Trial Summary
What is the purpose of this trial?This study seeks conduct a pilot study to test whether a cognitive training program can improve processing speed abilities in individuals with acute traumatic spinal cord injury.
What data supports the idea that Brain Training for Spinal Cord Injury is an effective treatment?The available research shows that Brain Training for Spinal Cord Injury, particularly using semi-immersive virtual reality, can be effective. In a study with 42 patients, those who used this type of brain training showed significant improvements in overall cognitive functioning, mood, and quality of life compared to those who received traditional therapy. This suggests that integrating cognitive exercises with movement and feedback can enhance recovery. Additionally, another study using tablet technology and gaming systems for rehabilitation showed improvements in trunk control and positive feedback from patients, indicating that game-based approaches can be beneficial.12489
What safety data exists for brain training in spinal cord injury treatment?The studies reviewed provide some insights into the safety of cognitive training programs, including game-based and virtual reality approaches, for individuals with spinal cord injuries. The study on semi-immersive VR cognitive training for SCI patients did not report any adverse effects, suggesting it may be safe. The RehaCom software study for brain injury patients noted potential negative effects like mental fatigue, headache, and eye irritation, but all patients showed improved cognitive performance. Overall, while specific safety data for spinal cord injury patients is limited, the available studies suggest these cognitive training methods are generally safe, with some minor side effects reported in related contexts.236910
Is the treatment of game-like computerized activities a promising treatment for spinal cord injury?Yes, game-like computerized activities are promising for spinal cord injury treatment. They can improve cognitive function, mood, and quality of life by making therapy more engaging and effective. These activities also help with balance and trunk control, which are important for recovery.24579
Do I need to stop my current medications for this trial?The trial protocol does not specify whether you need to stop your current medications.
Eligibility Criteria
This trial is for individuals aged 18-59 who have recently experienced a traumatic spinal cord injury, approximately within the last 6 months. It's designed to help those facing cognitive impairments due to their injury.Inclusion Criteria
I am between 18 and 59 years old.
Treatment Details
The study is testing if game-like computerized activities can speed up how fast patients with acute spinal cord injuries process information. Some participants will use these activities while others will receive a placebo as a comparison.
2Treatment groups
Experimental Treatment
Placebo Group
Group I: ExperimentalExperimental Treatment1 Intervention
pre-specified computer tasks using an Internet-based cognitive training portal, to be completed 3x per week for 60 minutes each session for 12 weeks total
Group II: Placebo ControlPlacebo Group1 Intervention
pre-specified computer tasks using an Internet-based cognitive training portal, to be completed 3x per week for 60 minutes each session for 12 weeks total
Find a clinic near you
Research locations nearbySelect from list below to view details:
Craig HospitalEnglewood, CO
Kessler FoundationEast Hanover, NJ
University of WashingtonSeattle, WA
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Who is running the clinical trial?
Kessler FoundationLead Sponsor
University of WashingtonCollaborator
Craig HospitalCollaborator
References
[Microcomputer and rehabilitation of cognitive cerebral performance disorders]. [2015]Clinical neuropsychology has so far mostly been concerned with theoretical aspects of the brain-behavior relationship, as well as the diagnosis of cognitive deficits after brain damage. Only very recently has cognitive rehabilitation of the brain injured patient become a major area of interest in neuropsychology, and computer-assisted therapy of higher cortical functions is playing an increasing role especially in the United States. A survey found that 73% of the rehabilitation centers included were using computers in delivering their cognitive rehabilitation therapy, major areas of computer-assisted therapy being deficits of eye-hand coordination, attention, concentration, orientation, visual-spatial processing, memory, discrimination, problem solving, and concept formation. Treatment of speech disorders using computers is so far limited but will improve when more efficient language analyzers and synthesizers become available. More powerful microcomputers will lead to both computer-assisted and computer-managed cognitive programs, which allow for maximum flexibility and individualization of treatment. Computer use in cognitive rehabilitation should be subject to supervision by a therapist, and the following requirements should be met: 1) detailed diagnostic analysis of the differential cognitive performance pattern of a patient; 2) individual adaptation of computer peripherals to achieve optimum patient-computer-interaction; 3) selection and adaptation of therapy software to match the individual cognitive performance profile of a patient. Cognitive computer therapy appears to be most profitable in the rehabilitation phase and in post-rehabilitation treatment.
Game-based exercises for dynamic short-sitting balance rehabilitation of people with chronic spinal cord and traumatic brain injuries. [2009]Goal-oriented, task-specific training has been shown to improve function; however, it can be difficult to maintain patient interest. This report describes a rehabilitation protocol for the maintenance of balance in a short-sitting position following spinal cord and head injuries by use of a center-of-pressure-controlled video game-based tool. The scientific justification for the selected treatment is discussed.
Clinical impact of RehaCom software for cognitive rehabilitation of patients with acquired brain injury. [2022]We describe the clinical impact of the RehaCom computerized cognitive training program instituted in the International Neurological Restoration Center for rehabilitation of brain injury patients. Fifty patients admitted from 2008 through 2010 were trained over 60 sessions. Attention and memory functions were assessed with a pre- and post-treatment design, using the Mini-Mental State Examination, Wechsler Memory Scale and Trail Making Test (Parts A and B). Negative effects were assessed, including mental fatigue, headache and eye irritation. The program's clinical usefulness was confirmed, with 100% of patients showing improved performance in trained functions.
Tablet Technology for Rehabilitation after Spinal Cord Injury: a Proof-of-Concept. [2016]Spinal cord injury (SCI) is a damage to the spinal cord resulting in a change, either temporary or permanent, in motor, sensory, or autonomic functions. Patients with SCI usually have permanent and often devastating neurologic deficits and disability. Trunk motor control is crucial for postural stability and propulsion after low thoracic SCI and several rehabilitative strategies are aimed at trunk stability and control. Tablet technology and gaming systems are novel and potentially useful strategies that apply relevant concepts in rehabilitation for these patients. In this study we combined the traditional training of trunk control with exercises administered through two iPad games apps, 2 or 3 times a week. All the participant patients showed increasing game scores during the treatment, as well as increasing Trunk Recovery Scale scores, showing a significant improvement in trunk control. Also the personal judgment of the patients, collected through evaluation questionnaires, was very positive.
Relationship between structural brainstem and brain plasticity and lower-limb training in spinal cord injury: a longitudinal pilot study. [2022]Rehabilitative training has shown to improve significantly motor outcomes and functional walking capacity in patients with incomplete spinal cord injury (iSCI). However, whether performance improvements during rehabilitation relate to brain plasticity or whether it is based on functional adaptation of movement strategies remain uncertain. This study assessed training improvement-induced structural brain plasticity in chronic iSCI patients using longitudinal MRI. We used tensor-based morphometry (TBM) to analyze longitudinal brain volume changes associated with intensive virtual reality (VR)-augmented lower limb training in nine traumatic iSCI patients. The MRI data was acquired before and after a 4-week training period (16-20 training sessions). Before training, voxel-based morphometry (VBM) and voxel-based cortical thickness (VBCT) assessed baseline morphometric differences in nine iSCI patients compared to 14 healthy controls. The intense VR-augmented training of limb control improved significantly balance, walking speed, ambulation, and muscle strength in patients. Retention of clinical improvements was confirmed by the 3-4 months follow-up. In patients relative to controls, VBM revealed reductions of white matter volume within the brainstem and cerebellum and VBCT showed cortical thinning in the primary motor cortex. Over time, TBM revealed significant improvement-induced volume increases in the left middle temporal and occipital gyrus, left temporal pole and fusiform gyrus, both hippocampi, cerebellum, corpus callosum, and brainstem in iSCI patients. This study demonstrates structural plasticity at the cortical and brainstem level as a consequence of VR-augmented training in iSCI patients. These structural changes may serve as neuroimaging biomarkers of VR-augmented lower limb neurorehabilitation in addition to performance measures to detect improvements in rehabilitative training.
Mobile game-based virtual reality rehabilitation program for upper limb dysfunction after ischemic stroke. [2019]Virtual reality (VR) has the potential to provide intensive, repetitive, and task-oriented training, and game-based therapy can enhance patients' motivation and enjoyment.
Relief of neuropathic pain after spinal cord injury by brain-computer interface training. [2022]The aim of this study was to report the effects of brain-computer interface (BCI) training, a neurofeedback rehabilitation technique, on persistent neuropathic pain (NP) after cervical spinal cord injury (SCI).
A novel use of virtual reality in the treatment of cognitive and motor deficit in spinal cord injury: A case report. [2022]Aim of this study is to evaluate the cognitive and motor outcomes after a combined rehabilitative training using a standard cognitive approach and virtual reality (VR), in a patient with spinal cord injury (SCI).
Do Individuals with Spinal Cord Injury Benefit from Semi-Immersive Virtual Reality Cognitive Training? Preliminary Results from an Exploratory Study on an Underestimated Problem. [2023]A spinal cord injury (SCI) is damage to any part of the spinal cord, caused by traumatic or non-traumatic events. Clinically, SCI is associated with partial or complete loss of motor, sensory, and autonomic functions below the site of injury. However, cognitive alterations in specific domains can also occur. The aim of this study was to evaluate the effects of semi-immersive virtual reality (VR) cognitive training (using the BTS Nirvana, Italy) in promoting global functional recovery in patients with SCI. Forty-two SCI patients were included in this retrospective case-control study, and the analysis was carried out using an electronic data retrieval system. The enrolled patients were divided into two groups with the same demographic and medical characteristics: the control group (CG: 21 patients) participated in traditional therapy, whereas the experimental group (EG: 21 patients) received training using semi-immersive VR. In both groups, there were patients with A- or B-grade impairments according to the American Spinal Injury Association (ASIA) scale. Both study groups underwent the same amount of cognitive training (but using a different type of training: conventional vs. innovative), consisting of three weekly sessions for eight weeks (24 sessions in total), each session lasting approximately sixty minutes, as well as the same amount of physiotherapy. The effect of the two treatments (EG/CG) was significantly different in global cognitive functioning (MOCA: p = 0.001), mood (BDI: p = 0.006), and overall quality of life (SF12 Total: p < 0.001), especially in physical perception (SF12-Physics: p = 0.004). Our results suggest that SCI patients could benefit from cognitive training using semi-immersive VR. Indeed, the integration of cognitive exercises that require movement and provide increased feedback could allow for better motor and cognitive recovery in people with SCI.
Effectiveness and therapeutic compliance of digital therapy in shoulder rehabilitation: a randomized controlled trial. [2023]Label="BACKGROUND" NlmCategory="BACKGROUND">Interactive videogames, virtual reality, and robotics represent a new opportunity for multimodal treatments in many rehabilitation contexts. However, several commercial videogames are designed for leisure and are not oriented toward definite rehabilitation goals. Among the many, Playball® (Playwork, Alon 10, Ness Ziona, Israel) is a therapeutic ball that measures both movement and pressure applied on it while performing rehabilitation games. This study aimed: (i) to evaluate whether the use of this novel digital therapy gaming system was clinically effective during shoulder rehabilitation; (ii) to understand whether this gaming rehabilitation program was effective in improving patients' engagement (perceived enjoyment and self-efficacy during therapy; attitude and intention to train at home) in comparison to a control non-gaming rehabilitation program.