Spinal Cord InjuryNCT07768930
BCI-Guided Tibialis Anterior FES for Gait Training in Spinal Cord Injury
A study testing Ankle Dorsiflexion Rehabilitation in people with Spinal Cord Injury, run by Santos Dumont Institute at 1 site in Brazil.
Trial summary
This study aims to investigate the effectiveness of Brain-Computer Interface (BCI)-guided Functional Electrical Stimulation (FES) in improving muscle activation and gait kinematics in individuals with Spinal Cord Injury (SCI). Read more about this study
- Who is it for?
- Ages 18 to 60 years
- Conditions the study is for
- Spinal Cord Injury
- What is being tested?
- Ankle Dorsiflexion Rehabilitation
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 10 participants
- Where
- 1 siteBrazil
- Study dates
- 1 Nov 2024to 6 Dec 2026
- 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 18 to 60 years
- All sexes
- No healthy volunteers
- Adult
Who may be able to join
- Clinical diagnosis of traumatic spinal cord injury (SCI), classified as AIS grades A to D
- Male or female participants
- Age between 18 and 60 years
Who cannot join
- Skin lesions that preclude the use of functional electrical stimulation (FES)
- Lower-limb contractures that preclude the use of FES
- Lower-limb spasticity that precludes the use of FES
- Osteoporosis
- Recent surgical procedure
Trial locations and contacts
1 site in 1 country.
About this study
Official title: Use of Brain Interface-Guided Functional Electrical Stimulation - Gait Training Machine in Individuals With Spinal Cord Injury
This study aims to investigate the effectiveness of Brain-Computer Interface (BCI)-guided Functional Electrical Stimulation (FES) in improving muscle activation and gait kinematics in individuals with Spinal Cord Injury (SCI).
Read the detailed description
Introduction:
Spinal Cord Injury (SCI) causes serious motor and sensory deficits, affecting thousands of people globally. Brain-Computer Interface (BCI) combined with Functional Electrical Stimulation (FES) emerges as a promising strategy to rehabilitate individuals with SCI. This mechanism will simultaneously stimulate the affected regions of the lower limbs, causing the compromised muscles to contract, causing movement. The FES technique, with its proven effectiveness in improving muscle strength, stands out as a crucial resource in this process of improving approaches integrated with advanced technology and physiotherapeutic principles to offer a promising perspective in neuromuscular rehabilitation.
Objective:
This study aims to investigate the effectiveness of Brain-Computer Interface (BCI)-guided Functional Electrical Stimulation (FES) in improving muscle activation and gait kinematics in individuals with Spinal Cord Injury (SCI).
Methodology:
This is a quasi-experimental study that will be conducted with four (n=4) volunteers with Spinal Cord Injury (age range: 18-60 years), of both sexes. Data collection will take place at the Edmond and Lily Safra International Institute of Neurosciences (IIN-ELS), Macaíba/RN, Brazil. For the characterization and eligibility of volunteers, the following instruments will be used: Modified Ashworth Scale, Douleur Neuropathique 4 questionnaire (DN4), and the Visual-10, Kinesthetic and Visual Imagery Questionnaire-10 (KVIQ-10). For clinical outcomes, the American Spinal Injury Association (ASIA), Spinal Cord Independence Measure - version III (SCIM-III), and the World Health Organization Quality of Life (WHOQOL-BREF) will be used. At the end of the protocol, the following questionnaires will be administered: System Usability Scale (SUS), Intrinsic Motivation Inventory (IMI), and Task Load Index (NASA-TLX) to assess system usability, intrinsic motivation, and perceived workload. The intervention will consist of 24 sessions aiming to use a brain-computer interface based on kinesthetic motor imagery of dorsiflexion associated with neurofeedback (visual and tactile), focused on the functional outcomes of individuals with paraplegia. During the intervention, volunteers will be instructed to imagine performing the dorsiflexion movement. An electroencephalogram (EEG) will be used to monitor brain activity through sensorimotor rhythms. When activity reaches a minimum threshold, functional electrical stimulation (FES) will be triggered, causing contraction of the tibialis anterior muscle.
Expected Results:
It is expected that BCI-guided FES targeting tibialis anterior muscle activation in individuals with SCI will contribute to the rehabilitation process by promoting improvements in neurological function, functional independence, and cortical activity. Changes are expected in clinical outcomes assessed by the International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI/ASIA) and the Spinal Cord Independence Measure III (SCIM III), as well as in EEG patterns associated with sensorimotor cortical activation. Furthermore, this innovative approach will not only provide improvements in the physical performance of individuals with SCI, but will also contribute to the continuous evolution of rehabilitation strategies, highlighting the fundamental role of technological advances in promoting the quality of life and autonomy of these individuals.
- Conditions
- Spinal Cord Injury
- Being tested
- Ankle Dorsiflexion Rehabilitation
- Keywords
- Spinal Cord Injury, Functional Electrical Stimulation, Brain-Computer Interface, Rehabilitation, Foot Ankle Dorsi- flexion
- 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.
Ankle Dorsiflexion RehabilitationOther
Also called Motor imagery, Brain - Computer Interface, Neurofeedback, Functional electrical stimulation
The intervention protocol will last 26 min. The first 2 min are used to collect EEG data under baseline conditions, during which the participant does not perform mental tasks or receive electrical stimulation. Then there is 6 min of motor training with Neurofeedback (NFB). During this time, two 10s periods: one in which the FES devices are activated without motor imagery (MI), and another in which the FES is activated by the MI to induce movements in the feet. This includes six separate attempts for the right foot, left foot, and both feet, for a total of 18 attempts. After completing the NFB phase, the participant rests for 6 min to avoid mental and muscular fatigue.
Subsequently, the user performs 12 min of training with BCI. This involves 20s intervals of MI to trigger the FES devices to dorsiflex the feet, followed by 20s rest periods. This cycle is repeated for a total of 18 exercises, six for each movement (right foot, left foot and both feet).
| Study group | Role | What they receive |
|---|---|---|
| Spinal Cord Injury | Experimental | Not described Receives: Other: Ankle Dorsiflexion Rehabilitation |
What is being measured
The primary outcome is the main question the study is designed to answer.
International Standards for Neurological Classification of Spinal Cord Injury
The International Standards for Neurological Classification of Spinal Cord Injury/ASIA will be used to assess the neurological level and severity of spinal cord injury, including motor and sensory function. The sensory score ranges from 0 (absent) to 2 (normal). The ASIA sensory scores for light touch and pinprick are calculated by summing the scores across 28 dermatomes, with a total score ranging from 0 to 112 for each modality. Higher scores indicate better sensory function. Motor function will be assessed bilaterally using the 10 key muscles corresponding to the C5-T1 and L2-S1 myotomes. Muscle strength is graded from 0 (total paralysis) to 5 (normal movement against maximum resistance). The ASIA Lower Extremity Motor Score (LEMS; range 0-50) will be used to assess lower-extremity motor function, with higher scores indicating better motor function.
Measured: Baseline (before start of the intervention) At 12 week after baseline At 24 week after baseline
Spinal Cord Independence Measure III
To assess functional independence in individuals with spinal cord injury. The instrument evaluates self-care, respiration and sphincter management, and mobility. The total Spinal Cord Independence Measure III score ranges from 0 to 100, with higher scores indicating greater levels of independence.
Measured: Baseline (before start of the intervention) At 12 week after baseline At 24 week after baseline
Secondary outcomes (5)
Electroencephalography Analysis
Verify the clinical effects and cortical activity of mu and beta rhythms through electroencephalography analysis. Power Spectral Density (PSD) will be estimated using Welch's periodogram. Mean power will be calculated across trials for the mu (8-12 Hz) and beta (18-24 Hz) frequency bands. Power values will then be normalized to the mean power across the 8-30 Hz passband. The percentage change in power during kinesthetic motor imagery relative to the resting condition will then be calculated.
Measured: Baseline (before start of the intervention); At 24 week after baseline.
System Usability Scale
To evaluate participants' perception and satisfaction in relation to the intervention protocol, using the System Usability Scale questionnaire, with the aim of identifying the most relevant and impactful aspects of the intervention for volunteers with SCI. The final score ranges from 0 to 100, with scores above 68 indicating good system usability.
Measured: At 24 week after baseline.
World Health Organization Quality of Life
The World Health Organization Quality of Life-BREF will be used to assess participants' perceived quality of life. The questionnaire evaluates four domains: physical health, psychological health, social relationships, and environment. The raw domain score will be converted into a standardized score, ranging from 0 to 100, with a higher score indicating a better perceived quality of life.
Measured: Baseline (before start of the intervention); At 12 week after baseline; At 24 week after baseline
Task Load Index
The Task Load Index will be used to assess participants' perceived workload during the intervention. The questionnaire evaluates six dimensions: mental demand, physical demand, temporal demand, performance, effort, and frustration. The sum of the weighted mean scores across these dimensions results in a total perceived workload score ranging from 0 to 100, classified as very low (0-20), low (21-40), moderate (41-60), high (61-80), and very high (81-100). Higher scores indicate greater perceived workload.
Measured: At 24 week after baseline
Intrinsic Motivation Inventory
It consists of 10 items rated on a 7-point Likert scale, ranging from 1 to 7, with higher scores indicating greater motivation and reflecting the level of agreement or satisfaction regarding different aspects of the motivational experience. The domains assessed include interest/enjoyment, effort/importance, and value/usefulness.
Measured: At 24 week after baseline.
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted17 Aug 2026
- Study start1 Nov 2024
- Primary completion30 Nov 2025
- Study completion6 Dec 2026 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Spinal Cord InjuryStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
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
- 10 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Santos Dumont Institute
- Sponsor type
- University, hospital or other
- Collaborators
- Coordination for the Improvement of Higher Education Personnel, Conselho Nacional de Desenvolvimento Científico e Tecnológico
- Responsible party
- Principal investigator, Caroline Cunha, Santos Dumont Institute
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07768930
- Sponsor's protocol ID
- 79344824.8.0000.0129
- Status last verified
- Aug 2026
- First submitted
- 6 Aug 2026
- Last updated
- 17 Aug 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Study at a glance
From the registry record, last updated by the sponsor on 17 Aug 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Use of Brain Interface-Guided Functional Electrical Stimulation - Gait Training Machine in Individuals With Spinal Cord Injury
- ClinicalTrials.gov ID
- NCT07768930
- Acronym / sponsor ID
- 79344824.8.0000.0129
- Conditions
- Spinal Cord Injury
- Keywords
- Spinal Cord Injury, Functional Electrical Stimulation, Brain-Computer Interface, Rehabilitation, Foot Ankle Dorsi- flexion
- Study type
- Interventional
- Recruitment status
- Active, not recruiting
- Enrolment
- 10 participants (estimated)
- Lead sponsor
- Santos Dumont InstituteUniversity, hospital or other
- Collaborators
- Coordination for the Improvement of Higher Education Personnel, Conselho Nacional de Desenvolvimento Científico e Tecnológico
- Study start
- 1 Nov 2024 (actual)
- Primary completion
- 30 Nov 2025 (actual)
- Study completion
- 6 Dec 2026 (estimated)
- First posted
- 17 Aug 2026 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
This study aims to investigate the effectiveness of Brain-Computer Interface (BCI)-guided Functional Electrical Stimulation (FES) in improving muscle activation and gait kinematics in individuals with Spinal Cord Injury (SCI).
Detailed description
Introduction:
Spinal Cord Injury (SCI) causes serious motor and sensory deficits, affecting thousands of people globally. Brain-Computer Interface (BCI) combined with Functional Electrical Stimulation (FES) emerges as a promising strategy to rehabilitate individuals with SCI. This mechanism will simultaneously stimulate the affected regions of the lower limbs, causing the compromised muscles to contract, causing movement. The FES technique, with its proven effectiveness in improving muscle strength, stands out as a crucial resource in this process of improving approaches integrated with advanced technology and physiotherapeutic principles to offer a promising perspective in neuromuscular rehabilitation.
Objective:
This study aims to investigate the effectiveness of Brain-Computer Interface (BCI)-guided Functional Electrical Stimulation (FES) in improving muscle activation and gait kinematics in individuals with Spinal Cord Injury (SCI).
Methodology:
This is a quasi-experimental study that will be conducted with four (n=4) volunteers with Spinal Cord Injury (age range: 18-60 years), of both sexes. Data collection will take place at the Edmond and Lily Safra International Institute of Neurosciences (IIN-ELS), Macaíba/RN, Brazil. For the characterization and eligibility of volunteers, the following instruments will be used: Modified Ashworth Scale, Douleur Neuropathique 4 questionnaire (DN4), and the Visual-10, Kinesthetic and Visual Imagery Questionnaire-10 (KVIQ-10). For clinical outcomes, the American Spinal Injury Association (ASIA), Spinal Cord Independence Measure - version III (SCIM-III), and the World Health Organization Quality of Life (WHOQOL-BREF) will be used. At the end of the protocol, the following questionnaires will be administered: System Usability Scale (SUS), Intrinsic Motivation Inventory (IMI), and Task Load Index (NASA-TLX) to assess system usability, intrinsic motivation, and perceived workload. The intervention will consist of 24 sessions aiming to use a brain-computer interface based on kinesthetic motor imagery of dorsiflexion associated with neurofeedback (visual and tactile), focused on the functional outcomes of individuals with paraplegia. During the intervention, volunteers will be instructed to imagine performing the dorsiflexion movement. An electroencephalogram (EEG) will be used to monitor brain activity through sensorimotor rhythms. When activity reaches a minimum threshold, functional electrical stimulation (FES) will be triggered, causing contraction of the tibialis anterior muscle.
Expected Results:
It is expected that BCI-guided FES targeting tibialis anterior muscle activation in individuals with SCI will contribute to the rehabilitation process by promoting improvements in neurological function, functional independence, and cortical activity. Changes are expected in clinical outcomes assessed by the International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI/ASIA) and the Spinal Cord Independence Measure III (SCIM III), as well as in EEG patterns associated with sensorimotor cortical activation. Furthermore, this innovative approach will not only provide improvements in the physical performance of individuals with SCI, but will also contribute to the continuous evolution of rehabilitation strategies, highlighting the fundamental role of technological advances in promoting the quality of life and autonomy of these individuals.
Study design
- Primary purpose
- Treatment
- Allocation
- Not applicable
- Intervention model
- Single group
- Masking
- None (open label)
- Number of arms
- 1
| Arm | Type | Receives |
|---|---|---|
| Spinal Cord Injury | Experimental | Other: Ankle Dorsiflexion Rehabilitation |
Who may qualify
- Ages
- 18 to 60 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult
Key inclusion criteria (3 listed)
- Clinical diagnosis of traumatic spinal cord injury (SCI), classified as AIS grades A to D
- Male or female participants
- Age between 18 and 60 years
Key exclusion criteria (5 listed)
- Skin lesions that preclude the use of functional electrical stimulation (FES)
- Lower-limb contractures that preclude the use of FES
- Lower-limb spasticity that precludes the use of FES
- Osteoporosis
- Recent surgical procedure
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Ankle Dorsiflexion RehabilitationAlso: Motor imagery, Brain - Computer Interface, Neurofeedback, Functional electrical stimulationThe intervention protocol will last 26 min. The first 2 min are used to collect EEG data under baseline conditions, during which the participant does not perform mental tasks or receive electrical stimulation. Then there is 6 min of motor training with Neurofeedback (NFB). During this time, two 10s periods: one in which the FES devices are activated without motor imagery (MI), and another in which the FES is activated by the MI to induce movements in the feet. This includes six separate attempts for the right foot, left foot, and both feet, for a total of 18 attempts. After completing the NFB phase, the participant rests for 6 min to avoid mental and muscular fatigue. Subsequently, the user performs 12 min of training with BCI. This involves 20s intervals of MI to trigger the FES devices to dorsiflex the feet, followed by 20s rest periods. This cycle is repeated for a total of 18 exercises, six for each movement (right foot, left foot and both feet). | Other | Spinal Cord Injury |
Primary outcome
International Standards for Neurological Classification of Spinal Cord Injury
Time frame: Baseline (before start of the intervention) At 12 week after baseline At 24 week after baseline
The International Standards for Neurological Classification of Spinal Cord Injury/ASIA will be used to assess the neurological level and severity of spinal cord injury, including motor and sensory function. The sensory score ranges from 0 (absent) to 2 (normal). The ASIA sensory scores for light touch and pinprick are calculated by summing the scores across 28 dermatomes, with a total score ranging from 0 to 112 for each modality. Higher scores indicate better sensory function. Motor function will be assessed bilaterally using the 10 key muscles corresponding to the C5-T1 and L2-S1 myotomes. Muscle strength is graded from 0 (total paralysis) to 5 (normal movement against maximum resistance). The ASIA Lower Extremity Motor Score (LEMS; range 0-50) will be used to assess lower-extremity motor function, with higher scores indicating better motor function.
Spinal Cord Independence Measure III
Time frame: Baseline (before start of the intervention) At 12 week after baseline At 24 week after baseline
To assess functional independence in individuals with spinal cord injury. The instrument evaluates self-care, respiration and sphincter management, and mobility. The total Spinal Cord Independence Measure III score ranges from 0 to 100, with higher scores indicating greater levels of independence.
5 secondary outcomes
Electroencephalography Analysis
Time frame: Baseline (before start of the intervention); At 24 week after baseline.
System Usability Scale
Time frame: At 24 week after baseline.
World Health Organization Quality of Life
Time frame: Baseline (before start of the intervention); At 12 week after baseline; At 24 week after baseline
Task Load Index
Time frame: At 24 week after baseline
Intrinsic Motivation Inventory
Time frame: At 24 week after baseline.
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 17 Aug 2026.
- Individual participant dataSharing planned: No
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
The record lists no contact. Use the official record to reach the sponsor.
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Ankle Dorsiflexion Rehabilitation in people with Spinal Cord Injury, run by Santos Dumont Institute at 1 site in Brazil.
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 3 inclusion and 5 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: under way, not looking for participants, as of the sponsor's last update on 17 Aug 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 Brazil. 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?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
International Standards for Neurological Classification of Spinal Cord Injury (time frame: Baseline (before start of the intervention) At 12 week after baseline At 24 week after baseline). The study lists 2 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 17 Aug 2026.