Current Projects

Harnessing Neuroplasticity of Postural Sensorimotor Networks Using Non-Invasive Spinal Neuromodulation to Maximize Functional Recovery After Spinal Cord Injury

This study explores how two types of spinal stimulation, lumbosacral epidural spinal stimulation (ESS) and transcutaneous spinal stimulation (TSS), can improve lower limb control and standing ability after spinal cord injury. Participants will receive targeted stimulation combined with physical therapy, and their brain responses will be monitored using fMRI. The study aims to develop diagnostic tools to predict the effectiveness of TSS or ESS, with participants compensated for their involvement.

Funding: National Institute of Health

Click Here to Learn More

Augmenting Rehabilitation Outcomes and
Functional Neuroplasticity Using Epidural
Stimulation of Cervical Spinal Cord

Our goal is to understand the neurological effects of cervical ESS intervention. Additionally, we aim to assess the efficiency of cervical ESS when paired with upper limb rehabilitation. In this study, cervical ESS will require surgery to place an electrode lead in the upper back. An external device connected to the leads will send electrical pulses to the spinal cord to enhance muscle contraction. Stimulation intensity will be adjusted for comfort and safety of the participants and will only be applied during the visits.

Funding: National Institute of Health

Click Here to Learn More

Past Projects

Non-invasive spinal neuromodulation and robotic exoskeleton to recover upper limb function after spinal cord injury

The overall objective of this study is to determine the effects of an intervention that combines transcutaneous electrical spinal cord stimulation with rehabilitation training using an upper limb robotic exoskeleton on the neurophysiological and functional outcomes in individuals with cervical spinal cord injury.

Funding: Craig H. Neilsen Foundation

Training with Exoskeleton and Transcutaneous Spinal Stimulation in SCI

This study aims to evaluate a novel approach to spinal cord injury (SCI) rehabilitation. This approach involves combining robot-assisted step training (RAST) and transcutaneous spinal stimulation (TSS). A group of 6 spinal cord injury (SCI) patients will participate in the study. Each participant will initially complete 3 RAST training sessions in order to become familiar with walking in a robotic exoskeleton. They will then complete a series of 2 training phases, with 12 sessions in each phase. The 2 training phases will include 1) RAST, and 2) RAST + TSS. The duration of each session (up to 60 min) will gradually progress over the course of each training phase. Each participant will complete 3 – 4 training sessions per week. Assessments will be carried out before and after each training phase. Functional assessments will measure the level of motor control during walking, supported standing, and in a gravity neutral condition. Neurophysiological assessments will measure the excitability of the spinal cord.

Funding: The Methodist Hospital Foundation

Functional reorganization of brain-spinal connectivity after stroke using non-invasive spinal neuromodulation and robotic upper limb exoskeleton for neuromotor rehabilitation

The overall objective of this study is to improve and regain upper limb motor control in individuals with sensorimotor impairments after stroke, utilizing a combination of novel robotic exoskeleton technologies and non-invasive spinal neuromodulation.

Funding: NeuroSpark Seed Funding Program

Combining Transcutaneous Spinal Stimulation and Functional Electrical Stimulation for Regaining Self-Assisted Standing after spinal cord injury (SCI)

Transcutaneous Spinal Stimulation (TSS) has been shown to promote activation of the lower limb and trunk muscles and is being actively explored for improving the motor outcomes of people with neurological conditions. However, individual responses to TSS vary, and often the muscle responses are insufficient to produce enough force for self-supported standing. Functional electrical stimulation (FES) can activate individual muscles and assist in closing this functional gap, but it introduces questions regarding timing between modalities.

Funding: Wings for Life – Spinal Cord Research Foundation

Equipment

Epidural Spinal Stimulation

  • Epidural paddle surgically placed into the epidural space using guided fluoroscopy ​
  • A technique used to stimulate spinal nerves through implanted electrodes on top of spinal cord​
  • Can offer selective activation of different muscle groups ​
  • Our lab employs ESS by optimizing the stimulation process through varying the conditioning-test intervals ​

Exolab

  • One-of-a-kind innovation made entirely from MRI friendly materials.
  • Used in combination with EMGs to measure force output of stimulated muscle responses in lower limbs. ​
  • Has the ability to have a participant in a resting or standing position. Adjustable to participant’s leg length and comfortable for long duration testing periods. ​

Stand Frame and Knee Assist

  • Used to support SCI participants in rehabilitation exercises.​
  • Force data from knees, and hands can be collected through the sensors embedded within the frame. 
  • Knee brakes can be controlled from an iPad to run perturbation drills. ​
  • A Wii board also works in tandem with the standing frame to collect standing force from feet when practicing arm float balancing, perturbation, and sit to stands. ​

Transcranial Magnetic Stimulation (TMS)

​

  • A Non-invasive neuromodulation stimulus.​
  • In our Lab we pair TMS  with TSS or ESS and use various conditioning-test intervals (CTIs) such as stimulation sequences and delays.​
  • These assessments help to calculate the latency of response between the motor cortex and upper body. ​

 

Delsys EMG


LabChart


EKSO Bionics

Collaborators


Rice University


Carnegie Melon University


Texas A&M University


University of Alberta


University of Houston


University of Southern California


TIRR Memorial Hermann


ANEUVO


Toronto Rehab Center


Mayo Clinic

Funding Organizations

National Institute of Neurological Disorders and Stroke

The National Institute of Neurological Disorders and Stroke (NINDS) is part of the U.S National Institutes of Health. It funds and conducts basic, translational, and clinical neuroscience research. 

Click to Learn More About The Craig H. Neilson Foundation

Craig H. Neilson Foundation

Craig H. Neilsen Foundation’s funding is dedicated to supporting both programs and scientific research to improve the quality of life for those living with spinal cord injury.

Click to Learn More About The Craig H. Neilson Foundation

Wings for Life

Wings for Life is a not-for-profit spinal cord research foundation. Our mission is to find a cure for spinal cord injury. We fund world-class scientific research and clinical trials around the globe aimed at healing the injured spinal cord.

Click to Learn More about Wings for Life

NeuroSpark Seed Foundation

NeuroSpark Seed Funding is intended to both build upon current neural regeneration research and also ‘spark’ novel interactions among Houston Methodist’s Centers of Excellence. Priority will be given to interdisciplinary projects in areas of emphasis that include regeneration and neuromodulation, systems and organ repair, acute neuroprotection and imaging biomarkers, and prosthetics and robotics.

Click to Learn More about NeuroSpark

Houston Methodist Academic Institute

At Houston Methodist, fostering innovations with the potential for clinical application is at the very heart of what we do. Our interdisciplinary teams of clinicians and researchers are committed to streamlining the process of translating discoveries into treatments and cures for our patients.

Click to Learn More about Houston Methodist Academic Institute

The Methodist Hospital Foundation

The Methodist Hospital Foundations mission is to improve the quality of life by supporting excellence in health care and health care education provided by Methodist Health System.
Click to Learn More about The Methodist Hospital Foundation