Do we have a scientific rationale for this intervention?
Yes. Reflex operant conditioning induces a targeted change in a specific reflex pathway, and as a result, behaviors and functions of the targeted pathway can be improved.
Can patients with chronic SCI be considered for this treatment?
For research, all of the participants were in their chronic phase to ensure that the majority of the changes detected in the study can be contributed to Operant Conditioning. In fact, a participant with an injury as chronic as 10 years was able to demonstrate changes. If your patient has spasticity or weakness that has affected his/her ADLs, we recommend trying out Operant Conditioning!
Who else could we treat using Operant Conditioning?
Ideally, we would love to work with everyone! While continued research is needed, the flexibility of the treatment method allows neural behavioral modification for various populations. Current and previous research included topics such as: multiple sclerosis, stroke, young adults, athletes, post-op, etc. We are looking forward to what the future of Operant Conditioning holds!
How many sessions will likely be needed for this therapy?
Typically, people start to see some functional improvements after 12 sessions over 4 weeks. Optimal dose hasn’t been determined at this moment.
Is the equipment costly? Does this require special facilities?
Currently, a custom assembled system costs $0-20K for a lab, depending on what you already have available. Software is completely free. The development of a new clinical system is currently underway (U44 NS114420). There is no specific facility requirements for this.
Can I get a hands-on training on Operant Conditioning?
Absolutely! The Medical University of South Carolina (Charleston, SC) offers lectures and hands-on experience for operant conditioning using peripheral nerve stimulation and TMS. Introductory and Advanced workshop are provided through National Center of Neuromodulation For Rehabilitation
Will booster therapy be necessary?
It is not required, but it may be beneficial to maintain therapeutic gains.
Are there significant risks?
For now, we have not seen any significant risks. However, this will have to be confirmed through a larger clinical trial.
Are there animal studies supporting this therapy in people?
Yes. Human reflex conditioning is developed based on 40+ years of animal and human research.
What is the difference between Operant Conditioning and Classical Conditioning?
Both methods of conditioning are used to modify behaviors. Like Pavalov’s dogs, Classical Conditioning utilizes positive reinforcement (i.e. food, verbal affirmation) to a specific behavior (i.e. responding to the sound of the bell) in order for the goal behavior to become habitual.
On the other hand, Operant Conditioning utilizes positive AND negative reinforcement (i.e. green vs. red light) in response to two possible behaviors. Operant Conditioning allows for more specific behavioral modification while controlling variables, which makes this an excellent method for research.
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