Spinal Cord Injury
Conditions
Brief summary
Establish if change from the baseline in ultrasound muscle parameters over 2 months of rehabilitation correlates with functional status of SCI patients at the end of rehabilitation
Detailed description
Rehabilitation is the key to ambulatory recovery in patients with spinal cord injury, although only 25% of patients regain this ability despite current rehabilitation protocols. There is emerging evidence that intensive and prolonged rehabilitation, though costly and manpower intensive, may result in ambulatory recovery in patients previously thought to be non-ambulant. However, there are no suitable clinical biomarkers which can identify these group of patients who will benefit from this intervention. Hence the aim is to establish if change from the baseline in ultrasound muscle parameters over rehabilitation correlates with functional status of SCI patients.
Interventions
DIAGNOSTIC_TESTMuscle ultrasound
The muscle thickness and muscle quality will be assessed on ultrasound
Sponsors
Tan Tock Seng Hospital
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
DIAGNOSTIC
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
21 Years to No maximum
Healthy volunteers
No
Inclusion criteria
1. First ever acute SCI 2. Age 21-65 years 3. Presence of weakness in the lower limbs (defined as either ASIA A, B, C or D) 4. Independent in ambulation prior to onset of SCI 5. Able to understand study procedures and sign informed consent 6. Clinical suitability for rehabilitation
Exclusion criteria
1. Presence of premorbid lower musculoskeletal conditions eg contractures, fractures, previous operations, that prevents proper ultrasound assessment of the affected limb 2. Cardiorespiratory conditions eg congestive cardiac failure (EF\<40%), chronic arrhythmias, COPD stage 3-4 3. End stage illness, end stage renal failure, life expectancy \<6 months 4. Other active neurological conditions 5. Botulinum toxin injection over the past 3 months
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Functional Independence Score | Baseline (Performed on admission to inpatient rehabilitation) | An 18-item of physical, psychological and social function (graded from 1-7) |
| Spinal Cord Independence Measure (SCIM) III | Baseline (Performed on admission to inpatient rehabilitation) | It is used by health care practitioners to assess and grade the functional status of a person based on the level of assistance he or she requires, in patients with spinal cord injury. Only the patient's indoor mobility subscore will be assessed from abilities, graded from 0-8. |
| ASIA score | Baseline (Performed on admission to inpatient rehabilitation) | This is an assessor administered test that systematically examines the dermatomes and myotomes in spinal cord patients through testing the strength and sensation |
| Walking Index for Spinal Cord Injury II (WISCI II) | Baseline (Performed on admission to inpatient rehabilitation) | A walking scale used by health care practitioners to grade the walking ability of SCI patients. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Range of motion of elbow, hip and knee | Baseline (Performed on admission to inpatient rehabilitation) | Range of motion of elbow, hip and knee |
| Spasticity | Baseline (Performed on admission to inpatient rehabilitation) | (2) Spasticity of the elbow flexors, knee extensors and ankle plantarflexors using the Modified Ashworth Scale, with a higher score indicating worse spasticity |
Countries
Singapore
Outcome results
None listed