or movement during the study period unless medically necessary.

What are the characteristics of participants you are looking for?

Participants (18-70 years of age) with spinal cord injury that results in reduction or loss of movement and sensation.

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. We are also unable to include international participants.

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 or adaptive fitness and experience improved sensation or movement. 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 $100 after attending and completing all test 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 assessment visits around your working schedule. Visits early in the morning, after 5pm or during the weekend can be discussed. However, the therapy sessions will be during work hours. The gym session will be held within the time schedule provided by Courage Kenny.

Principal Investigators (PI):

Ann Van de Winckel, PhD, MSPT, PT

Interested in Participating?

This study takes about 5 months which includes 8 weeks of therapy or adaptive fitness 3x/week at the University of Minnesota.

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