Baclofen with Locomotor Training: The Effect on Function and Neuroplasticity in Chronic Incomplete Spinal Cord Injury

Frazier Rehab is recognized as a leader in the field of motor recovery, particularly through the use of locomotor training (LT), an activity-based intervention in which an individual with paralysis is suspended over a treadmill while specially trained therapists move his or her legs to simulate walking. LT has been shown to improve gait in individuals with incomplete motor SCI, even several years postinjury and has been indicated for spasticity reduction. Spasticity, a common medical complication in SCI, is most often treated with baclofen. There is currently considerable controversy regarding whether baclofen use is beneficial or detrimental to recovery of walking, most notably when LT is the therapeutic intervention. There are concerns that baclofen affects the same circuitry as that targeted by this training and may, therefore, negatively impact recovery of walking. The proposed project will use a prospective, controlled, randomized study to examine the effectiveness of LT for recovery of walking in subjects with chronic incomplete SCI who are taking oral baclofen compared to those who do not, with secondary outcomes examining improvement in cardiovascular and pulmonary function, quality of life, and electrophysiological factors.