About this trial
Associative plasticity has been used to promote functional recovery from conditions affecting movement. The long term goal of this project is to use electrical stimulation techniques to improve arm and hand function. The goal of this prospective experimental study in adults with hemiplegic cerebral palsy (hCP) is to test the effects of pairing hand motor cortical and median nerve stimulation targeted to induce plasticity in the cervical spinal cord. Based on preliminary data in neurotypical adults, the investigators are testing the effects of this approach in adults with hCP.
This study will first verify the present stimulation parameters as sufficient to promote induction of associative plasticity of sensorimotor connections for manual dexterity in adults with hCP. This will be assessed through neurophysiological, biomechanical, and clinical functional outcome measures. Successful pairing showing meaningful improvements in dexterity could then be used as an impetus for a larger study examining the efficacy of SCAP in people with hCP.
Eligibility criteria
This trial does not accept healthy volunteersQualifiers
Maintenance of caffeine and exercise levels at time of sessions
Ability to provide informed consent
Manual ability classification system (MACS) level I to III
Disqualifiers
History of seizures in last two years
Use of medications that lower seizure threshold
History of implanted equipment including stimulators/pacemakers
Trial design
Single group
Treatments tested in this trial
Paired brain and nerve stimulation
DeviceThis utilizes pairing of repetitive transcranial magnetic stimulation (rTMS) and peripheral nerve stimulation (rPNS) timed to converge in the cervical spinal cord.
Treatment groups
Trial outcomes
Primary outcomes
Size of muscle response to brain stimulation after intervention (percentage)
Size of muscle response will be measured in response to brain stimulation. This value will be normalized to the equivalent measure taken before the SCAP protocol.
Number of blocks moved during box and blocks testing (BBT) after intervention
Number of blocks moved during box and blocks testing will be measured after SCAP protocol. This value will be normalized to the equivalent measure taken before the SCAP protocol.
Sponsors and contacts
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