An interventional study of MEP Operant Up-conditioning of the Wrist Extensor in Spinal Cord Injuries and Quadriplegia, sponsored by Medical University of South Carolina. Recruiting at 1 site in United States. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-07-08.
Sponsored by Medical University of South Carolina · Not applicable, Interventional, and Treatment
The purpose of this study is to examine the relationship between common clinical assessments and measurements of the function of brain-spinal cord-muscle connections, and to examine the effects of training a brain-spinal cord-muscle response in individuals with incomplete spinal cord injury. A transcranial magnetic stimulator (TMS) is used for examining brain-to-muscle pathways. This stimulator produces a magnetic field for a very short period of time and indirectly stimulates brain cells with little or no discomfort. The target muscle is the wrist extensor (extensor carpi radialis) muscle that bends the wrist back. It is hypothesized that training the wrist extensor muscle response to transcranial magnetic stimulation will increase the strength of the brain-to-muscle pathway, which will improve the ability to move the arm.
It is hoped that the results of this training study will help in developing therapy strategies for individuals, promoting better understanding of clinical assessments, and understanding treatments that aim to improve function recovery in people with spinal cord injury (SCI).
This study requires 30 visits, and each visit will last approximately 1.5 hours.
1,948 studies on the registry are indexed under Spinal Cord Injuries; 505 are open to participants now.
This study's planned enrollment of 5 is below the median of 24 across 1,566 interventional studies indexed under Spinal Cord Injuries.
Browse Spinal Cord Injuries studies →Medical University of South Carolina is the lead sponsor of 852 studies on the registry; 165 are open to participants now.
Of its 128 completed or terminated interventional studies of FDA-regulated products, 101 (79%) have results posted.
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Exclusion Criteria:
Behavioral: MEP Operant Up-conditioning of the Wrist Extensor
This is a training intervention in which the brain-spinal cord-muscle pathways are strengthened in individuals with incomplete spinal cord injury. Transcranial magnetic stimulation (TMS), a type of brain stimulation, will be used to elicit a muscle response from the wrist extensor (extensor carpi radialis), the muscle the bends the wrist back.
Change in the excitability/strength of the brain-spinal cord-muscle pathway at the brain level as measured by the Motor Evoked Potential
An increased average MEP size (mV) would indicate increased excitability/strength of the brain-spinal cord-muscle pathway
Time frame: Baseline and final training session (approximately 2.5 months)
Change in ability to move the arm as measured by the Action Research Arm Test (ARAT). Maximum score of 57 points
An increase in ARAT score indicates an improvement in the ability to move the arm
Time frame: change from baseline to immediately after completing the training protocol
Change in ability to move the arm as measured by the Fugl-Meyer Assessment (FMA)
An increase in the FMA score indicates better movement of the arm. Maximum score of 66 points
Time frame: change from baseline to immediately after completing the training protocol
Change in gross manual dexterity as measured by the Box and Block Test (BBT)
An increased number of blocks moved in 60s indicates increased gross manual dexterity
Time frame: change from baseline to immediately after completing the training protocol
Change in fine motor ability and finger dexterity as measured by the Nine Hole Peg Test
Decreased amount of time (s) to place and remove pegs in a peg board indicates improved fine motor ability and finger dexterity
Time frame: change from baseline to immediately after completing the training protocol
Change in strength as measured by Manual Muscle Testing (MMT)
Increased score on MMT indicates increased strength in the muscle being tested. The examiner grades the patient's strength on a 0 to 5 scale. 0: No muscle activation; 1: Trace muscle activation, such as a twitch, without achieving full range of motion; 2: Muscle activation with gravity eliminated, achieving full range of motion; 3: Muscle activation against gravity, full range of motion; 4: Muscle activation against some resistance, full range of motion; 5: Muscle activation against examiner's full resistance, full range of motion.
Time frame: change from baseline to immediately after completing the training protocol
Change in sensation on the back and palm of the hand as measured by the Semmes Weinstein Monofilament Test
Ability to detect increasingly thinner monofilaments indicates increased sensation
Time frame: change from baseline to immediately after completing the training protocol
Change in spasticity as measured by the Modified Ashworth Scale (mAS)
The mAS score ranges from 0: normal muscle tone to 4: rigid in flexion or extension. A decrease in mAS indicates decreased spasticity.
Time frame: change from baseline to immediately after completing the training protocol
Plan to share: No
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Medical University of South Carolina