A Pilot Clinical Trial of Cognitive Multisensory Rehabilitation for Sensory and Motor Recovery in Adults with Spinal Cord Injury

Research Objectives: To determine if 8 weeks of CMR vs. adaptive fitness improves sensory and motor function in adults with SCI/D.

Design: Pilot randomized controlled trial.

Setting: Brain Body Mind Lab, University of Minnesota and Courage Kenny Rehabilitation Institute, Twin Cities, MN.

Participants: Fourteen adults were recruited, with an average age of 51.78 ± 8.19 years (range of 38-64 years), 6 women, 8 men; 26.67% African-American adults, 78.57% White non-Hispanic adults; 21.43% living rurally; an average of 13.11 ± 10.64 years after SCI (range of 0.75-28.47 years) 1 adult with Brown Sequard; 6 adults with tetraplegia, and 8 with paraplegia.

Interventions: 8 weeks of CMR, in-person, 1-on-1 with a CMR-certified physical therapist, 45 min/session, 3x/week or 8 weeks of adaptive fitness gym with trainer available, in-person, 45 min/session, 3x/week.

Main Outcome Measures: We assessed outcomes at 3 time points: baseline, after the interventions, and at 3-month follow-up. We used the ISNCSCI Neurologic exam, to quantify changes in sensory and motor function. We also used the Neuromuscular Recovery Scale (NRS) to evaluate the quality of motor function (core, hand function, and activities in standing position). We calculated the effect size by dividing the average of the pre-post change score by the standard deviation of the change score.

Results: Our results show an indication of greater sensorimotor improvements after CMR (n=8) than after adaptive fitness (n=6). We found large effect sizes for the CMR group on the AIS exam (touch: Cohen’s d=1.50; pinprick: d=1.41; lower limb motor function: d=0.82) vs. moderate effect sizes for the adaptive fitness group (touch: d=0.54; pinprick: d=0.54; lower limb motor function: d=0.48).
Similar results were found for the NRS testing, with moderate to large effect sizes for CMR (core: d=2.19; upper limb: d=0.74; lower limb: d=0.74) vs. no effect size to moderate effect sizes for the adaptive fitness group (core: d=0.64; upper limb: d=0.36; lower limb: d=0.00). The improvements on both measures were maintained or improved at the 3 month-follow up.

Conclusions: So far, the results indicate the preliminary efficacy of CMR for improved sensorimotor function in adults with SCI/D. Results need to be validated in a larger randomized controlled clinical trial.

Author(s) Disclosures: No conflict of interest.