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Spinal Cord Injuries (SCI)NCT07306052

Epidural Spinal Cord Stimulation for Restoring Walking in Spinal Cord Injury

A study testing Epidural spinal cord stimulation, Rehabilitation Therapy and positron emission tomography-computed tomography (PET-CT) in people with Spinal Cord Injuries (SCI), run by Second Affiliated Hospital, Zhejiang University, School of Medicine at 1 site in China.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
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Trial summary

The goal of this clinical trial is to evaluate the safety and effectiveness of Epidural Electrical Stimulation (EES) combined with rehabilitation training for the reconstruction of walking in patients with chronic spinal cord injury (SCI) classified as AIS B-D. Read more about this study

Who is it for?
Ages 16 to 70 years
Conditions the study is for
Spinal Cord Injuries (SCI)
What is being tested?
Epidural spinal cord stimulation, Rehabilitation Therapy and positron emission tomography-computed tomography (PET-CT)
Type of treatment
Surgery or procedure
Could I receive a placebo?
No, everyone receives an active treatment
How many people
12 participants
Where
1 siteChina
Study dates
12 Dec 2025to Jun 2027
Phase
Interventional
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 16 to 70 years
  • All sexes
  • No healthy volunteers
  • Child, Adult, Older adult

Who may be able to join

  • Age between 16 and 70 years.
  • Diagnosed with traumatic spinal cord injury for ≥ 6 months and ≤ 60 months.
  • American Spinal Injury Association Impairment Scale (AIS) grade B-D.
  • Spinal cord injury level above T10;
  • Walking Index for Spinal Cord Injury II (WISCI II) score ≤ 13.
  • Completion of a standard conventional rehabilitation program prior to enrollment.
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  • Preserved upper limb function sufficient for self-propelling a manual wheelchair.
  • Sitting balance grade ≥ 1.
  • Ability to elicit clear electromyographic responses in lower limb muscles (e.g., rectus femoris, biceps femoris, gastrocnemius, tibialis anterior) upon transcutaneous electrical spinal cord stimulation at the T12-L1 vertebral levels.
  • Willingness to voluntarily participate, and commitment to compliance with all necessary postoperative rehabilitation, assessments, and follow-up visits.

Who cannot join

  • History of myocardial infarction or stroke within the past 6 months.
  • Diagnosis of psychiatric disorders with active suicidal ideation or risk.
  • Current pregnancy or planned pregnancy during the study period.
  • Bleeding tendency or coagulopathy (prothrombin time ≥18 seconds).
  • History of alcohol or substance abuse or dependence.
  • Intellectual disability, cognitive impairment, or personality disorders.
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  • Other chronic medical conditions that may interfere with rehabilitation (e.g., unhealed severe fractures, hepatic or renal failure, severe anemia, etc.).
  • Implantation of cardiac pacemakers, cardioverters, or defibrillators.
  • Any other condition deemed inappropriate for participation by the investigators.

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

Junming Zhu, Chief Physician contact

0571-87784716

dr.zhujunming@zju.edu.cn

Zhoule Zhu, Attending Physician contact

0571-87784716

doczhuzl@zju.edu.cn

China1 site, 1 recruiting
  • Second Affiliated Hospital, School of Medicine, Zhejiang University

    Hangzhou, Zhejiang, 310009

    Junming Zhu, Chief Physician, 0571-87784716, dr.zhujunming@zju.edu.cn

    Zhoule Zhu, Attending Physician, 0571-87784716, doczhuzl@zju.edu.cn

    Recruiting

Other trials in China

About this study

Official title: Safety and Efficacy of Epidural Spinal Cord Stimulation for Restoring Walking in Spinal Cord Injury

The goal of this clinical trial is to evaluate the safety and effectiveness of Epidural Electrical Stimulation (EES) combined with rehabilitation training for the reconstruction of walking in patients with chronic spinal cord injury (SCI) classified as AIS B-D. The main questions it aims to answer are:

Does the intervention of EES combined with rehabilitation significantly improve walking capacity? Is the combined intervention a safe approach for this patient population? Researchers will compare participants' functional assessments before EES implantation and at 2, 4, 7, 10, and 13 months post-implantation to evaluate the longitudinal effects. The primary assessments include the Walking Index for Spinal Cord Injury II (WISCI II), the Spinal Cord Independence Measure (SCIM III), and the adverse event. Secondary outcome measures encompass the International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI), the Functional Independence Measure (FIM), the Modified Ashworth Scale (MAS), the Penn Spasm Frequency Scale, the 10-Meter Walk Test (10mWT), the 6-Minute Walk Test (6minWT), and pain Visual Analogue Scale (VAS) scores. Neurophysiological and imaging evaluations, including electromyography (EMG), motor evoked potentials (MEPs), somatosensory evoked potentials (SEPs), and positron emission tomography-computed tomography (PET-CT), will be conducted preoperatively and at 6 months postoperatively to explore the mechanisms of neuroplasticity.

Read more

Participants will:

Undergo surgical implantation of an EES device. Receive personalized EES parameter programming combined with rehabilitation training (≥2 hours daily) post-operatively.

Complete a series of standardized functional and clinical outcome assessments at scheduled follow-up intervals.

Undergo scheduled neurophysiological and metabolic imaging studies. Report any adverse events throughout the study duration.

Being tested
Epidural spinal cord stimulation, Rehabilitation Therapy, positron emission tomography-computed tomography (PET-CT), Somatosensory Evoked Potentials (SEPs), Motor Evoked Potentials (MEPs)
Keywords
Epidural Electrical Stimulation, Spincal cord stimulation, Spincal cord injury
Medical subject headings
Spinal Cord Injuries

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Epidural spinal cord stimulationProcedure or surgery

    Epidural spinal cord stimulation is a medical technology that involves delivering controlled electrical impulses to the spinal cord through electrodes implanted in the epidural space-the area between the outermost membrane of the spinal cord (dura mater) and the vertebrae. This technique aims to modulate the activity of spinal neural networks, thereby regulating neurological functions and promoting functional recovery, particularly in individuals with spinal cord injuries or certain neurological disorders.

  • Rehabilitation TherapyProcedure or surgery

    A structured, multidisciplinary rehabilitation program designed to improve motor function, mobility, and independence in participants with paralysis. The therapy typically includes physical Therapy and occupational Therapy.

  • positron emission tomography-computed tomography (PET-CT)Radiation

    PET-CT is an advanced hybrid imaging modality that combines metabolic information from positron emission tomography with anatomical details from computed tomography.

  • Somatosensory Evoked Potentials (SEPs)Procedure or surgery

    SEPs are electrophysiological responses recorded from the central or peripheral nervous system following electrical stimulation of sensory nerves. They assess the functional integrity of somatosensory pathways.

  • Motor Evoked Potentials (MEPs)Procedure or surgery

    MEPs are electrophysiological responses elicited by transcranial magnetic stimulation or electrical stimulation of the motor cortex, recorded from peripheral muscles or the spinal cord. They evaluate the integrity of corticospinal tracts.

  • Diffusion Tensor Imaging (DTI)Radiation

    DTI is an advanced MRI technique that maps white matter tracts by measuring the directionality (anisotropy) and magnitude of water molecule diffusion in neural tissues. It provides quantitative metrics of fibers.

Study groups in NCT07306052
Study groupRoleWhat they receive
Epidural spinal cord stimulation + Standard RehabilitationExperimentalParticipants receive the epidural spnial cord stimulation combined with individualized standard rehabilitation therapy for 12 months.
Receives: Procedure: Epidural spinal cord stimulation; Procedure: Rehabilitation Therapy; Radiation: positron emission tomography-computed tomography (PET-CT); Procedure: Somatosensory Evoked Potentials (SEPs); Procedure: Motor Evoked Potentials (MEPs); Radiation: Diffusion Tensor Imaging (DTI)

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Adverse Events (AEs)

    The incidence, severity, and relationship to the intervention of all AEs . All AEs will be defined, recorded, and graded according to the International Council for Harmonisation Good Clinical Practice guidelines. Serious adverse events will be reported specifically based on established criteria. This assessment will comprehensively cover all safety concerns related to the surgical procedure (epidural stimulator implantation), the electrical stimulation itself (across various parameter sets).

    Measured: Entire study period from implantation to the 13-month postoperative follow-up.

  2. WISCI II (Walking Index for Spinal Cord Injury II)

    The WISCI II evaluates walking ability in spinal cord injury patients. It has 21 levels (0-20), with scores based on mobility aids and assistance needed. A score of 0 means no walking; 20 indicates independent walking without aids.

    Measured: baseline, and 2, 4, 7, 13 monthes after surgery.

  3. Spinal Cord Independence Measure III (SCIM III)

    SCIM III is a disease-specific, validated assessment tool designed to evaluate the functional independence of individuals with spinal cord injury in performing essential activities of daily living, self-care, mobility, and respiration/management. It is tailored to reflect the unique challenges and priorities of the SCI population.

    The SCIM III consists of 19 items across three subscales:

    Self-care subscale (0-20 points): Includes feeding, grooming, bathing, and dressing.

    Respiration and sphincter management subscale (0-40 points): Covers respiration, bladder management, and bowel management.

    Mobility subscale (0-40 points): Assesses mobility in room and toilet, indoors and outdoors mobility, and stair management.

    The total score ranges from 0 to 100 points, with higher scores indicating greater functional independence.

    Measured: baseline, and 2, 4, 7, 13 months after surgery

Secondary outcomes (7)
  1. International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI)

    ISNCSCI is the most authoritative and widely used standard for evaluating neurological function after spinal cord injury, comprising:

    Motor Scores:

    Range:

    Upper limbs (C5-T1): 0-25 per limb (total 0-50) Lower limbs (L2-S1): 0-25 per limb (total 0-50) Total motor score: 0-100 points Higher scores indicate better motor function

    Sensory Scores:

    Light touch:

    0-2 points per dermatome (C2-S4/5) Total: 0-112 points

    Pinprick:

    0-2 points per dermatome (C2-S4/5) Total: 0-112 points Interpretation: Higher scores indicate better sensory preservation Neurological Level of Injury: determined by the most caudal segment

    ASIA Impairment Scale (AIS) Grading:

    A = Complete (no motor/sensory function in S4-S5) B = Sensory incomplete C = Motor incomplete (<50% key muscles strength ≥3/5 grade) D = Motor incomplete (≥50% key muscles strength ≥3/5 grade) E = Normal

    Measured: baseline, and 2, 4, 7, 13 monthes after surgery

  2. Functional Independence Measure (FIM)

    The Functional Independence Measure (FIM) is a widely used assessment tool designed to evaluate a person's functional status and level of independence in daily living activities, particularly among individuals with disabilities.

    FIM items are scored based on the level of assistance required to complete a task, ranging from 1 to 7 points per item.

    The FIM consists of 18 items across two domains: Motor domain (13 items): Includes activities such as eating, grooming, bathing, dressing, toileting, transfers (bed/chair, toilet, tub/shower), walking, and stair climbing. Cognitive domain (5 items): Covers communication (comprehension and expression) and social cognition (memory, problem-solving, and social interaction).

    The total score ranges from 18 to 126 points:

    ≤ 35 points: Severe dependence 36-89 points: Moderate dependence 90-119 points: Mild dependence 120-126 points: Functional independence

    Measured: baseline, and 2, 4, 7, 13 months after surgery

  3. The 10-Meter Walk Test (10m-WT)

    10mWT is a widely used, objective performance-based assessment tool designed to evaluate short-distance walking speed and functional mobility in individuals with neurological impairments, including spinal cord injury.

    The time taken to walk the middle 6 meters is recorded in seconds.

    Measured: baseline, and 2, 4, 7, 10, 13 monthes after surgery

  4. The 6-Minute Walk Test (6min-WT)

    The 6min-WT is a widely used, objective performance-based assessment tool designed to evaluate submaximal exercise capacity, functional endurance, and walking distance in individuals with chronic cardiopulmonary or neurological conditions, including spinal cord injury.

    The participant is instructed to walk back and forth as far as possible within the 6-minute time period, at a self-selected pace that can be sustained throughout the test.

    Measured: baseline, and 2, 4, 7, 10, 13 monthes after surgery

  5. Modified Ashworth Scale (MAS)

    MAS is a clinical tool used to assess muscle spasticity by grading resistance during passive movement. It scores from 0 (no tone increase) to 4 (rigid joint), with intermediate grades: 1 (slight resistance), 1+ (mild resistance through ≤50% ROM), 2 (marked resistance), and 3 (considerable resistance). Higher MAS scores (max=4) indicate worse outcomes, reflecting more severe spasticity that impairs mobility.

    Measured: baseline, and 2, 4, 7, 13 monthes after surgery

  6. Penn

    The Penn Scale is a specific assessment tool for measuring muscle spasticity. Scores range from 0 (no spasticity) to 4 (severe, rigid spasticity), with higher scores indicating more intense muscle stiffness and involuntary contractions.

    Measured: baseline, and 2, 4, 7, 13 months after surgery

  7. Visual Analog Scale (VAS) Pain Score

    The VAS Pain Score is a self-reported measure of pain intensity. It consists of a 10-cm horizontal line, anchored by "no pain" (0) on one end and "worst pain imaginable" (10) on the other. Patients mark the line to represent their current pain level, and the score is determined by measuring the distance from "no pain." It provides a simple, quick method to quantify subjective pain experiences, monitor fluctuations, and guide pain management strategies.

    Measured: baseline, and 2, 4, 7, 13 monthes after surgery

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted29 Dec 2025
  2. Study start12 Dec 2025
  3. Primary completionJun 2027 (estimated)
  4. Study completionJun 2027 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrolment
12 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07306052
Sponsor's protocol ID
2025-1940
Status last verified
Dec 2025
First submitted
12 Dec 2025
Last updated
29 May 2026
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No

Questions about this trial

What is this clinical trial studying?

A study testing Epidural spinal cord stimulation, Rehabilitation Therapy and positron emission tomography-computed tomography (PET-CT) in people with Spinal Cord Injuries (SCI), run by Second Affiliated Hospital, Zhejiang University, School of Medicine at 1 site in China.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 10 inclusion and 9 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: looking for participants now, as of the sponsor's last update on 29 May 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in China. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Junming Zhu, Chief Physician (0571-87784716, dr.zhujunming@zju.edu.cn), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Adverse Events (AEs) (time frame: Entire study period from implantation to the 13-month postoperative follow-up.). The study lists 3 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 29 May 2026.

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