UC to Study Whether 'Rehearsal' Can Help Spinal Cord Injury Patients Walk

CINCINNATI—University of Cincinnati (UC) researchers will examine how mental “rehearsal” of physical activities, already shown to improve motor skills in stroke patients, can also help spinal cord injury patients walk again.

The study, led by Stephen Page, PhD, associate professor in the College of Allied Health Sciences rehabilitation sciences department, is funded by a multiyear National Institutes of Health grant and will be conducted at Drake Center, a 314-bed rehabilitation facility also located in Cincinnati.

For nearly a decade, Page’s research with stroke patients has shown that mental practice, or thinking about performing physical movements, activates the same muscles and brain regions as actual practice of the same task. His most recent work has shown that repeated mental practice also causes the brain to rewire itself (called “neuroplasticity”). This phenomenon seems to be a key event that usually coincides with recovery of movements.

As a result, Page’s team has shown that patients who both mentally and physically practice their rehabilitative exercises have significantly better outcomes than those who only physically practice the exercises, as is usually done in most rehabilitative hospitals.

Page hopes that this finding also proves true for spinal cord patients relearning to walk.

“This study is extending our work from stroke into spinal cord injury by testing it in people who have trouble walking,” he says. “Walking is a significant problem after spinal cord injury, and so far few therapies work.”

According to Page, most of the treatments for spinal cord injury involve simply managing the patient with braces or a wheelchair, or administering drugs to ease recovery or regeneration.

“This is exploratory because it’s totally different from conventional treatment and it’s using a mind-body technique,” he says.

The study will couple physical therapy with mental practice that can be done in the patient’s home.

“There’s no equipment involved, no drugs involved, no real personnel involved and it’s safe,” Page says, adding that actual walking is unsafe for spinal cord patients to practice at home. “You just imagine yourself doing these things under the guidance of audio and visual tapes.”

 This is a two-center study with the University of California, Irvine. Studies there, Page says, have already shown that brain activity increases in spinal cord patients while they are mentally rehearsing. “So it makes sense that there will probably be some physical effects as well,” he says.

 “This study is a classic example of translating basic research to bedside,” Page says. “We are looking not only at how well the patients walk, but also how their brain changes as a result of participating in our intervention.”

 The study is a joint collaboration with Drake Center, where Page’s lab is based. Startup work has already begun, and he expects to begin recruiting participants in January.