Brooks Center for Rehabilitation Studies in Collaboration with the University of Florida
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Kids STEP Enrolls Second Participant with Third Expected February 2008

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Executive Summary

The Kids STEP study for children with spinal cord injuries is underway at UF and Brooks Rehabilitation. While three participants may not seem like a lot, children enrolled in the Kids STEP Study represent a very unique population. Of all the spinal cord injuries in the nation, only 5%  are children.

To participate in the Kids STEP Study (KSS) the child must have a specific type of spinal cord injury- one that is termed "incomplete". An incomplete spinal cord injury is defined as a spinal cord lesion in which some sensation or muscle function below the level of injury is preserved.  The child must also be one year post-injury, still unable to walk, and have a low ASIA motor score in the legs (<20), which represents children who are not traditionally expected to recover walking ability.

Jeff Johns, M.D., Spinal Cord Injury Program Medical Director, and Louise Spierre, M.D., Director of Pediatric Rehabilitation provide medical support for the study and review the medical records of each child that applies to enroll in the study. This review process ensures the child's injury matches the study's inclusion criteria and that the child is safe to participate in the study.

Recently, someone asked Andrea Behrman, Ph.D., PT, the study's principal investigator, why she seeks to study children who are not expected to recover walking. She explained that this population of children may help researchers and therapists understand the potential of the spinal cord to respond to an activity-dependent intervention, such as locomotor training. 

According to Behrman, "The spinal cord is believed to contain neural centers that respond to sensory input specific to walking. In response to sensory input, such as walking speed and appropriate joint kinematics, the spinal cord alternately excites flexor and extensor motor neurons to generate a walking pattern."  Therefore, children with severe injuries will likely have to rely on the circuitry of the spinal cord, as well as the inherent plasticity of a pediatric nervous system, to recover a walking pattern. Understanding the neural pathways that control walking and the potential for walking recovery is what the Kids STEP Study is all about.

The second participant, KSS-2, has successfully completed a battery of examinations to evaluate the child's spinal cord injury and functional status. These tests are focused on the aims of the research study in that they provide evidence of the neurologic pathways likely damaged or intact in this child. Additionally, clinical assessments examine the child's ability to perform lower extremity movement, describe and quantify movement patterns, as well as performance during a variety of tasks, such as crawling, and pedaling. Because children enrolled in the study are non-ambulatory, assessments of walking are initially completed in a locomotor training environment using a treadmill and supportive harness to partially unweight the child.  Trainers are also on hand to assist the child.  

Now that many of these pre-tests are completed, KSS-2 is performing daily locomotor training with a team of therapists, trainers, physical therapy students, and volunteers. Testing will be repeated at specific intervals and after completing a total of 60 training sessions. 

If you have any questions pertaining to the Kids STEP Study, contact Andrea Behrman, Ph.D., PT, Principal Investigator (abehrman@phhp.ufl.edu) or Emily Fox, Project Coordinator (ejfox@phhp.ufl.edu).

Click here to visit the Kids STEP Study website.