Medicine

New spinal cord therapy helps patients walk again

New spinal cord therapy helps patients walk again

The research, by scientists at the Swiss Federal Institute of Technology in Lausanne (EPFL), the University of Lausanne (UNIL) and the Lausanne University Hospital (CHUV), has been published in two studies in the journals Natureexternal link and Nature Neuroscienceexternal link.

The treatment was administered to three male patients who had suffered a spinal cord injury that resulted in partial or complete lower limp paralysis.

The three patients had electrodes surgically implanted at the back of their spinal cords, which were connected to a wireless electrical pulse generator.

"Selected configurations of electrodes are activating specific regions of the spinal cord, mimicking the signals that the brain would deliver to produce walking", she said. Within one week, this spatiotemporal stimulation had re-established adaptive control of paralysed muscles during overground walking. The implanted device was developed to treat pain, but when combined with 5 months of intensive physical therapy, it restored movement years after a paralyzing injury, researchers reported yesterday in Nature.

Second, and even more important, the research team fine-tuned the stimulation to work in conjunction with the patients' proprioceptive sensory system.

The researchers had to adjust the details for each of the three patients in the study, adapting to the individual measurements of each person's spinal cord.

For centuries, experts thought recovery from spinal injury paralysis could never surpass progress made during the first six months following injury.

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During rehabilitation sessions, the three participants were able to walk hands-free over 1km with the help of targeted electrical stimulation and an intelligent bodyweight-support system.

The University of Technology Sydney will have a research centre capable of administering this treatment in trials within the next year, according to Professor Vissel. Also the movement seen is in controlled laboratory conditions. With EES switched on, he's able to walk using a walker.

The study also focused only on patients who had retained some feeling in their lower body.

The patients wore a series of sensors on their legs and feet that wirelessly communicated to the stimulators as they began to walk.

"It was a very emotional moment the first time they walked", he said. "I was like, should we enroll this participant?" Courtine says that if they could use the implant early after the injury, the results may be more encouraging.

When the stimulation was fed in pulses that worked in conjunction with the proprioceptive system, patients achieved remarkable improvement in their ability to move previously paralyzed legs in coordination, the researchers said. 'Two of them can walk long distances with crutches, ' he adds. Getting EES working is one thing, but they also have an eye on making it possible for patients to use at home-supporting "rehabilitation in clinical settings and use in the community".


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