Temporary Inactivation of Strong Muscle Sensation to Improve Rehabilitation Interventions in SCI

Eligibility Criteria

• * Provision of signed and dated informed consent form
• * Stated willingness to comply with all study procedures and availability for the duration of the study
• * Male or female, aged between 18 and 75 years old
• * Have physician diagnosed cervical incomplete spinal cord injury or lesion (iSCI)
• * Classified by the American Spinal Cord Association (AIS) impairment scale as AIS C or D
• * iSCI occurred at least 18 months ago
• * Level of injury or lesion is between C2 and T1
• * Bicep strength must be classified as ≥ 3 muscle grade as defined by the medical research council scale
• * Tricep strength must be at least an MRC grade of 2 and bet at least 1 muscle grade lower than the bicep
• * Both the biceps and triceps will be required to elicit an active motor evoked potential \>200 uV with transcranial magnetic stimulation
• * Must maintain current medication regime
• * Must present with a weaker side of the body, as indicated by a Upper extremity motor score difference between the left and right side
• * UEMS \< 40 (50 max score)
• * Must be able to perform reaching movement training task
• * Provision of signed and dated informed consent form
• * Stated willingness to comply with all study procedures and availability for the duration of the study
• * Male or female, aged between 18 and 75 years old
• * Must be right-handed
• * Must be able to perform hand exercises
• * Pacemaker or another implanted device
• * Metal in the skull
• * History of seizures
• * Pregnancy
• * First-degree relative with medication-resistant epilepsy
• * Current participation in upper limb rehabilitation therapies
• * Current use of illicit drugs, abusing alcohol, or have withdrawn from alcohol in the last 6 months
• * Other neurological impairment or condition
• * Pressure ulcers
• * Significant lower motor neuron loss at C7 as noted by a nerve conduction velocity \<50 m/s
• * History of traumatic brain injury as documented by Rancho Scale Impairment of \<5
• * History of brain MRI documented focal cerebral cortex infarct (e.g. hydrocephalus)
• * Contractures at the elbow
• * Severe spasticity as noted by a modified ashworth scale (MAS) \> 4
• * Documented, non-sedated post-traumatic amnesia lasting more than 48 hours
• * Pregnancy
• * Allergic to lidocaine
• * A neuroactive medication that has the potential to lower the seizure threshold
• * Based on documented publications in stroke, this will include bupropion (wellbutrin), psychostimulants and neuroleptics
• * All medications will be reviewed with physician, Dr. Amol Utturkar (DHR)
• * Pacemaker or other implanted device
• * Metal in the skull
• * History of seizures
• * First-degree relative with medication-resistant epilepsy
• * Current use of illicit drugs (including heroin, crack/cocaine, marijuana), abusing alcohol or having withdrawn from alcohol in the last 6 months
• * Allergy to lidocaine
• * Other neurological impairment or condition
• * Pregnancy
• * A neuroactive medication that has the potential to lower the seizure threshold
• * Based on documented publications on stroke, this will include bupropion (wellbutrin), psychostimulants and neuroleptics