Date of Award

December 2013

Degree Type

Thesis

Degree Name

Master of Science

Department

Occupational Therapy

First Advisor

Roger O. Smith

Committee Members

Mark V. Johnston, Kathy L. Rust

Keywords

CN-NINM, TBI

Abstract

Objective: Document and describe benefits and withdrawal effects of the Cranial Nerve Non-Invasive Neuromodulation (CN-NINM) intervention.

Background: Neuromodulation techniques can be used for the treatment of many diagnoses and conditions. Many current neuromodulation techniques have or can have negative consequences such as high cost, risk of surgical complications or infections, effects not lasting without the drug or stimulation presence, and need for medical experts' direct oversight. A new rehabilitation intervention called CN-NINM may eliminate these negative factors, making it a promising tool for clinicians and participants. CN-NINM combines targeted training activities with mild, portable, electrical stimulation of the tongue to facilitate learning. It was created after repeated clinical observations and functional improvements were noted in related research. However, a great deal is not known about the intervention mechanisms. To date, no negative consequences have been documented.

Methods: An A-B-A-B-A single case experimental design five week intensive protocol was implemented with one participant with a TBI. Seven measures were collected including the Timed Up and Go, Romberg, Sharpened Romberg, 4 components of the Dynamic Gait Index, 5 components of the Community Balance & Mobility Scale, Gait Efficacy Scale-modified, Community Integration Questionnaire, and Participation Objective, Participation Subjective.

Results: While several assessments suggested improved function over the study period, quantitative measures did not demonstrate statistically significant improvement across phases of the study. No quantitative decline in functional gait was evident during withdrawal phases. The participant reported improvements during intervention weeks, including reduced tone and pain, increased gait confidence, and increased activity tolerance.

Conclusion: CN-NINM warrants additional research. While this study demonstrated no statistically significant effects during either intervention or withdrawal phases, several qualitative observations suggest that the intervention can potentially provide fast results with little to no risk and comparatively small cost. Further research should involve multiple individuals with a number of repeated baseline and outcome measures sufficient to attain pre- and post- treatment stability.

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