Individual with complete spinal cord injury regains voluntary motor function
A study published today in Scientific Reports describes the recovery of motor function in a research participant who previously had received long-term activity-based training along with spinal cord epidural stimulation (scES).
In the article, senior author Susan Harkema, Ph.D., professor and associate director of the Kentucky Spinal Cord Injury Research Center (KSCIRC) at the University of Louisville, and her colleagues report that over the course of 34.5 months following the original training, the participant recovered substantial voluntary lower-limb motor control and the ability to stand independently without the use of scES.
"Activity-dependent plasticity can re-establish voluntary control of movement and standing after complete paralysis in humans even years after injury," Harkema said.
"This should open up new opportunities for recovery-based rehabilitation as an agent for recovery, not just learning how to function with compensatory strategies, even for those with the most severe injuries."
Previous research at KSCIRC involving four participants with chronic clinically motor-complete spinal cord injury found that activity-based training with the use of scES - electrical signals delivered to motor neurons in the spine by an implanted device - allowed the participants to stand and to perform relatively fine voluntary lower limb movements when the scES device was activated. Andrew Meas was one of the four participants in that study.
The original training protocol included daily one-hour activity-based training sessions with the aid of epidural stimulation.
During these sessions, the participant trained on standing activity for several months, followed by several months of training on stepping.
After completing a nine-month training program in the lab, Meas continued activity-based stand training at home. After a year of independent training, he returned to the lab to train for three months in a revised activity-based training schedule.
The revised training called for two daily one-hour training sessions and included both stand and step training each day, all with the aid of epidural stimulation.
After that training, Meas was able to voluntarily extend his knees and his hip flexion was improved.
In addition, using his upper body and minimal additional assistance to reach a standing position, he was able to remain in a standing position without assistance and even stand on one leg, without the use of epidural stimulation. ■