Electromyography-Triggered Electrical Stimulation on Trunk Balance and Muscle Thickness in SCI Patients

NCT ID: NCT06527417

Last Updated: 2024-07-31

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

15 participants

Study Classification

INTERVENTIONAL

Study Start Date

2023-08-18

Study Completion Date

2024-07-25

Brief Summary

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The aim of this study was to investigate the effect of electromyography (EMG) triggered electrical stimulation (ES) applied to multifidus and erector spinae muscles on trunk balance in patients with complete thoracic spinal cord injury (SCI).

The fundamental questions that investigators want to answer are as follows:

* \[question 1\]: "Does multifidus and erector spinae EMG ES improve trunk balance in patients with complete SCI?"
* \[question 2\]: "Does multifidus and erector spinae EMG ES improve muscle thickness in patients with complete SCI?"

Detailed Description

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Spinal cord injury results in loss of sensory and motor function below the level of injury, causing difficulty with unaided sitting and activities of daily living, especially at the thoracic level in SCI patients. The paraspinal muscles that provide trunk balance are weakened in these patients. Methods such as neuromuscular electrical stimulation and EMG ES are used to improve trunk balance and restore muscle function. This study aims to investigate the effect of EMG ES applied to the multifidus and erector spinae muscles on trunk balance in patients with complete thoracic SCI.

Conditions

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Spinal Cord Injury Thoracic

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

In this randomized controlled and prospective study, investigators included 15 participants with complete thoracic spinal cord injury. Investigators divided the participants into two groups, where one group received the electromyography-triggered electrical stimulation applied to the erector spinae and multifidus muscles, and the control group received trunk eccentric exercises only, applied three times a week for four weeks.
Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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electromyography-triggered electrical stimulation

EMG ES was applied to the bilateral multifidus and erector spina muscles of the experimental group 3 times a week for 10 minutes in each session for 4 weeks. At the beginning of each session, the participants were instructed to position themselves in a comfortable sitting position.

EMG ES was performed using six self-adhesive electrodes (37 × 64 mm) and two Neuro Trac Myo Plus Pro devices.

Group Type EXPERIMENTAL

Neuro Trac Myo Plus Pro

Intervention Type DEVICE

Electrical stimulation parameters; stimuli were monophasic, rectangular, stimulus duration 300 µs, frequency 25 Hertz, amplitude was increased up to a maximum of 100 milliampere until contraction was seen.

trunk eccentric exercises

The control group performed back eccentric exercises for 4 weeks, 3 times a week, 3 times in each session.

Group Type ACTIVE_COMPARATOR

Trunk eccentric exercises

Intervention Type OTHER

The control group performed back eccentric exercises for 4 weeks, 3 times a week, 3 times in each session

Interventions

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Neuro Trac Myo Plus Pro

Electrical stimulation parameters; stimuli were monophasic, rectangular, stimulus duration 300 µs, frequency 25 Hertz, amplitude was increased up to a maximum of 100 milliampere until contraction was seen.

Intervention Type DEVICE

Trunk eccentric exercises

The control group performed back eccentric exercises for 4 weeks, 3 times a week, 3 times in each session

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* have traumatic SCI and this injury occurred at least 3 months ago,
* be between the ages of 18 and 65,
* have a neurological injury level between thoracic 4 and thoracic 12
* be fully paraplegic according to the American Spinal Cord Injury Association (ASIA) impairment scale
* be able to sit unsupported in a wheelchair

Exclusion Criteria

* patients with a diagnosis of heart failure
* malignancy
* intracardiac defibrillators
* epilepsy
* open wounds
* patients using trunk corsets
Minimum Eligible Age

18 Years

Maximum Eligible Age

65 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Ankara City Hospital Bilkent

OTHER

Sponsor Role lead

Responsible Party

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Handan Elif Nur BAYRAKTAR

Principal Investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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Ankara Bilkent City Hospital

Ankara, , Turkey (Türkiye)

Site Status

Countries

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Turkey (Türkiye)

References

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Bjerkefors A, Carpenter MG, Cresswell AG, Thorstensson A. Trunk muscle activation in a person with clinically complete thoracic spinal cord injury. J Rehabil Med. 2009 Apr;41(5):390-2. doi: 10.2340/16501977-0336.

Reference Type BACKGROUND
PMID: 19363574 (View on PubMed)

Bergmann M, Zahharova A, Reinvee M, Asser T, Gapeyeva H, Vahtrik D. The Effect of Functional Electrical Stimulation and Therapeutic Exercises on Trunk Muscle Tone and Dynamic Sitting Balance in Persons with Chronic Spinal Cord Injury: A Crossover Trial. Medicina (Kaunas). 2019 Sep 21;55(10):619. doi: 10.3390/medicina55100619.

Reference Type BACKGROUND
PMID: 31546613 (View on PubMed)

Gill M, Linde M, Fautsch K, Hale R, Lopez C, Veith D, Calvert J, Beck L, Garlanger K, Edgerton R, Sayenko D, Lavrov I, Thoreson A, Grahn P, Zhao K. Epidural Electrical Stimulation of the Lumbosacral Spinal Cord Improves Trunk Stability During Seated Reaching in Two Humans With Severe Thoracic Spinal Cord Injury. Front Syst Neurosci. 2020 Nov 19;14:79. doi: 10.3389/fnsys.2020.569337. eCollection 2020.

Reference Type BACKGROUND
PMID: 33328910 (View on PubMed)

Shima D, Nishimura Y, Hashizaki T, Minoshima Y, Yoshikawa T, Umemoto Y, Kinoshita T, Kouda K, Tajima F, Kamijo YI. Surface electromyographic activity of the erector spinae and multifidus during arm- and leg-ergometer exercises in young healthy men. Front Physiol. 2022 Nov 25;13:974632. doi: 10.3389/fphys.2022.974632. eCollection 2022.

Reference Type BACKGROUND
PMID: 36505070 (View on PubMed)

Wilson RD, Page SJ, Delahanty M, Knutson JS, Gunzler DD, Sheffler LR, Chae J. Upper-Limb Recovery After Stroke: A Randomized Controlled Trial Comparing EMG-Triggered, Cyclic, and Sensory Electrical Stimulation. Neurorehabil Neural Repair. 2016 Nov;30(10):978-987. doi: 10.1177/1545968316650278. Epub 2016 May 24.

Reference Type BACKGROUND
PMID: 27225977 (View on PubMed)

Triolo RJ, Bailey SN, Foglyano KM, Kobetic R, Lombardo LM, Miller ME, Pinault G. Long-Term Performance and User Satisfaction With Implanted Neuroprostheses for Upright Mobility After Paraplegia: 2- to 14-Year Follow-Up. Arch Phys Med Rehabil. 2018 Feb;99(2):289-298. doi: 10.1016/j.apmr.2017.08.470. Epub 2017 Sep 9.

Reference Type BACKGROUND
PMID: 28899825 (View on PubMed)

Qiu S, Draghici AE, Picard G, Taylor JA. Muscle Fatigue in Response to Electrical Stimulation Pattern and Frequency in Spinal Cord Injury. PM R. 2020 Jul;12(7):699-705. doi: 10.1002/pmrj.12282. Epub 2019 Dec 12.

Reference Type BACKGROUND
PMID: 31702873 (View on PubMed)

Tharu NS, Alam M, Ling YT, Wong AY, Zheng YP. Combined Transcutaneous Electrical Spinal Cord Stimulation and Task-Specific Rehabilitation Improves Trunk and Sitting Functions in People with Chronic Tetraplegia. Biomedicines. 2022 Dec 23;11(1):34. doi: 10.3390/biomedicines11010034.

Reference Type BACKGROUND
PMID: 36672542 (View on PubMed)

Lee HS, Akimoto T, Kim AR. Effects of trunk extensor eccentric exercise on lipid profile and glycaemic response. BMJ Open Sport Exerc Med. 2020 Oct 28;6(1):e000861. doi: 10.1136/bmjsem-2020-000861. eCollection 2020.

Reference Type BACKGROUND
PMID: 33178444 (View on PubMed)

Quinzanos-Fresnedo J, Fratini-Escobar PC, Almaguer-Benavides KM, Aguirre-Guemez AV, Barrera-Ortiz A, Perez-Zavala R, Villa-Romero AR. Prognostic validity of a clinical trunk control test for independence and walking in individuals with spinal cord injury. J Spinal Cord Med. 2020 May;43(3):331-338. doi: 10.1080/10790268.2018.1518124. Epub 2018 Sep 12.

Reference Type BACKGROUND
PMID: 30207875 (View on PubMed)

Arsh A, Darain H, Rahman MU, Ullah I, Shakil-Ur-Rehman S. Reliability of modified functional reach test in the assessment of balance function in people with spinal cord injury: A systematic review. J Pak Med Assoc. 2021 Aug;71(8):2040-2044. doi: 10.47391/JPMA.1276.

Reference Type BACKGROUND
PMID: 34418026 (View on PubMed)

Masaki M, Aoyama T, Murakami T, Yanase K, Ji X, Tateuchi H, Ichihashi N. Association of low back pain with muscle stiffness and muscle mass of the lumbar back muscles, and sagittal spinal alignment in young and middle-aged medical workers. Clin Biomech (Bristol). 2017 Nov;49:128-133. doi: 10.1016/j.clinbiomech.2017.09.008. Epub 2017 Sep 14.

Reference Type BACKGROUND
PMID: 28934633 (View on PubMed)

Masaki M, Ikezoe T, Fukumoto Y, Minami S, Tsukagoshi R, Sakuma K, Ibuki S, Yamada Y, Kimura M, Ichihashi N. Association of sagittal spinal alignment with thickness and echo intensity of lumbar back muscles in middle-aged and elderly women. Arch Gerontol Geriatr. 2015 Sep-Oct;61(2):197-201. doi: 10.1016/j.archger.2015.05.010. Epub 2015 May 28.

Reference Type BACKGROUND
PMID: 26058723 (View on PubMed)

Bayraktar HEN, Yalcin E, Sipal MS, Akyuz M, Akinci MG, U Delialioglu S. The effect of electromyography triggered electrical stimulation to abdominal muscles on sitting balance, respiratory functions, and abdominal muscle thickness in complete spinal cord injury: a randomized controlled trial. Int J Rehabil Res. 2024 Jun 1;47(2):87-96. doi: 10.1097/MRR.0000000000000620. Epub 2024 Mar 19.

Reference Type BACKGROUND
PMID: 38501227 (View on PubMed)

Other Identifiers

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AnkaraCHBilkent-PMR-DRHENY-02

Identifier Type: -

Identifier Source: org_study_id

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