Transcutaneous Electrical Spinal Cord Stimulation for Lower Limbs

This study is to determine if non-invasive electrical stimulation of the spinal cord can be
used to: 1) assess spared function following a spinal cord injury; and 2) be use for
rehabilitation.

The investigators hypothesize that this type of stimulation can be used to locate and
determine if any spinal (nerve) pathways or connections were spared following a spinal cord
injury. We also hypothesize the same stimulation can help revive or recover function to
muscles connected to these spared spinal (nerve) pathways in individuals who are clinically
paralyzed. Our research has demonstrated that modifying the activation state of the spinal
cord after an injury, or awakening the spinal cord, can benefit people with paralysis years
after a spinal cord injury. This method and device have not yet been approved by the FDA for
the treatment of paralysis and are under investigation. This study if successful will help
provide further evidence that could be use to one day to gain FDA approval.

Inclusion Criteria: SCI ASIA A, B, C

- Spinal cord injury 1 or more years prior

- Non progressive cervical or thoracic SCI

- Half of key muscles below neurological level having a motor score of less than 2/5

- Ability to commit to home exercises and 16 week participation

- Stable medical condition without cardiopulmonary disease or dysautonomia that would
contraindicate participation in lower extremity rehabilitation or testing activities

- Not dependent on ventilation support

- No painful musculoskeletal dysfunction, unhealed fracture, pressure sore, or urinary
tract infection that might interfere with lower extremity rehabilitation or testing
activities

- No clinically significant depression or ongoing drug abuse

- Adequate social support network to be able to participate in weekly training and
assessment sessions for the duration of the 16 week study period

- No current anti-spasticity regimen

- Must not have received botox injections in the prior six months

- Be unable to use lower extremity for functional tasks

Exclusion Criteria:

- Pregnancy

- No functional segmental reflexes below the lesion