Technology Changes Outlook for Spinal Cord Injury Recovery

For many, when you woke up this morning, you likely got out of bed without giving it another thought. You simply took the first step of the thousands you’ll take in any given day. For the millions living with spinal cord injury around the world, however, getting out of bed is the first impasse of the many hurdles they face in their daily routine.

When most of us encounter someone with a spinal cord injury, our first instinct is to look away. Paralysis, from whatever cause, has always been thought to be a life sentence of confinement to a wheelchair. An injury so devastating that able-bodied individuals choose to not think about it or acknowledge it.

But what if there was a switch that could be turned on that allowed someone living with paralysis to regain control of their body? And, what if, rather than look away, we could all be in a position to help? While this may sound like science-fiction, let me assure you it’s real — today.

A gathering avalanche of new research is showing more evidence that technology holds limitless potential for helping people with spinal cord injury recover — maybe even cure — some of the functions lost as a result of trauma to the spinal cord. There is also overlap with many disease categories, such as stroke, Parkinson’s and traumatic brain injury, as well as others in which an advance in one can be applied to others.

Three separate research papers in renowned medical journals have made international headlines recently, as they each demonstrate how epidural stimulation, a device implanted on the base of the spine, has helped individuals living with paralysis regain cardiovascular functions and movement — with a few individuals able to take their first steps since their injury.

[See: 8 Cool Uses for 3-D Printers in Health Care.]

Pioneering Scientists Were Early Believers

A founding pioneer of modern day spinal cord research, Dr. Reggie Edgerton, along with researchers from the Mayo Clinic and UCLA, unveiled new research in the scientific journal Nature Medicine. Through the application of epidural stimulation in combination with task-specific training, a young man living with chronic complete paraplegia recovered the ability to step over ground while using a front-wheeled walker with trainers providing only sporadic assistance. Additionally, he was able to take bilateral steps on a treadmill. Not only is this discovery unprecedented, it was deemed impossible only a few years ago by many prominent leaders in the field.

At the same time, Dr. Susan Harkema and Dr. Claudia Angeli at the Kentucky Spinal Cord Injury Research Center at University of Louisville have published two groundbreaking papers. The New England Journal of Medicine paper details how epidural stimulation can foster greater brain-to-spine connectivity in individuals with chronic complete paralysis. As a result of that connection, two of the four research participants featured in the paper are able to walk over ground with a walker and no physical assistance. In addition, all four participants achieved independent standing and trunk stability while maintaining their mental focus, which is defined as purposefully wanting to pick up their foot or leg to take steps. Small steps for us to be sure, but, in our view, at least as big as stepping on the moon.

In addition, the Journal of the American Medical Association reported another four research participants, all living with chronic cervical spinal cord injuries, at the University of Louisville have experienced improved cardiovascular function as a result of epidural stimulation, including blood pressure and heart rate regulation. In addition to diminishing quality of life, cardiovascular dysfunction can be very dangerous and even deadly, as people often gasp for air and lose consciousness.

Simple Tech, Endless Possibility

Still a fairly simple technology, epidural stimulation is the star player in these latest advancements. It involves an electronic stimulator being implanted inside the body over the dura (the protective coating of the lower section of the spinal cord) of the lumbar cord where the central pattern generator exists. The CPG is like a mini-brain within the spinal cord that interprets sensory information.

Hard wired to the spinal cord, it then applies a continuous electrical current to specific locations on the lower part of the spinal cord to activate the nerve circuits and generate signals that would normally come from the brain. Controlled by a remote about the size of a smartphone, the operator can manipulate frequencies and intensities. When the stimulator is on, commands such as “move my right leg” result in movement. In a way, the electrical impulses are awakening the dormant nerve connections in the spinal cord.

This is just the start. While we all wonder what impact technology — such as robotics and human machine interfaces — will have on us and society, here is real technology with real human benefit. Like any technology, we are now moving into a phase of rapid advancement where we expect to see many competing approaches and applications with new ‘features’ being added at an accelerating pace. ‘Features’, in this case, equate greater quality of life and include AI to understand movement intent; increased device coverage to target more specific areas of the spinal cord and advanced algorithms for attenuation and configuration; as well as power advances to use the body as an electrical source.

[See: 10 Lessons From Empowered Patients.]

What Can You Do?

When my brother Greg sustained a spinal cord injury in 1982, there wasn’t a resource to help our family navigate the challenges of paralysis. We vowed to make a difference, so no one would ever feel as hopeless as we did, by partnering with like-minded families impacted by spinal cord injury. When Christopher Reeve compelled the field to look deeper into the possibility of cures for paralysis in the 90s, my family joined forces with the Christopher & Dana Reeve Foundation and helped to restructure its research program by uniting the most talented scientists across the field of spinal cord research.

Over the years, the Reeve Foundation has invested more than $138 million in labs around the world to unite the brightest minds and accelerate scientific discovery. It is thanks to the Reeve Foundation’s persistence that cures for spinal cord injury are no longer the impossible dream, but an inevitable reality.

Epidural stimulation holds tremendous potential for paralysis, and we have celebrated unprecedented milestones the more we investigate with this technology. There is certainly more to learn and the technology must improve, but it takes perseverance and investment to achieve the goal of bringing this therapy to the clinical setting, where anyone who is living with a spinal cord injury would receive this as a standard treatment. To that end, we need widespread support from innovators on the tech front who will help us build smarter, more sophisticated devices — and, continued support from individuals and corporate leaders who see the potential to, quite literally, help people regain control of their bodies. People often say they want their lives to have impact. Nothing is as impactful to use your gifts to impact someone else in a positive way.

That is why the Reeve Foundation is working to fast-track the next phase of epidural stimulation research and usher this life-changing technology from the lab to the community by providing irrefutable evidence of its effectiveness while learning how to improve it. The study is well under way with research candidates being screened and enrolled, but it is critical that we raise the remaining funds as quickly as possible.

We’re living in an historic time in which spinal cord research is rapidly maturing and approaching an inflection point. For the first time, spinal cord injury may no longer mean a lifelong sentence of paralysis.

[See: 8 Health Technologies to Watch For.]

Many years ago, my brother inspired me — just because someone is in a wheelchair doesn’t mean they can’t be very persuasive — that we would never stop until cures for spinal cord injury were discovered despite every medical professional saying it was impossible. One thing I always agreed with Christopher Reeve about is that nothing is impossible. Cures are within our reach — hope has transformed into certainty — and technology is the catalyst accelerating the pace from bench to bedside.

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