Lower Limb Table 21: Cellular Transplantation Therapies to Augment Strength and Walking Function

Author Year; Country
Score
Research Design
ample Size
 

Methods

 

Outcomes

Kishk et al. 2010;

Egypt

Case Control

N=64

Population: Treated Group – 36 males, 7 females; mean (SD) age 31.7(10.4); 12 complete, 31 incomplete SCI

Control Group – 15 males, 5 females; mean (SD) age 33.8(11.8); 3 complete, 17 incomplete SCI

Treatment: Monthly intrathecal injection of autologous bone marrow MSCs for 6 months, all participants received 3 rehabilitation therapies per week.

Outcome Measures: Trunk muscle assessment, MASS, Functional Ambulation Categories, AISsensorimotor, motor and sensory scores, lower-limb somatosensory evoked potentials (SSEPS)

  1. A significantly greater proportion of the treatment group showed improved motor scores, but this is not clinically relevant as it was only by 1-2 points in 18/44 participants (48.7(9.1) to 49.3(9.2)).
  2. There were no significant differences between-groups for trunk support,Functional Ambulatory Categories, sensory exam (pin prick), scores, tone, bladder control questionnaire, bowel control, and AIS changes.
  3. 1 patient dropped out due to adverse reactions (acute disseminated encephalomyelitis)

 

Lima et al. 2010;

Portugal

Pre-post

N=20

Population: 17 males, 3 females; mean (SD) age 30.2(5.7); 15 patients AIS grade A, 5 patients AIS grad B; all > 1 YPI

Treatment: OMA into the area of the SCI a mean of 49 months after injury, with pre-operative rehabilitation (mean (SD) 31.8(6.8) hours/week for 34.7(30) weeks) and post-operative rehabilitation (mean (SD) 32.7(5.2) hours/week for  92(37.6) weeks) with BIONT or robotic BWSTT.

Outcome Measures: AISscore and AIS grade, FIM, WISCI

 

  1. Estimated mean change in all ASIA neurological measures (pink prick, light touch, motor arms, motor legs) was statistically significant. ASIA motor legs score improved from 0 to 4.95(7.1) post intervention.
  2. 11 patients improved their AIS grades (6 by 2 grades), and 1 patient’s score deteriorated and suffered ARs (aseptic meningitis, spinal cord edema)
  3. 9 of the patients with an AIS score of 0 at baseline improved from 4 to 22 at last evaluation.
  4. Of the 13 patients assessed for functional studies, all had improvements on FIM scores (mean (SD) 71(23) to 85(28)) and WISCI scores (0.2(0.4) to 7.4(2.6)).
  5. Patients at facilities focusing on BIONT showed better motor recovery compared with those at facilities focusing on BWSTT.
  6. Voluntary motor potentials of the lower limb muscles were found in 11/20 patients.
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