RISES-T2: Non-Invasive Electrical and Magnetic Neuromodulation in Persons With Chronic Spinal

Thomas Jefferson University (Other)
Overall Status
Enrolling by invitation
CT.gov ID
Tim Reynolds (Other)

Study Details

Study Description

Brief Summary

The objectives of this study are to (1) determine the effects of neuromodulation techniques on mobility in persons with chronic SCI, as measured by subjective and objective measures, and (2) to determine the optimal combination of techniques that modify mobility and movement in an individual. The neuromodulation techniques explored will be methods of electromagnetic stimulation - that is, electrical stimulation and magnetic stimulation.

Condition or Disease Intervention/Treatment Phase
  • Device: RISES-T System

Detailed Description

The study is designed in two Parts. Part 1 of the study will collect information about the participant's baseline mobility and muscular activation potential. The information collected in these sessions will, in effect, assess the participant's eligibility to continue in the study and move onto Part 2.

Part 1- Assessment Sessions This part of the study designed to determine (1) which, if any, of the participant's muscles respond to stimulation and, if there are responses observed, (2) what stimulation parameters and modalities would be best suited for the participant during Part 2 of the trial. The team will create a participant-specific menu of modalities and pre-defined parameters for electromagnetic stimulation (e.g., amplitude, channels, frequencies, electrode placement, etc.) from which they will select for participant visits in Part 2 of the study. They will also capture the participant's Movement Signature (the pattern of movement as measured by accelerometers and surface EMG that a person exhibits while sitting/standing at rest and/or doing specific tasks to inform Part 2 of the study. Finally, the participants will complete a Baseline Clinical Outcome Measures validated for SCI to provide baseline data prior to the neuromodulation intervention.

Part 2 - The Experimental Cycles This part of the study will consist of Intervention Sessions, in which the team will apply transcutaneous stimulation to the participant's target muscles identified in Part 1, using the parameters and modalities deemed best suited for the participant. during tasks and activities deemed most appropriate for the targeted muscles. The team will measure the effects of electromagnetic stimulation on the participant's muscle activity and movement.

The Cycle will also include Biometric sessions, where the participant will engage in a series of upper extremity, trunk and/or lower extremity repetitive tasks from their prescribed "activity library" that was created for them during Part 1 of the study and the team will measure changes in muscle tone, strength, and movement before and after stimulation. In other sessions, the participant will undergo a series of more targeted tasks with and without electromagnetic stimulation applied, to measure changes in the participant's neurophysiology, kinetics, and kinematics due to electromagnetic stimulation.

After a series of Intervention and Biometrics Sessions, if there are no changes observed in the participant's kinematics or EMG signals in the and/or in select outcome measures, the participant will enter a Parameter Optimization Session. During this session, the study team will revisit the library of stimulation parameters that were defined for the participant during Part 1 of the study and refine the parameters for use in the next Experimental Cycle. The manipulation and refinement of these parameters will be done with the aim of achieving changes in the subsequent Experimental Cycle.

The participant will continue in the study until the time that there is no observed effect of stimulation for three (3) consecutive Experimental Cycles, or may continue for a maximum of six (6) Experimental Cycles. At the end of the study, the participant will repeat the series of Clinical Outcome Measures that were completed at Baseline.

Study Design

Study Type:
Anticipated Enrollment :
10 participants
Intervention Model:
Single Group Assignment
Intervention Model Description:
Prospective, unblinded, feasibility study where participants will serve as their own controls.Prospective, unblinded, feasibility study where participants will serve as their own controls.
None (Open Label)
Primary Purpose:
Official Title:
The Reynolds Innovative Spinal Electrical Stimulation Program: Transcutaneous Stimulation (RISES-T 2.0)
Actual Study Start Date :
Jun 23, 2023
Anticipated Primary Completion Date :
Jun 23, 2025
Anticipated Study Completion Date :
Jun 23, 2026

Arms and Interventions

Arm Intervention/Treatment
Experimental: Experimental Treatment Arm

Participants will receive closed-loop transcutaneous spinal cord stimulation via the RISES-T System while completing repetitive task practice

Device: RISES-T System
The RISES-T system is a hardware and software platform that has been designed and developed to help people living with movement impairment due to Spinal Cord Injury (SCI) to improve and/or restore mobility. The hardware consists of a functional electrical stimulation device that delivers stimulation to the skin through surface electrodes; a series of wearable sensors that collect kinematic (IMU) data and muscle activity (EMG) data, and RISES Software, which incorporates algorithms that utilizes the streaming IMU and EMG sensor data to inform the electrical stimulation parameters and enables real-time visualization of the sensor data and stimulation parameters via Graphical User Interface (GUI).
Other Names:
  • Trancutaneous spinal stimulation
  • Outcome Measures

    Primary Outcome Measures

    1. Spinal Cord Injury-Motor Index (SCI MovIN) [Starting 4 weeks after consent, 3 times every 2 weeks for up to 22 weeks]

      evaluates movement, and recovery of neurotypical movement, within a functional context that accounts for compensations and disallows substitutions

    2. Modified Ashworth Scale (MAS) [Starting 4 weeks after consent, 3 times every 2 weeks for up to 22 weeks]

      measures spasticity in patients with lesions to the central nervous system. MAS is an assessment that is used to measure the increase in muscle tone

    3. Manual Muscle Testing (MMT) [Starting 4 weeks after consent, 3 times every 2 weeks for up to 22 weeks]

      standardized set of assessments that measure muscle strength and function

    Secondary Outcome Measures

    1. Capabilities of Upper Extremity Test (CUE-T) [Once at 2 weeks after consent, and once within 9-24 weeks after consent]

      A performance measure intended to assess upper extremity function following spinal cord injury (SCI)

    2. PROMIS Pain Interference- Adult Short Form 8a (PROMIS-PI) [Once at 2 weeks after consent, and once within 9-24 weeks after consent]

      A patient self-reported measure of consequences of pain on aspects of their life

    3. Walking Index for SCI (WISCI-II) [Once at 2 weeks after consent, and once within 9-24 weeks after consent]

      A measure of physical assistance needed, as well as devices required, for walking following paralysis that results from SCI

    4. Numeric Pain Rating Scale (NPRS) [Once at 2 weeks after consent, and once within 9-24 weeks after consent]

      The patient reported outcome measure the subjective intensity of pain

    5. Patient Global Impression of Change (PGIC) Questionnaires (bowel program, bladder function, dysreflexia, pain, sensation) [Once at 2 weeks after consent, and once within 9-24 weeks after consent]

      Questionnaires to assess the status of or changes in bladder function, bowel regimen, dysreflexia, pain and sensation.

    Eligibility Criteria


    Ages Eligible for Study:
    18 Years and Older
    Sexes Eligible for Study:
    Accepts Healthy Volunteers:
    Inclusion Criteria:

    Has a non-progressive or central cord spinal cord injury

    American Spinal Injury Association (ASIA) Impairment Scale (AIS) classification A, B, C, or D

    Can participate in physical and occupational therapy rehabilitation programs

    Is at minimum 12 months post-injury

    Can provide informed consent

    Has adequate caregiver support to facilitate participation in study

    Is willing to undergo audio-visual recording sessions


    Exclusion Criteria:

    Has uncontrolled cardiopulmonary disease or cardiac symptoms (as determined by investigators)

    Has any unstable or significant medical condition that is likely to interfere with study procedures or likely to confound study endpoint evaluations like severe neuropathic pain, depression, mood disorders or other cognitive disorders

    Has autonomic dysreflexia that is severe, unstable, and uncontrolled or uncontrolled orthostatic hypotension that may interfere with rehabilitation.

    Requires ventilator support Has an autoimmune etiology of spinal cord dysfunction/injury

    Has spasms that limit the ability to participate in the study training (as determined by the Investigator)

    Has skin breakdown in area(s) that will come into contact with electrodes

    Has any active implanted medical device (e.g., cochlear implant, pacemaker, neurostimulator or medication infusion device) Is pregnant, planning to become pregnant or currently breastfeeding

    Has concurrent participation in another drug or device trial that may interfere with this study

    Has other traumatic injuries such as peripheral nerve injuries, severe musculoskeletal injuries (e.g., shattered pelvis, long bone fractures), that prevent evaluation of response to or participation in rehabilitation.

    Is not a candidate for other reason determined by the investigators


    Contacts and Locations


    Site City State Country Postal Code
    1 Thomas Jefferson University Philadelphia Pennsylvania United States 19107

    Sponsors and Collaborators

    • Thomas Jefferson University
    • Tim Reynolds


    None specified.

    Study Documents (Full-Text)

    None provided.

    More Information


    Responsible Party:
    Mijail Demian Serruya, Associate Professor, Thomas Jefferson University
    ClinicalTrials.gov Identifier:
    Other Study ID Numbers:
    • Rises-T 2.0 iRISID-2023-2024
    First Posted:
    Aug 16, 2023
    Last Update Posted:
    Aug 16, 2023
    Last Verified:
    Aug 1, 2023
    Individual Participant Data (IPD) Sharing Statement:
    Plan to Share IPD:
    Studies a U.S. FDA-regulated Drug Product:
    Studies a U.S. FDA-regulated Device Product:
    Product Manufactured in and Exported from the U.S.:
    Keywords provided by Mijail Demian Serruya, Associate Professor, Thomas Jefferson University
    Additional relevant MeSH terms:

    Study Results

    No Results Posted as of Aug 16, 2023