Transformation of Paralysis to Stepping

About this trial

This trial is enrolling individuals with chronic thoracic (chest area) spinal cord injuries to test the effect of combining skin-surface spinal cord stimulation with the drug Buspirone on stepping function. Trial participants will be assigned to one of three study groups: Group 1: Participants with complete injuries will receive stepping training for 3-4 months using a bodyweight supported treadmill. Then, participants will get skin surface (transcutaneous) spinal cord stimulation (TSCS) along with 2-hour training sessions, 3 days/week in a gravity neutral device (legs suspended by small slings). Lastly, participants will undergo the same training with daily intake of either Buspirone or placebo, crossing over to the opposite medication halfway through the study Group 2: Participants with complete injuries will start with stepping training using an external powered robotic device to assist movement (EKSO Exoskeleton). The participants will then undergo 2-hour training sessions, 3 days/week in the EKSO device with TSCS and oral drug (Buspirone or placebo). Afterwards, participants will train 2 sessions/week in the EKSO device with TSCS and 1 session/week with a rolling walker and TSCS. Lastly, participants will train 2 sessions/week with a rolling walker, TSCS, and a drug (Buspirone or placebo). Group 3: Participants with incomplete injuries will start with stepping training in the EKSO device. Participants will then train 3 days/week for 1 hour in the EKSO device with TSCS and then 1 hour with a rolling walker and TSCS stimulation. Lastly, participants will undergo the same training with daily intake of a drug (Buspirone or placebo). Participants will be followed over a 5 year period