Assessment and diagnosis of spinal cord injury
Clinical Initiative Stage I - Development of diagnostic and assessment tools for spinal cord injury.
Funding: ISRT. With The National Spinal Injuries Centre, Stoke Mandeville Hospital. Peter Ellaway, Nick Davey Chris Mathias, Praveen Anand, Hans Frankel and Ali Jamous.
Once surgical intervention is available to repair the damaged spinal cord, it will be necessary to be in a position to carry out accurate tests of the outcome. Phase I of the Clinical Initiative is developing tools with which the vertebral level and the completeness of spinal cord injury can be assessed. Techniques have been developed that can be used in the clinic or on the ward as well as those that involve laboratory testing (sensory, motor and autonomic function).
Clinical Initiative Stage II - Practical testing of diagnostic and assessment tools for spinal cord injury.
Funding: ISRT. With The National Spinal Injuries Centre, Stoke Mandeville Hospital. Peter Ellaway, Nick Davey, Chris Mathias, Hans Frankel and Ali Jamous.
Stage II of the Clinical Initiative will tests out the assessment tools developed in Stage I in patients receiving non-invasive therapies. The Initiative will involve our "core" group at Stoke Mandeville administering rTMS (see above) and treadmill-assisted walking therapies. In addition, teams from Zurich (computerised treadmill-assisted walking) and Vancouver (prosthetic hand) will use the tests from Stage I to provide independent assessments of their therapies. We anticipate that this programme will leave the groups in a position to assess spinal cord repair therapies whenever they become available.
Professor Volker Dietz, Balgrist Klinik, Zurich, Switzerland www.neurozh.ch/e/groups/dietz00.htm Project: Functional and Neuronal Recovery in incomplete SCI. Interproject of the ISRT (clinical initiative) and the European Multicenterproject (EM-SCI) for monitoring motor recovery in human SCI.
Dr Arthur Prochazka, University of Alberta, Edmonton, Canada www.ualberta.ca/~aprochaz/hpage.html Project: Outcome evaluation of FES-assisted exercise therapy for hand function in quadriplegic people.
References
Tunstill SA, Wynn-Davies AC, McGregor AH, Nowicky AV and Davey NJ (2001) Corticospinal facilitation studied during voluntary contraction of human abdominal muscles. Experimental Physiology 86:131-136.
Davey NJ, Nowicky AV, Zaman R (2001) Somatotopy of perceptual threshold to cutaneous electrical stimulation in man. Experimental Physiology 86:127-130.
Nowicky AV, McGregor AH, Davey NJ (2001) Corticospinal facilitation studied during voluntary contraction of human back muscles. Motor Control 3:270-280.
Cariga P, Catley M, Nowicky AV, Savic G, Ellaway PH, Davey NJ (2002) Segmental recording of cortical motor evoked potentials from thoracic paravertebral myotomes in complete spinal cord injury. Spine 27:1438-1443.
Ellaway PH, Anand P, Bergstrom EMK, Catley M, Davey NJ, Frankel HL, Jamous A, Mathias C, Nicotra A, Savic G, Short D, S. Theodorou S. (2004) Towards improved clinical and physiological assessments of recovery in spinal cord injury: a clinical initiative. Spinal Cord 42:325-337.
Strutton PH, Beith ID, Theodorou S, Catley M, McGregor AH, Davey NJ (2004) Corticospinal activation of internal oblique muscles has a strong ipsilateral component and can be lateralised in man. In press: Experimental Brain Research.
