A new study from the University of Louisville describes exciting progress in a groundbreaking technique that is helping paraplegic and quadriplegic patients walk again. The experimental process, involving electrically stimulating the spinal cord, is proving increasingly promising as ongoing research works to improve the design of the treatment.
The technique was revealed back in 2011 with the first documented human subject showing improvements in standing, walking, and other anatomical functions, after years of being paralyzed from the waist down following a hit-and-run accident. Since then, the technique has been further improved, and the technology refined to achieve more effective results.
The latest study documents four patients with motor complete spinal cord injury undergoing the new treatment process. The technique involves two elements. An epidural stimulator is first surgically implanted into specific areas of the spinal cord corresponding with the neural networks that control hip, knee and ankle movement. Then, the subject undergoes repetitive locomotor training, designed to help the spinal cord remember how to stand, step and walk.
After extensive work, two out of the four subjects ultimately achieved the ability to walk over ground for significant durations. The other two patients, while not as successful, still could independently stand at the conclusion of the trial. All physical activity was only achieved while the epidural stimulator was on.
"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," says Susan Harkema, one of the authors of the new study.
The remarkable technique doesn't directly stimulate any muscles but instead is designed to reengage the spinal cord's local nerve network. The process has shown that voluntary movement can be regained via a combination of local electrical stimulation and the individual relearning how to use the stimulation to trigger leg muscles.
Kelly Thomas, one of the participants in this new trial, describes the stunning effects of the treatment as changing her life, after a car accident several years ago resulted in major spinal cord injury leaving her paralyzed from the chest down.
"The first day I took steps on my own was an emotional milestone in my recovery that I'll never forget as one minute I was walking with the trainer's assistance and, while they stopped, I continued walking on my own," explains Thomas. "It's amazing what the human body can accomplish with help from research and technology."
While hope is certainly on the horizon for the millions around the globe suffering from spinal cord injury, more work needs to be completed before the treatment is widely rolled out. Larger clinical cohorts need to be tested to further confirm and refine the treatment process, but the researchers are incredibly confident that this process will become a standard treatment method in the future.
"We are seeing increasing interest in the use of neuromodulation procedures and technologies such as epidural stimulation in the treatment of spinal cord injury and restoration of locomotor, cardiovascular and urodynamic functions," suggests Maxwell Boakye, a researcher on the project, from the Kentucky Spinal Cord Injury Research Center. "Epidural stimulation is likely to become a standard treatment with several improvements in design of the device to target more specific neurological circuits."
Take a closer look at the new treatment process in the video below.
The new research was published in The New England Journal of Medicine.
Source: University of Louisville
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