This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Despite the fundamental desire to walk after spinal cord injury (SCI), no conventional rehabilitation regimen has reliably shown to improve functional ambulation. Mental practice (MP) is a complementary/alternative medicine (CAM) mind-body technique in which physical skills can be cognitively rehearsed in a safe, repetitive manner. Additionally, MP increases motor skill learning and performance by activating the same neural and muscular structures when movements are mentally practiced as during physical practice of the same skills. Pilot data suggests that a rehabilitation program including MP increases gait velocity and leg movement in people with motor incomplete SCI. The purpose of this study is to show that MP participation renders a functional effect in ambulation training and validate ankle dorsiflexion as a neural biomarker of ambulation recovery using functional MRI (F MRI) by using randomized controlled methods. This multi-center study will be conducted at 2 academic centers: Drake Rehabilitation Hospital at the University of Cincinnati will serve as the primary study center and UC Irvine will serve as the secondary study center. The complete study will randomize a total of 32 individuals with motor incomplete SCI to either: (1) 30-minute MP sessions combined with locomotor training;or (2) conventional locomotor training only. At each study site, 16 subjects with SCI and 8 healthy subjects without SCI will be enrolled. The randomized comparison of subjects will help determine the functional impact of a gait training regimen including MP in SCI patients with impaired ambulation due to paralysis. Gait analysis modalities and F MRI will measure the outcomes variables including gait velocity (primary outcome), gait kinematics, and active voluntary leg and ankle movement.
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