Trial Outcomes & Findings for Transcutaneous Electrical Spinal Stimulation to Restore Upper Extremity Functions in Spinal Cord Injury (NCT NCT03184792)

NCT ID: NCT03184792

Last Updated: 2025-11-04

Results Overview

GRASSP is a clinical impairment measurement tool that quantifies hand impairment caused by cervical spinal cord injury. The tool measures three domains of function: strength (manual muscle strength testing), sensibility (Semmes-Weinstein monofilament sensation test), and prehension (ability and performance to generate various grasp and pinch movements using a water bottle, jar, key, pegs, coins, and nuts). The total score is calculated as the sum of the subscale scores. The minimum score is zero, and the maximum score is 232 points. Higher Scores mean a better outcome. Score change before and after each intervention is calculated.

Recruitment status

COMPLETED

Study phase

NA

Target enrollment

15 participants

Primary outcome timeframe

6 months

Results posted on

2025-11-04

Participant Flow

We use advertisement flyers and information sheets that will be clearly displayed in the neurosurgery and rehabilitation outpatient departments at the University of Washington, for all to see. Recruitment began on December 1, 2017, and concluded on December 1, 2023.

Participant milestones

Participant milestones
Measure
Group 1 (Cross-over Intervention arm sequence: AB)
The sequence of cross-arm intervention for Group 1 will be as follows: "Physical therapy only (Arm A) first" and "Transcutaneous Spinal Cord Stimulation combined with Physical Therapy (Arm B) second."
Group 2 (Cross-over Intervention arm sequence: BA)
The sequence of cross-arm intervention for Group 2 will be as follows: "Transcutaneous Spinal Cord Stimulation combined with Physical Therapy (Arm B) first" and "Physical therapy only (Arm A) second."
Overall Study
STARTED
7
8
Overall Study
COMPLETED
5
6
Overall Study
NOT COMPLETED
2
2

Reasons for withdrawal

Reasons for withdrawal
Measure
Group 1 (Cross-over Intervention arm sequence: AB)
The sequence of cross-arm intervention for Group 1 will be as follows: "Physical therapy only (Arm A) first" and "Transcutaneous Spinal Cord Stimulation combined with Physical Therapy (Arm B) second."
Group 2 (Cross-over Intervention arm sequence: BA)
The sequence of cross-arm intervention for Group 2 will be as follows: "Transcutaneous Spinal Cord Stimulation combined with Physical Therapy (Arm B) first" and "Physical therapy only (Arm A) second."
Overall Study
Pandemic
2
2

Baseline Characteristics

Race and Ethnicity were not collected from any participant.

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Group 1 (Cross-over Intervention arm sequence: AB) - Active Comparator
n=7 Participants
The sequence of cross-arm intervention for Group 1 will be as follows: "Physical therapy only (Arm A) first" and "Transcutaneous Spinal Cord Stimulation combined with Physical Therapy (Arm B) second." Physical Therapy only is the active comparator intervention.
Group 2 (Cross-over Intervention arm sequence: BA) - Experimental
n=8 Participants
The sequence of cross-arm intervention for Group 2 will be as follows: "Transcutaneous Spinal Cord Stimulation combined with Physical Therapy (Arm B) first" and "Physical therapy only (Arm A) second." Transcutaneous Spinal Cord Stimulation, combined with physical therapy, is the experimental intervention.
Total
n=15 Participants
Total of all reporting groups
Age, Continuous
59 years
STANDARD_DEVIATION 14 • n=7 Participants
60 years
STANDARD_DEVIATION 6 • n=8 Participants
59 years
STANDARD_DEVIATION 10 • n=15 Participants
Sex: Female, Male
Female
1 Participants
n=7 Participants
2 Participants
n=8 Participants
3 Participants
n=15 Participants
Sex: Female, Male
Male
6 Participants
n=7 Participants
6 Participants
n=8 Participants
12 Participants
n=15 Participants
Race and Ethnicity Not Collected
0 Participants
Race and Ethnicity were not collected from any participant.
Region of Enrollment
United States
7 participants
n=7 Participants
8 participants
n=8 Participants
15 participants
n=15 Participants
International Standards for Neurological Classification of SCI (ISNCSCI)
Subscale 1: Myotomal-based Motor Examination
50.1 units on a scale
STANDARD_DEVIATION 21.5 • n=7 Participants
49.8 units on a scale
STANDARD_DEVIATION 15.0 • n=8 Participants
49.9 units on a scale
STANDARD_DEVIATION 17.8 • n=15 Participants
International Standards for Neurological Classification of SCI (ISNCSCI)
Subscale 2:Dermatomal-based Sensory Examination
111.0 units on a scale
STANDARD_DEVIATION 43.3 • n=7 Participants
113.8 units on a scale
STANDARD_DEVIATION 36.4 • n=8 Participants
112.4 units on a scale
STANDARD_DEVIATION 35.8 • n=15 Participants

PRIMARY outcome

Timeframe: 6 months

GRASSP is a clinical impairment measurement tool that quantifies hand impairment caused by cervical spinal cord injury. The tool measures three domains of function: strength (manual muscle strength testing), sensibility (Semmes-Weinstein monofilament sensation test), and prehension (ability and performance to generate various grasp and pinch movements using a water bottle, jar, key, pegs, coins, and nuts). The total score is calculated as the sum of the subscale scores. The minimum score is zero, and the maximum score is 232 points. Higher Scores mean a better outcome. Score change before and after each intervention is calculated.

Outcome measures

Outcome measures
Measure
Physical Therapy only
n=11 Participants
All participants, when they receive the "physical therapy only" intervention arm.
Transcutaneous Spinal Cord Stimulation combined with Physical Therapy
n=11 Participants
All participants, when they receive Transcutaneous Spinal Cord Stimulation combined with Physical Therapy
Graded and Redefined Assessment of Strength, Sensibility and Prehension Test (GRASSP Test)
4.5 score change before and after
Standard Deviation 4.1
19.4 score change before and after
Standard Deviation 6.3

SECONDARY outcome

Timeframe: 6 months

International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI) Examination Subscale 1: Myotomal-based Motor Examination - measures the motor function of the extremities. The minimum score is zero, and the maximum score is 100. Higher scores represent better outcomes. Subscale 2: The Dermatomal-based Sensory Examination - measures the sensory function of the whole body dermatomes. The minimum score is zero, and the maximum score is 224. Higher scores represent better outcomes.

Outcome measures

Outcome measures
Measure
Physical Therapy only
n=11 Participants
All participants, when they receive the "physical therapy only" intervention arm.
Transcutaneous Spinal Cord Stimulation combined with Physical Therapy
n=11 Participants
All participants, when they receive Transcutaneous Spinal Cord Stimulation combined with Physical Therapy
International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI) Examination
Subscore 1: Myotomal-based Motor Examination
0.5 score on a scale
Standard Deviation 0.8
5.5 score on a scale
Standard Deviation 2.3
International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI) Examination
Subscale 2: The Dermatomal-based Sensory Examination
1.6 score on a scale
Standard Deviation 5.2
6.4 score on a scale
Standard Deviation 9.5

SECONDARY outcome

Timeframe: 6 months

Hand strength measurement by dynamometry. The change in strength (improvement) before and at the end of each intervention arm is calculated.

Outcome measures

Outcome measures
Measure
Physical Therapy only
n=11 Participants
All participants, when they receive the "physical therapy only" intervention arm.
Transcutaneous Spinal Cord Stimulation combined with Physical Therapy
n=11 Participants
All participants, when they receive Transcutaneous Spinal Cord Stimulation combined with Physical Therapy
Grip and Pinch Strength
3 kilogram
Standard Deviation 2
12 kilogram
Standard Deviation 4

SECONDARY outcome

Timeframe: 6 months

Patient reported pain rating on a 0 to 10 scale. The mean score change (improvement) before and at the end of each intervention arm is calculated. Zero means no pain, 10 means the worst pain one can imagine. Higher scores mean worse pain.

Outcome measures

Outcome measures
Measure
Physical Therapy only
n=11 Participants
All participants, when they receive the "physical therapy only" intervention arm.
Transcutaneous Spinal Cord Stimulation combined with Physical Therapy
n=11 Participants
All participants, when they receive Transcutaneous Spinal Cord Stimulation combined with Physical Therapy
Numeric Pain Rating Scale
4.0 score on a scale
Standard Deviation 1.1
2.0 score on a scale
Standard Deviation 0.5

SECONDARY outcome

Timeframe: 6 months

Patient-reported spasm rating. Scores are mild (0), moderate (1), and severe (2).

Outcome measures

Outcome measures
Measure
Physical Therapy only
n=11 Participants
All participants, when they receive the "physical therapy only" intervention arm.
Transcutaneous Spinal Cord Stimulation combined with Physical Therapy
n=11 Participants
All participants, when they receive Transcutaneous Spinal Cord Stimulation combined with Physical Therapy
Penn Spasm Score
1.5 score on a scale
Standard Deviation 0.5
1.0 score on a scale
Standard Deviation 0

SECONDARY outcome

Timeframe: 6 months

Clinician-administered disability questionnaire for patients with spinal cord lesions. The total SCIM scores range from 0 to 100. Higher scores mean better outcomes. Score change (improvement) relative to baseline or previous intervention arm is calculated.

Outcome measures

Outcome measures
Measure
Physical Therapy only
n=11 Participants
All participants, when they receive the "physical therapy only" intervention arm.
Transcutaneous Spinal Cord Stimulation combined with Physical Therapy
n=11 Participants
All participants, when they receive Transcutaneous Spinal Cord Stimulation combined with Physical Therapy
Spinal Cord Independence Measure (SCIM)
0.2 score on a scale
Standard Deviation 0.4
3.2 score on a scale
Standard Deviation 2.2

SECONDARY outcome

Timeframe: 6 months

Patient-reported quality of life scale. A higher score indicates a higher quality of life. Score change (improvement) relative to baseline or prior intervention arm is calculated.

Outcome measures

Outcome measures
Measure
Physical Therapy only
n=11 Participants
All participants, when they receive the "physical therapy only" intervention arm.
Transcutaneous Spinal Cord Stimulation combined with Physical Therapy
n=11 Participants
All participants, when they receive Transcutaneous Spinal Cord Stimulation combined with Physical Therapy
World Health Organization-Quality of Life - (WHO-QoL-BREF)
4.3 score on a scale
Standard Deviation 7.7
12.5 score on a scale
Standard Deviation 8.9

Adverse Events

Arm A: "Physical therapy only"

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Arm B: "Transcutaneous spinal stimulation & Physical therapy"

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Adverse event data not reported

Additional Information

Dr. Fatma Inanici

University of Washington

Phone: 2067872692

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place