# The Effect of Exoskeleton-Assisted Walking and Transcutaneous Spinal Cord Stimulation on Measures of Bone Strength in Persons with Spinal Cord Injury

> **NIH VA IK1** · JAMES J PETERS VA  MEDICAL CENTER · 2022 · —

## Abstract

PROJECT SUMMARY/ABSTRACT
Dr. Christopher M. Cirnigliaro has been working with researchers as a Research Health Science
Specialist/Research Coordinator to the National Center for the Medical Consequences of Spinal Cord Injury for
almost 20 years. Over this time, he has displayed an extraordinary commitment to improving the health and
general welfare of Veterans with spinal cord injury (SCI). As the Senior Research Coordiantor, Dr. Cirnigliaro
has helped author an impressive list of publications for his stage of professional development, having just
received his doctoral degree; his name appears on over 50 original articles (first author on 9) and 2 review
articles (first author on both). Under the tutelage of Dr. William A. Bauman, he completed 2 projects for his
Ph.D. dissertation work that have been significant in advancing our approach and understanding of bone
disease in persons with SCI. There is a paucity of research that have successfully implemented rehabilitation
and/or exercise training interventions to mitigate the bone loss after acute spinal cord injury (SCI), or possibly
reverse bone loss that has already occurred in chronic SCI. Advanced ambulatory strategies that can restore
sublesional bone in persons with SCI would reduce the morbidity and days lost from work associated with
fractures, a known secondary complication of profound and prolonged immobilization. More important,
improvements in sublesional bone would also improve confidence of patients to engage in recreational
endeavors and improve their independence and ease when performing activities of daily living. The protocol
proposed in my CDA-1 application that compares the effects of exoskeleton-assisted walking (EAW) alone
versus EAW plus transcutaneous spinal cord stimulation (TSCS) and the finite element (FE) approach, along
with traditional radiologic measurements, represents a continuation of previous work aimed at reducing the
risk of fracture by improving bone health in persons with SCI. A successful outcome would be associated with
increased bone strength that would be anticipated to have a direct impact on expanding treatment options for
rehabilitation. In addition to completing the CDA-1 protocol proposed, Dr. Cirnigliaro will complete
additional hands-on research activities, specific academic courses and seminars, and extensive mentoring from
a team of experts in the field of SCI research. The CDA-1 will provide Dr. Cirnigliaro the opportunity to
complete this clinically relevant research plan and improve his knowledge base, develop new skills, and grow
professionally so he can mature into an independent VA RR&D Service clinical scientist.

## Key facts

- **NIH application ID:** 10536913
- **Project number:** 1IK1RX003974-01A1
- **Recipient organization:** JAMES J PETERS VA  MEDICAL CENTER
- **Principal Investigator:** Christopher Cirnigliaro
- **Activity code:** IK1 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2022
- **Award amount:** —
- **Award type:** 1
- **Project period:** 2022-10-01 → 2024-09-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10536913

## Citation

> US National Institutes of Health, RePORTER application 10536913, The Effect of Exoskeleton-Assisted Walking and Transcutaneous Spinal Cord Stimulation on Measures of Bone Strength in Persons with Spinal Cord Injury (1IK1RX003974-01A1). Retrieved via AI Analytics 2026-05-28 from https://api.ai-analytics.org/grant/nih/10536913. Licensed CC0.

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