Spinal cord injury research

Author: SCIRE Community Team | Reviewer: Janice Eng | Published: 24 April 2017 | Updated: 23 February 2024

Doing research in populations with SCI is essential to improving treatment, rehabilitation, and management options for people with SCI, but there are some obstacles. Some research limitations unique to research in SCI populations include:

You may notice that many SCI studies have small sample sizes. SCI is not a common condition, so the number of people with SCI in a given location is often small. Even within that population, the level of injury and level of function will be very diverse. To make sure that this variation in injury types does not impact research results, studies often have strict participant criteria that require specific ranges for level of injury, level of function, time since injury, secondary health issues, medication use, etc. Also, people with SCI are more likely to have trouble accessing and maintaining participation in a study due to transportation, mobility, and ongoing health issues. All these factors contribute to the small sample sizes in studies of SCI and SCI treatments.

Although RCTs are considered the gold standard for treatment research, they may not always be possible or ethical. There are ethical concerns over some of the strategies used in RCTs to reduce study bias when used for certain treatments. For example, randomizing participants to a non-treatment group in an exercise study, when it is commonly known that exercise is beneficial to health could be considered unethical. Invasive procedures such as surgeries are also difficult to study in RCTs because blinding participants might require a “sham” treatment (e.g. prepping the patient and making incisions but not doing the procedure). If a sham treatment is invasive and carries some risk, recruitment of willing participants in an already small participant pool becomes even more challenging. For the SCI population, it can be difficult to come up with a matched control group because of large variations in level of function and level of injury.