Technology and therapy help individuals with chronic spinal cord injuries take steps
Staff Writer |
Of four research participants living with traumatic, motor complete spinal cord injury, two are able to walk over ground with epidural stimulation following epidural stimulation paired with daily locomotor training.
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In addition, all four participants achieved independent standing and trunk stability when using the stimulation and maintaining their mental focus.
The study was conducted at the Kentucky Spinal Cord Injury Research Center at the University of Louisville (UofL) and is published in this week's New England Journal of Medicine. The study was funded by the Leona M. and Harry B. Helmsley Charitable Trust, University of Louisville Hospital and Medtronic plc.
This ground-breaking progress is the newest development in a string of outcomes at UofL, all pointing to the potential of technology in improving quality of life - and even recovery - following spinal cord injury.
This latest study builds on initial research published in The Lancet in 2011 that documented the success of the first epidural stimulation participant, Rob Summers, who recovered a number of motor functions as a result of the intervention.
Three years later, a study published in the medical journal Brain discussed how epidural stimulation of the spinal cord allowed Summers and three other young men who had been paralyzed for years to move their legs. Later research from UofL demonstrated this technology improved blood pressure regulation.
"This research demonstrates that some brain-to-spine connectivity may be restored years after a spinal cord injury as these participants living with motor complete paralysis were able to walk, stand, regain trunk mobility and recover a number of motor functions without physical assistance when using the epidural stimulator and maintaining focus to take steps," said author Susan Harkema, Ph.D., professor and associate director of the Kentucky Spinal Cord Injury Research Center at the University of Louisville.
"We must expand this research - hopefully, with improved stimulator technology - to more participants to realize the full potential of the progress we're seeing in the lab, as the potential this provides for the 1.2 million people living with paralysis from a spinal cord injury is tremendous."
The American Spinal Injury Association Impairment Scale (AIS) was used to classify the spinal cord injuries of each of the four participants. When the four participants joined the study, they were at least 2.5 years post injury.
They were unable to stand, walk or voluntarily move their legs. Eight to nine weeks prior to the implantation of an epidural stimulator, they started daily locomotor training - manual facilitation of stepping on a treadmill - five days per week for two hours each day.
Although there were no changes to their locomotor abilities prior to the implant, following the epidural stimulation participants were able to step when the stimulator was on and the individual intended to walk. Participants 3 and 4 were able to achieve walking over ground - in addition to on a treadmill - with assistive devices, such as a walker and horizontal poles for balance while the stimulator was on. ■