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Research Initiatives
The known benefits of exercise along with anecdotal and clinical case study evidence provides strong support for the value of Activity Based Restorative Therapies (ABRT) in helping individuals with spinal cord injury recover sensation, function, and mobility. The next step for spinal cord injury researchers will be evaluating the results of clinical trials designed to measure the therapies’ efficacy.
The close proximity of ICSCI's research labs and the therapy gym allows our scientists and patients to meet and understand that we share the common goals of recovery. Patients may request a lab tour with Dr. Michael Shamblott where he will highlight our ongoing work in stem cell therapy and discuss the Center's other research priorities.
In addition to these groundbreaking clinical trials, Drs. McDonald and Sadowsky and their colleagues are exploring new ways to perform cell transplantation. The current cell supply is limited and cell transplantation involves an expensive, complex procedure requiring a long-term inpatient hospital stay. Using animal models, Dr. McDonald is developing a new process that can be performed on an outpatient basis using nuclear transfer of embryonic stem cells.
Depending on the focus of a particular study, the Center’s research personnel can rely on a wide variety of technologies to gather and evaluate their data. Techniques in regular use include organotypic culture, immunohistochemistry, autoradiography, fluorescence videomicroscopy, calcium imaging, electron microscopy, and frozen, paraffin and plastic section light microscopy.
Current Clinical Research
Volunteers Needed
NA_00014481: Patterned FES Ergometry of Arm and Shoulder in Individuals with Spinal Cord Injury
NA_00001271 — Adult Volunteers with spinal cord injury are needed for structural and functional magnetic resonance imaging scans of the brain, spinal cord, or nerves.
If you need additional information about a specific clinical research or if you think that you may be eligible, please call the ICSCI Clinical Research Coordinator at 443-923-9235 or clinicaltrials@spinalcordrecovery.org. Please be prepared to leave a detailed message, including the protocol number of the clinical research you are interested in and your contact information so that we may respond with a confidential message for you.
We apologize that we cannot provide consultations or general information about spinal cord injury by phone. If you need general information about spinal cord injury, please call our Care Management Office at 888-923-9222 or visit other sections of this website. The information provided within this website is intended to provide a general overview of potential treatment options and should not be used as a substitute for a visit with a health care professional.
For additional information on current research studies, please call 888-923-9222 or 443-923-9222.
Recent Presentations
Brooke Bamford, PT, DPT “Neurological and Functional Recovery Following Long-Term Activity-Based Restorative Therapy in a Patient with Chronic Cervical Incomplete Spinal Cord Injury”
Background and Purpose
Rehabilitation following spinal cord injury (SCI) has previously focused on compensatory strategies for loss of function below the level of injury due to the fact that significant functional recovery was not expected. More recently, new techniques for rehabilitation after SCI have emerged, including activity-based restorative (ABR) therapies. The purpose of this case report is to describe the neurological and functional recovery which occurred in a patient with chronic cervical incomplete spinal cord injury following a long-term bout of activity-based restorative therapy.
Case Description
This case report describes a 48 year-old female who sustained a traumatic SCI in 2004 due to a fall off of a horse, who underwent intensive ABR therapies on a clinical and home basis over the course of approximately two and a half years. Therapy began 8 months after the injury occurred. Interventions consisted of both patterned and non-patterned activity. Patterned activity included functional electrical stimulation (FES) leg cycle ergometry, reciprocal upper and lower extremity movement in a stander with glider component, gait training with body weight support (overground and over treadmill), and gait training overground without body weight support. Non-patterned activity consisted of strengthening with and without use of FES, functional mobility training and balance activities.
Outcomes
The patient experienced consistent, clinically meaningful neurological and functional recovery over the two and a half year time period. The patient was originally classified as having a C4 ASIA A (complete) SCI after her injury. At the time of discharge from clinically-based ABR therapies, the patient was classified as having a C4 ASIA D (incomplete) injury, an improvement of 3 ASIA grades. ASIA scores at discharge were improved as follows: light touch score increased from 40/112 to 77/112, pinprick score increased from 20/112 to 45/112, and motor score improved from 5/100 to 68/100. Functionally, the patient went from a non-ambulatory status to ambulating with a platform rolling walker and ankle-foot orthosis (AFO) with assistance only to advance the left lower extremity. The patient’s score on the Walking Index for Spinal Cord Injury (WISCI II) went from 0/20 to 6/20. She also decreased the amount of assistance needed for functional mobility from requiring dependence or maximum assistance to requiring minimal assistance or less.
Discussion
This case report demonstrates clinically meaningful neurological and functional recovery following intensive clinical and home application of long-term ABR therapies in a patient with chronic cervical spinal cord injury. Given the potential for late onset of neurological and functional improvement, more research is warranted to determine the optimal frequency, intensity, and duration to maximize recovery following spinal cord injury.
Research Publications
- Sadowsky CL & McDonald JW (2009). “Activity-based restorative therapies: concepts and applications in spinal cord injury-related neurorehabilitation.” Developmental Disabilities Research Reviews 15(2), 112-116.
- McDonald, J.W., Becker, D., Holekamp, T.F., Howard, M.J., Liu, S., Lu, A., Lu, J., Platik, M.M., Qu, Y., Stewart, T., & Vadivelu, S. (2004). “Repair of the injured spinal cord and the potential of embryonic stem cell transplantation.” Journal of Neurotrauma, 21(4), 383-393.
- Myckatyn T.M., Mackinnon S.E., & McDonald J.W. (2004). “Stem cell transplantation and other novel techniques for promoting recovery from spinal cord injury.” Transplant Immunology, 12(3), 343-358.
- Dong, H., Fazzaro A., Xiang, C., Korsmeyer, S., Jacquin, M.F., & McDonald, J.W. (2003). “Enhanced oligodendrocyte survival after spinal cord injury in Bax-deficient mice and mice with delayed Wallerian degeneration.” Journal of Neuroscience, 23(25), 8682-91.
- McDonald, J.W. & Becker, D. (2003). Spinal Cord Injury: Promising Interventions and Realistic Goals.” American Journal of Physical Medicine and Rehabilitation, 82(10 Suppl), S38-49.
- Becker, D., Grill, W.M., & McDonald, J.W.. “Functional electrical stimulation replenishes the neural progenitor pool in the adult CNS after spinal cord injury.” Program No. 245.3. 2003 Neuroscience Meeting Planner. New Orleans, LA: Society for Neuroscience, 2003. Online.
- Becker D, Sadowsky, C., & McDonald, J.W. (2003). “Restoring function after spinal cord surgery.” The Neurologist, 9(1), 1-15.
- Sadowsky, C., Volshteyn, O., Schultz, L., & McDonald, J.W. (2002). “Spinal Cord Injury.” Disability and Rehabilitation, 24(13), 680-687.
- McDonald, J.W., Becker D, Sadowsky, C., Jane, J.A., Conturo, T.E., & Schultz, L.M. (2002). “Late recovery following spinal cord injury; case report and review of the literature.” Journal of Neurosurgery, 97(2 Suppl), 252-265.
- Sadowsky, C.L. (2001). “Electrical Stimulation in spinal cord injury.” NeuroRehabilitation, 16(3), 164-169.
September 16, 2009
International Center for Spinal Cord Injury to Participate in 2009 World Stem Cell Summit
Summer, 2009
Ravens Host International Center for Spinal Cord Injury Patients at Training Camp
July 27, 2009
Read Family Meetings: an Important Resource, by ICSCI physical therapist Varsha Gandhi in Advance the magazine for PTs and PT assistants.
Related Events
2009 World Stem Cell Summit
September 21-23, 2009
Baltimore, MD
Stompin’ for the Cord
Save the Date: October 10, 2009
Research Initiatives
NA_00014481
Patterned FES Ergometry of Arm and Shoulder in Individuals with Spinal Cord Injury
Adult Volunteers Needed
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