Published on: 27th February 2026
A landmark international clinical trial - including contributions from leading rehabilitation centres across seven countries - has found that adding intensive task‑specific training to specialist standard inpatient rehabilitation does not improve motor recovery for people with recent spinal cord injury (SCI).
The findings, published in The Lancet Neurology, provide important clarity for clinicians, therapists, and patients by demonstrating that more intensive training does not necessarily lead to better outcomes during the early stages of recovery.
The phase 3 randomised, assessor‑blinded trial involved 220 participants across 15 specialist spinal injury centres, RNOH. It examined whether providing an additional 12 hours per week of intensive task‑specific therapy - focused on voluntary movement at and below the level of injury - would improve functional motor recovery beyond what is achieved through usual inpatient rehabilitation.
After 10 weeks, researchers found no meaningful difference in motor scores between the group receiving standard rehabilitation and the group receiving intensive additional training. There was also no evidence of improvement in secondary outcomes at either 10 weeks or six months.
Dr Joanne Glinsky, Associate Professor of Allied Health University of Sydney, said: “We were really excited and grateful to have the involvement of the Royal National Orthopaedic Hospital and the other many sites across Europe in the SCI-MT Trial. Trials like this are not possible without the cooperation of so many different people. The successful completion of the SCI-MT Trial shows what can be achieved when we combine forces.
We are very confident in our results. And whilst on the one hand people with SCI and all of us would like to see solutions and cures for SCI, on the other hand the field will only progress if we tease out what therapies do and do not make a difference. People with SCI can be reassured that they don’t need to chase costly and time-consuming intensive exercise programs to maximise their potential for recovery. What they are currently receiving is just as good. This means that any residual disability is not because they did not work hard enough. Hopefully, this gives people with SCI some form of comfort.”
Sue Paddison, Clinical Specialist Physiotherapist (Research) Spinal Cord Injuries at RNOH, said: “Site participation has offered our therapists excellent learning opportunities and insight into running a high quality, well led study. This study has provided insight into the acceptability and tolerance of intensive motor training for patients, in the early stages post SCI.
The results have been reassuring and positive, allowing us to reassure our patients that we are providing enough therapy input, during the acute phase of inpatient rehabilitation to facilitate the best possible motor outcomes.
The international network brought together for this study, will facilitate opportunity for future collaboration in studies, providing large numbers of participants and meaningful data.”
The Total Motor Score - measured on a 100‑point scale - was 78.8 in the control group and 78.4 in the intervention group. The between‑group difference was not statistically significant.
Although four serious adverse events were reported, none were judged to be related to the study intervention.
These findings have significant implications for rehabilitation services worldwide. They highlight the strength of current standard inpatient rehabilitation practices and indicate that resources may be better directed toward other interventions, technologies, or approaches to improve outcomes after SCI.