Up and Walking: Electrical Stimulation Helps Three Paraplegics Regain Mobility
March 12th, 2019 By: JobsTherapy.com Content Staff
Groundbreaking research in Switzerland is giving paraplegics a reason to believe in medical miracles. The research is centered around a new treatment approach called Stimulation Movement Overground (STIMO), in which the spinal cord is electrically stimulated through wireless implants.
STIMO, combined with physical therapy to help patients support their bodyweight, already has allowed three men to regain the ability to walk, many years after severe neck injuries left them paralyzed in their lower bodies. According to a report in Medical News Today, the three men are able to take several steps without any assistance and can walk farther using walking frames or crutches.
The new treatment is the result of a collaboration between Ecole Polytechnique Fédérale de Lausanne and the Lausanne University Hospital in Switzerland, and research papers detailing the medical advancement have been published in the journals Nature and Nature Neuroscience. Unlike two recently published studies from the United States on a similar topic, the men in the Swiss study still could move their legs after the electrical stimulation to the spinal cord was switched off, Medical News Today reported.
There are about 288,000 people living with spinal-cord injuries in the United States, and every year, about 17,700 new cases are diagnosed, with men and boys accounting for 78 percent of patients, according to the National Spinal Cord Injury Statistical Center at the University of Alabama-Birmingham. The leading causes of spinal-cord injury in the United States are vehicle crashes (38 percent), falls (32 percent), gunshots and other acts of violence (14 percent) and sports and recreation accidents (8 percent), according to Medical News Today.
According to the Swiss researchers, “preserving proprioception” – the ability to sense bodily position and movement through signals that the body sends out – is vital in restoring mobility to spinal-cord patients. There are examples of patients who have lost proprioception due to illness or injury. In one noteworthy example, a man could make his muscles contract but was essentially immobile due to an infection that robbed him of his sense of position, movement and touch, according to Medical News Today.
The Swiss researchers said that to prevent STIMO from interfering with a patient’s proprioception, the wireless implants must be precisely located and the timing of the electrical pulses just right.
“The exact timing and location of the electrical stimulation are crucial to a patient’s ability to produce an intended movement,” Jocelyne Bloch, the doctor who performed the implant surgery, told Medical News Today.
The implants are made up of electrodes that target muscles in the legs. The three patients were able to generate new nerve connections due to the precise location of the implants and the precise timing of electrical pulses. That success followed years of experimental STIMO research on animals that allowed researchers to mimic the way the brain naturally engages with the spinal cord.
The three men surprised doctors with their rapid progress. At first, they had to learn how to time their intention to take each step with the stimulation pulses, but after only one week of this “calibration” process, all three were walking with the help of bodyweight support, Medical News Today reported. Less than five months later, the men were able to walk hands-free for more than a kilometer during physical-therapy sessions.
Through intense and lengthy sessions, the men’s nervous systems triggered “activity-dependent plasticity” and reorganized their nerve fibers, leading to improved mobility even without electrical stimulation.
The researchers hope to use their findings to develop tailored treatment plans for use in hospitals and clinics, and they are developing new technology that they hope to test soon after an injury, when the affected tissue has not begun to die off and there is a greater chance of recovery, Medical News today said.