Location: University of Southampton, Faculty of Health Sciences
INSPIRE Grant: £38,575
Date/duration: May 2013/36 months
Abstract of Research:
Neuroscience research that has identified potential for recovery (neuroplasticity) following incomplete SCI has changed clinical practice away from compensation strategies towards optimizing recovery. Important factors are: repetitive exercise, Functional Electrical Stimulation and appropriate feedback. The INSPIRE iCycle combines repetitive exercise with FES and provides feedback on performance in a virtual cycle race. Unlike previous devices, performance in the race is determined only by voluntary effort (i.e. not torque generated by FES plus voluntary effort). In this study with incomplete SCI participants we will test the iCycle with six inpatients to refine the protocol and make technical improvements. We will then conduct an ABA pilot clinical trial (n=20) in which the Internet enabled iCycle is used in people’s own homes. We will compare standard care (A) with iCycle exercise (B). Changes in neural connectivity (TMS evoked EMG potentials), muscle strength and walking will be measured as well qualitative analysis of users’ views.
The expected outcome
If the iCycle is found to be both feasible to use at home and effective in improving walking it could be a cost effective rehabilitation device that would enable people with incomplete spinal cord injury to achieve greater independence. It will also enable people to continue to exercise at home after discharge from hospital rehabilitation and accrue the potential benefits not only of improved functional recovery but also better fitness.
The study is also exploring a new intervention that could provide better understanding of recovery, particularly the relationship between neural and functional recovery. This knowledge may also be useful in predicting which individuals are likely to experience recovery and what other factors are important such as level and severity of the lesion and intensity of training.
The research will be published in high impact peer reviewed Journals and at scientific conferences, but in addition we will host a dissemination event to target the SCI community and clinicians working in SCI rehabilitation. We also have a good track record of publicizing our work through the media – television, newspapers and popular Journals and will take opportunities to do this and to publicize the work of INSPIRE.