About this trial

This trial is recruiting individuals with spinal cord injuries to study two rehabilitation approaches intended to improve hand function. One approach uses non-invasive magnetic stimulation (transcranial magnetic stimulation; TMS) applied above the skull. The second approach uses an acoustic startle stimulus, measuring hand movement in response to a surprising and unexpected sound stimulus. The trial will study two basic grasping behaviors: a precision grip (grasping of the thumb to a fingertip) and a power grip (holding of an object using the palms of the hand). Both grips are necessary for eating, writing, dressing, and many other daily living functions. Researches want to know if the grip training is enhanced by TMS — that is, whether the stimulation encourages spinal cord circuit remodeling (plasticity). and whether that increases voluntary function of hand muscles. If selected for the trial, participants will receive motor training for hand and arm function, using different hand activities. TMS or acoustic stimuli will be applied during training; each participant will receive both interventions. The study design includes a control group of healthy volunteers in order to compare the stimulation effects in fully intact nervous systems.