Rehabilitation and Cortical Remodeling After Surgical Intervention for Spinal Cord Injury

About this trial

This is a trial to test the effect of upper limb rehabilitation with a robotic device (InMotion Hand and InMotion Arm robots) after nerve transfer surgery in individuals with a cervical spinal cord injury. Nerve transfer surgery is the connection of a functionally intact nerve to a target nerve attached to a muscle that has significant weakness or paralysis. The main study goal is to test at what time point the robotic rehabilitation has the greatest effect on upper limb function (experimental group: robotic training 1 year after nerve transfer surgery; control group: 1 year after nerve transfer surgery + an additional 6 weeks before robotic training is begun). If included, the participant will receive nerve transfer surgery and undergo 18 sessions of upper limb robotic training, 3 times per week, for 6 weeks at one of 2 different time points after nerve transfer surgery. Clinical neurological, functional or cortical stimulation tests will be conducted before surgery, after surgery and after robotic training. The cortical stimulation is a non-invasive technique which uses transcranial magnetic stimulation (TMS) over the outer surface of the head to activate the central nervous system (CNS) and is applied to test whether there have been changes in neuronal connections within the CNS.