Spinal cord injury causes permanent loss of movement, sensation, and autonomic function below the injury level — and for decades, the belief that the spinal cord could not repair itself set a low ceiling on recovery expectations. New research is challenging that assumption with a wave of biological, device, and rehabilitation approaches.
What's actually going on in research
Epidural electrical stimulation delivered to the spinal cord below the injury level is enabling voluntary movement in people with previously "complete" injuries, and trials are scaling this approach and combining it with rehabilitation. Stem cell and gene therapy trials are attempting to bridge injured cord tissue with new cells and encourage axon regrowth. Anti-Nogo and other drugs targeting the molecular brakes that prevent nerve regeneration are in human trials.
Epidural spinal stimulation
Electrodes placed on the spinal cord below the injury can activate dormant circuits, enabling standing and in some cases walking. Large trials are testing optimal placement, parameters, and pairing with rehabilitation.
Cell-based repair
Schwann cells, oligodendrocyte precursors, and induced pluripotent stem cell-derived neurons are being transplanted into injury sites in early human trials to promote reconnection.
Anti-regeneration inhibitors
Drugs blocking proteins like Nogo-A that suppress nerve regrowth in the spinal cord are in human trials to see whether removing these molecular barriers restores function.
What to know before you search
Eligibility depends on injury level (cervical vs. thoracic), injury completeness (AIS classification), time since injury (acute vs. chronic), and prior rehabilitation.
What types of trials are currently open
- Device trials — Testing epidural spinal stimulators, brain-computer interfaces, and exoskeletons for motor recovery.
- Cell therapy trials — Evaluating stem cell transplantation, Schwann cell grafts, and other regenerative approaches.
- Drug trials — Testing neuroprotective drugs in acute injury and regeneration-promoting drugs in chronic injury.
- Rehabilitation trials — Comparing locomotor training, activity-based therapy, and technology-assisted rehabilitation intensities.
- Autonomic and quality of life trials — Testing treatments for bladder, bowel, blood pressure, and sexual function after spinal cord injury.
Recently added Spinal Cord Injury trials
Hybrid HIIT-FES Cycling Program on Individuals With Spinal Cord Injury to Improve Health
Project Summary/Abstract Obesity and metabolic syndrome (obesity, dyslipidemia, hyperglycemia, hypertension) are epidemic in the spinal cord injured (SCI) population. A recent study assessing the body composition and metabolic syndrome rates of 72 motor complete chronic SCI individuals revealed an obesity rate of over 90% and a metabolic syndrome rate of 60%. These results are significantly higher than in the general population. As such individuals with SCI typically have systemic inflammation and an accelerated trajectory towards cardiometabolic disease, and early mortality. Although the accelerated trajectory is multi-factorial, substantial evidence implicates sedentary behavior and low physical activity levels as significant contributing factors. Exercise strategies for individuals with SCI have included upper body arm crank exercise (ACE), functional electrical stimulation leg cycling exercise (FES-LCE), or a combination of the two (FES Hybrid Exercise). These modalities have yielded modest improvements in physical fitness and cardiometabolic risk profiles in individuals with SCI. FES-LCE reportedly increased lean-to-fat mass ratio, enhanced peripheral blood flow and vasoreactivity, and increased bone mass in the paralyzed legs. In addition, FES-LCE improves metabolic function as evidenced by increased glucose disposal. There is evidence that high-intensity interval training exercise can increase muscle mass and improve cardiovascular fitness with considerably less time commitment than non-interval activities. However, given many individuals with SCI respond poorly to the onset of training a primer exercise program for the extremely deconditioned muscles is recommended for optimal results. The investigators intend to investigate the optimization of benefits by using a novel hybrid FES cycling protocol (FES legs cycling plus voluntary arms cycling) combined with high intensity interval training (HIIT) and preceded by a preparatory muscle strengthening program called "peripheral remodeling intermittent muscular exercise (PRIME) to prepare the deconditioned muscles for the more intense exercise in the hybrid HIIT-FES cycling program. The investigators hypothesize that individuals in the PRIME + hybrid HIIT-FES cycling program will demonstrate significantly greater cardiometabolic health and functional benefits than the control group receiving standard of care range of motion exercises.
Low Volume Nose Resistance Breathing Exercise With Incentive Spirometer in Patient With Cervical Spinal Cord Injuries
This randomized clinical trial aims to evaluate the effectiveness of combining Low Volume Nose Resistance Breathing Exercises (LVNRBE) with Incentive Spirometry (IS) on respiratory outcomes in patients with cervical spinal cord injury (SCI). Respiratory complications are a major concern in cervical SCI due to impaired respiratory muscle function, leading to reduced lung volumes, dyspnea, ineffective cough, and sputum retention. The study will recruit 42 inpatients aged 18-38 years with cervical SCI (C4-C7), randomly divided into two groups: Data Analysis: Statistical tests (paired and independent t-tests) will determine intra- and intergroup differences using SPSS v25, with significance set at p \< 0.05. * Group A (Intervention): Receives LVNRBE using an Acapella device plus IS for 20 minutes, three times daily, five days a week for four weeks. * Group B (Control): Receives conventional respiratory physiotherapy with the same frequency and duration. Outcomes will be assessed pre- and post-intervention using: * Pulmonary Function Tests (FVC, FEV1), * Modified Borg Dyspnea Scale, * Cough Frequency Scale, * Sputum Grading Scale.
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