Cognitive Multisensory Rehabilitation for Sensory and Motor Function in Adults with Spinal Cord Injury: Proof of Concept

Abstract

<h3>Research Objectives</h3> About 296,000 Americans have a spinal cord injury (SCI) resulting in reduced or complete loss of motor and sensory function, including loss of body awareness. The objective is to establish the proof of concept of using Cognitive Multisensory Rehabilitation (CMR), for sensory and motor improvement in adults with SCI. <h3>Design</h3> Single group, pre-post design. <h3>Setting</h3> Brain Body Mind Lab, University of Minnesota. <h3>Participants</h3> We recruited 3 men and 3 women, mean age of 52.00±12.22 years, 2-16 years after a complete (n=3) or incomplete (n=3) SCI injury, ranging from T6 to L2, with resulting paraplegia and neuropathic pain. Recruitment methods included fliers, recruitment letters, and posting of the study on ClinicalTrials.gov. <h3>Interventions</h3> A physical therapist, specialized in CMR treated the participants for 6 weeks (3x/week, 45min/session). CMR tasks help restore awareness of where the body is in space and restore sensory function through texture discrimination and discrimination of sponges that have varying resistance. <h3>Main Outcome Measures</h3> Outcome measures were recorded pre-therapy, post-therapy, and at 6 weeks follow-up. Sensory (pinprick, touch) and lower limb motor function were tested using the American Spinal Cord Injury Association (ASIA) Impairment Scale. <h3>Results</h3> Touch sensation (average change score of 4.50±3.75, effect size Cohen's d=0.71, moderate effect size); pinprick sensation (4.08±2.81, d=0.68, moderate effect size) and lower limb motor function (5.58±3.40, d=1.23, large effect size) improved after CMR compared to baseline. Both sensory function and motor function were maintained at the 6-week follow-up testing (average change score baseline to follow-up: touch=7.58±4.42, d=1.11, large effect size; pinprick=5.00±2.34, d=0.81, large effect size; lower limb motor function=6.50±3.29, d=1.56, large effect size). <h3>Conclusions</h3> The pilot study confirms the proof of concept that CMR can improve sensory and motor function. Further validation is needed. <h3>Author(s) Disclosures</h3> No conflict of interests.