Rehabilitation Science and Bioengineering Partner to Improve Spinal Cord Injury Intervention

Nick Balenger (center) works with Jared Gollie (left) and Donal Murray (right), both graduate students in the Department of Rehabilitation Science, in the Functional Performance Lab.

Researchers in CHHS’s Department of Rehabilitation Science and Volgenau School of Engineering’s Department of Bioengineering are partnering to understand how to link functional improvements in patients with incomplete spinal cord injury to changes in muscle at the tissue level using muscle ultrasound techniques in a study funded by George Mason’s Provost Multidisciplinary Research Initiative.

Patients who experience an incomplete spinal cord injury have some intact sensory or motor function in the muscles innervated below the level of the injury to the spinal cord. There are approximately 260,000 people living in the United States with spinal cord injuries, and approximately 60 percent of these injuries are classified as incomplete, according to the National Spinal Cord Injury Statistical Center. The average yearly health care and living expenses with incomplete spinal cord injury is approximately $347,000 in the first year and $42,000 in subsequent years, according to the National Spinal Cord Injury Statistical Center, and the burden on individuals and family is substantial.

This new study, “Effects of intensive task-specific training in patients with spinal cord injury: from physiology to function,” is focusing on confirming which measures researchers can best use to identify changes in neural, muscular, and cardiovascular systems in patients who have participated in a novel intervention developed at Mason in the Department of Rehabilitation Science.

“We are interested in how changes at the tissue level relate to the patient’s improved functional performance,” said Andrew Guccione, chair of the Department of Rehabilitation Science. “Adding muscle ultrasound analysis gives us another level of data to evaluate how a patient is recovering and may allow us to tailor their interventions and care.”

The partnership between rehabilitation science and bioengineering departments evolved from conversations Guccione had with Siddhartha Sikdar, associate professor in the Department of Bioengineering. Sikdar is the co-principal investigator on this study and his colleagues have been studying how to use ultrasound energy to improve treatment monitoring for a variety of diseases.

“Dr. Sikdar is an expert in muscle ultrasound imaging and needed a cohort of patients actively experiencing a change in muscle function to further refine their techniques,” Guccione said. “It’s a natural fit that we would partner with them and our work in the Functional Performance Laboratory.”

The new study will involve a cohort of patients who are currently involved in a research study at George Mason in the Functional Performance Laboratory. Patients with spinal cord injuries are receiving intensive task-specific training that focuses on small, specific elements of the gait cycle (elements of how a person walks).

“We break down the gait cycle and essentially train performance by rotations through a series of movement drills designed to promote neuromuscular adaptation and improve walking,” Guccione said. “Our approach is based on motor learning principles, especially task-specific practice, and emphasizes the voluntary control of movement during full weight-bearing standing and walking activities.”

Guccione and Sikdar are leading the study. Michelle Harris-Love, associate professor in rehabilitation science, and Wilsaan Joiner, assistant professor in bioengineering, are also involved.