# Amplify Gait to Improve Locomotor Engagement in Spinal Cord Injury (AGILE SCI Trial)

> **NIH VA I01** · EDWARD HINES JR VA HOSPITAL · 2022 · —

## Abstract

Background: Among ambulatory individuals with incomplete spinal cord injury (iSCI), residual balance deficits
are common and are a primary factor limiting participation in walking activities. There is broad recognition that
effective evidence-based interventions are needed to enhance dynamic balance following iSCI. However,
improving dynamic balance after iSCI has proven to be very challenging. Experimental interventions that amplify
self-generated movements (e.g. error augmentation) may accelerate motor learning by intensifying sensory-
motor feedback and facilitating exploration of alternative motor control strategies. These features may be
beneficial for retraining dynamic balance after iSCI. We have developed a cable-driven robot to create a
movement amplification environment during treadmill walking by applying a continuous viscous force field to the
pelvis that is proportional in magnitude to a participant’s real-time COM velocity. Our purpose is to investigate if
locomotor training performed in a movement amplification environment can effectively improve dynamic balance
and increase participation in walking activities of individuals with iSCI.
Specific Aims: Aim 1: To evaluate if locomotor training performed in a movement amplification environment is
effective for improving dynamic balance of individuals with iSCI.
 Our pilot data found that following locomotor training performed in a movement amplification environment
three individuals with iSCI each improved dynamic balance by more than 30%. These improvements were
accompanied by faster over ground walking speeds and improved reactive balance. Thus, we hypothesize that
improvements in dynamic balance during walking will be greater when locomotor training is performed in a
movement amplification environment when compared to locomotor training performed in a traditional treadmill
environment.
 Aim 2: To evaluate the impact of locomotor training performed in either a movement amplification environment
or in a traditional treadmill environment on participation in walking activities.
 Based on evidence identifying a strong relationship between balance and steps per day in ambulatory
individuals with iSCI, we hypothesize that training in the movement amplification environment will positively
impact dynamic balance, and in turn increase participating in walking activities.
Approach: We will conduct a two-arm parallel-assignment intervention. We will enroll 36 ambulatory participants
with chronic motor incomplete spinal cord injury. Participants will be randomized into either a Control group
receiving locomotor training or an Experimental group receiving locomotor training performed in a movement
amplification environment. All participants will receive 20 training sessions. We will assess changes in dynamic
balance using measures that span the International Classification of Functioning, Disability and Health (ICF)
framework including; 1) clinical outcome measures of gait, balance, and quality o...

## Key facts

- **NIH application ID:** 10382289
- **Project number:** 5I01RX003371-03
- **Recipient organization:** EDWARD HINES JR VA HOSPITAL
- **Principal Investigator:** Keith Edward Gordon
- **Activity code:** I01 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2022
- **Award amount:** —
- **Award type:** 5
- **Project period:** 2020-05-01 → 2024-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10382289

## Citation

> US National Institutes of Health, RePORTER application 10382289, Amplify Gait to Improve Locomotor Engagement in Spinal Cord Injury (AGILE SCI Trial) (5I01RX003371-03). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10382289. Licensed CC0.

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