Effects of stimulating hip and trunk muscles on seated stability, posture, and reach after spinal cord injury.
Ronald J Triolo, Stephanie Nogan Bailey, Michael E Miller...
https://pubmed.ncbi.nlm.nih.gov/23500182/Actively Recruiting
Led by VA Office of Research and Development · Updated on 2025-10-27
10
Participants Needed
1
Research Sites
N/A
Total Duration
Researchers are studying a surgically implanted functional electrical stimulation FES system designed to improve stability of the trunk and hips in people with spinal cord injuries, paralysis, tetraplegia, or paraplegia. This system uses small electric currents to make muscles contract, aiming to help users sit more steadily, breathe better, reach farther, push a wheelchair, or roll in bed. The study is conducted by the VA Office of Research and Development and focuses on how this neuroprosthesis affects posture and mobility. The study involves one surgical procedure to implant electrodes into the trunk and hip muscles. These electrodes connect to an 8-channel stimulator implanted in the abdomen. After surgery, participants spend two to six weeks at home with limited activity to allow healing. Following this, they undergo exercise and training to begin using the neuroprosthesis functionally. Participants will be assessed in the lab for strength, balance, and functional abilities both with and without the system, while the implanted devices technical performance is also monitored. Participants will be involved for up to 36 months, during which researchers will measure the effects of trunk stimulation on posture control, breathing, pressure distribution while seated, reach ability, stability, and personal mobility. They will also work on designing a simple position controller. The study includes post-operative training and follow-up visits to track progress, device function, and safety over time.
CONDITIONS
A Neuroprosthesis for Seated Posture and Balance
L
Lisa M Lombardo, MPT
E
Emily C Johnson, BA
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VA Office of Research and Development
Lead Sponsor
This table compares participation in this trial with other options available for this condition. The information is drawn from published research and the trial’s study details and is provided for educational purposes only.
| Factors | IRS-8 Implanted Neuroprosthesis | Conventional Postural Management (No Implanted Device) |
|---|---|---|
| What it is | An implanted 8-channel stimulator system (IRS-8) surgically placed in the abdomen. Wires deliver electrical signals to trunk and pelvic muscles, aiming to improve seated posture, balance, stability, reach, and mobility for people with spinal cord injury. | Standard postural management without an implanted stimulator. Strategies include appropriate wheelchair selection and adjustments, use of contoured seat cushions, belts or straps, and physical therapy for seated stability. No electrical stimulation is delivered directly to trunk or pelvic muscles. |
| Role in the trial | All eligible participants undergo IRS-8 implantation and device activation as the only assigned study intervention. No randomization to other treatments occurs. | No trial participants assigned; represents how eligible patients would otherwise be managed without a trunk/pelvis neuroprosthesis. |
| Primary use | To support seated posture and balance by activating trunk and pelvic muscles in people with mid to lower cervical or thoracic spinal cord injuries. | To maintain seated stability and prevent falls or poor posture through passive physical strategies (wheelchair setup, seat cushions, therapist training), without activated trunk/pelvic muscles. |
| How it is given or performed | The IRS-8 device is implanted surgically in the abdomen. Electrodes are placed to activate specific trunk and pelvic muscles. Device settings are adjusted over time, and the stimulator can be operated by the participant to support posture during daily activities. | Physical management is tailored by clinicians and may include seat and wheelchair adjustments, specialized cushions, supportive straps or belts, and periodic training. No surgery or implanted hardware is involved. |
| Evidence status | Clinical trials and early publications show that implanted trunk/pelvis stimulation can acutely improve seated stability, trunk alignment, reach, and interface pressure in SCI patients. Long-term safety and functional outcome data remain limited. | Widely accepted strategies (wheelchair and cushion adjustments, straps, therapist instruction) are supported by guidelines for maintaining seated balance, minimizing falls, and protecting tissue health, although do not provide active muscle support. |
| Important limitations | Requires major surgery, long-term commitment to device use, and careful selection based on muscle status and psychological suitability. The effects and durability beyond early studies are not fully established and device-related risks remain possible. | Conventional postural management does not activate paralyzed trunk muscles, and individuals may continue to have limited stability, posture control, and increased risk of pressure-related problems compared to those with working muscle groups. |
Disclaimer: This comparison is created with the help of artificial intelligence(AI) and may contain errors or missing information. It is not medical advice and does not mean one option is better or safer than another. Clinical trials are still being studied, and joining a trial is your choice. Please consult your healthcare professional before making any decisions.
You may qualify if you...
You will not qualify if you...
Duration - 2 to 4 weeks
Participants are screened for eligibility to participate in the trial.
1 visit (in-person)
Duration - 2 to 5 days
Participants undergo a single surgical procedure to implant the neuroprosthesis, followed by 2 to 5 days of post-operative care in the hospital to promote healing.
Hospital stay for surgery and immediate recovery
Duration - 2 to 6 weeks
After hospital discharge, participants have 2 to 6 weeks of restricted activity to promote healing of surgical incisions, followed by exercise and training for functional use of the neuroprosthesis.
Multiple follow-up visits during recovery and training period
Duration - Up to 36 months
Participants use the implanted neuroprosthesis for trunk and hip muscle stimulation to improve seated posture, balance, and functional abilities.
Regular laboratory assessments of strength, balance, and functional abilities
Study Type
INTERVENTIONAL
Masking
NONE
Allocation
NA
Model
SINGLE_GROUP
Primary Purpose
TREATMENT
Number of Arms
1
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https://pubmed.ncbi.nlm.nih.gov/29530053/Gary A Wu, Lisa Lombardo, Ronald J Triolo...
https://pubmed.ncbi.nlm.nih.gov/23542776/VA Office of Research and Development
Lead Sponsor