More than 1.2 million people in the United States have a spinal cord injury (SCI), and each year there are 10,000
new cases. In the last few years, we have shown that neuromodulation using epidural stimulation of the
lumbosacral spinal cord can activate latent neural circuits and restore voluntary movement, standing and
stepping in individuals with chronic SCI. One participant in this study also reported gains in bladder function
following training with spinal cord epidural stimulation. However, there are persistent gaps that need to be filled
in order to advance the field of neuromodulation forward. Technological advances to upgrade the stimulator’s
programming and wireless communication platforms are critically needed in order to integrate multiple training
paradigms across multiple systems (i.e. motor and autonomic), as well as take advantage of wireless monitoring
technology that could improve the patient experience. For this study, first we will acquire data necessary for the
implementation of learning algorithms and closed-loop systems with the implanted neurostimulator. Second, 8
additional individuals will be randomized into training interventions for locomotion and bladder. The purpose of
this phase is to implement the closed-loop controls and learning algorithms developed with data from phase 1.
This two phase design will allow us to acquire necessary data for the development of technical tools with a group
of 8 individuals, and test the closed-loop controls with a second group of individuals that have not received prior
to training. This trial will upgrade technology for epidural stimulation and make it specific for use by individuals
with spinal cord injury.