3. Activity Based Rehabilitation (ABR) to restore changes in the central nervous system and in trunk muscle function following spinal cord injury: TRUNK CONTROL

Location: Imperial College London, Charing Cross Hospital Campus

INSPIRE Grant: £105,000

Date/duration: October 2015-2017/ 24 months

Abstract of Research

Almost all movements of the body require the trunk muscles to become active to help stabilize the body and to prevent falling.  More specifically, movements of the arms are associated with increases in activity of the trunk muscles which occur before, during and after the arm movements.  Research has recently shown that the brain pathways responsible for controlling muscles of the trunk become more excitable when movements of the arms are performed and are greater than movements of the trunk (such as bending forwards or backwards) in isolation. Restoration of function driven by rehabilitation appears to happen through the ability of the surviving pathways to change; this is known as “plasticity”. This project will target the pathways controlling trunk muscles in SCI subjects in order to improve trunk function.

The Proposal:

The team proposes to expand on its previous work in this field by researching:

(1) Whether structured exercise of the upper limbs in SCI subjects improves stability and control of the trunk, consequently providing more effective arm and hand control.

(2) The underlying changes in the neural pathways involved that would provide targets for further refinement of remedial therapy

Anticipated outcome

That improved trunk control and stability will benefit SCI subjects by aiding wheelchair transfers, preventing falls and allowing more effective use of the arms and hands.  Successful outcome of the project will pave the way for a larger scale clinical trial of appropriate therapeutic exercise for SCI rehabilitation.