September 2015 - Restoring upper limb function using a novel combination of neuro-rehabilitation techniques

As reported in our last Connections, the best chance of spinal cord repair will most likely come from “combining therapies”. Electrical stimulation (ES) is increasingly viewed as an important part of any such combination as it is both practical, feasible and has demonstrated benefits in patients.

We recently awarded funding to an exciting project that will test the benefits of combining ES with specific upper limb rehabilitation. The study, led by Dr Elizabeth Bradbury and Professor Stephen McMahon at King’s College, London, aims to develop a targeted neurorehabilitation programme designed to maximise and restore useful upper limb function.

“Findings generated from this project will inform future rehabilitation programmes aimed at improving upper limb and hand function, one of the top priorities for tetraplegic patients” Dr Liz Bradbury

They will apply both conventional rehabilitation (intensive training on skilled forelimb tasks) and neurophysiological rehabilitation (repeated electrical activation of neurological pathways from the brain known to be important in forelimb function). The study will be carried out in adult rats with cervical contusion injury to ensure clinical relevance. Specific focus will be placed on elbow extension, hand rotation and digit dexterity, as these address priority areas of function for spinally injured patients. A student trained under this grant will use these studies to develop the optimal combination of physical and electrical neurorehabilitation techniques. In the later stages of the project the group plans to introduce a promising plasticity enhancing therapeutic, known as chondroitinase, in the hope that this will increase plasticity even further and that the skilled
training programme will become even more effective in improving upper limb and digit functions.

As part of a clinical collaboration the student will spend time at Stanmore, a specialised spinal cord injury rehabilitation centre, to gain insight on human rehabilitation techniques.

Eleni Sinopoulou will be joining the Bradbury group at KCL to study for her PhD as part of our Nathalie Rose Barr Studentship programme. Eleni comes from the laboratory of Professor John Martin (City College of the City University of New York). Her training and experience with Martin has been in chronic electrophysiological stimulation and recording techniques monitoring plasticity in corticospinal motor systems in spinal cord injury and complements the proposed PhD.

We wish Eleni all the very best in her new studies and look forward to hearing about her progress over the next three years.