After someone has injured his or her spinal cord, they can get a motor complete’ diagnosis. This means that they are unable to move any part of the body below the injury voluntarily. According to some evidence, staying motor complete’ for about two years will result in the patient never being able to move those body parts again. The good news is that this prognosis is now different, thanks to a new study funded by the Christopher and Dana Reeve Foundation.
Four patients with spinal cord injuries can now move muscles that were previously paralyzed after undergoing a novel therapy involving electrical stimulation of the spinal cord. The patients had been paralyzed for over two years. They were able to flex their ankles, knees and toes voluntarily when the stimulator was active, with the movements being enhanced when done together with physical rehabilitation. According to the researchers involved in the study, the therapy is likely to change the prognosis of paralysis patients even years after they incurred the injury.
The study appears to indicate that electrical stimulation is capable of reprogramming damaged spinal cord nerves in a way that they can regain ability to respond to stimuli. After getting injured, patients are told that they may not be able to move again and are likely to be wheelchair bound for the remainder of their lives. This means the study has far-reaching consequences, especially for people who have been classified as sensory or motor complete.
A notable finding of the study is that two of the participants who benefited from the spinal stimulation had complete sensory and motor paralysis. In the two, the pathway sending sensation stimuli from legs to the brain is disrupted, together with the one that sends information from the brain to legs so as to control movement. The outcome came as a surprise to the researchers. This is because they had assumed that for the therapy to be successful, some of the sensory pathway had to at least be intact.
The aim of the stimulation was to improve local circuits’ sensitivity in the spinal cord that carries out basic motor functions without the brain’s input. The stimulation may not be strong enough to induce muscle activation directly by itself. However, the researchers feel that the stimulation could result in movement if combined with sensory input. They highlight the speed at which each patient recovered voluntary movement as proof that dormant connections may exist in people suffering from complete motor paralysis.
A vital aspect of the study was about assessing the ability of each participant to modulate movements in response to audio and visual clues. The researchers hoped they would determine if the patients could move voluntarily after being stimulated, as well as the level of control they had on their movements. All four participants were able to synchronize ankle, toe and leg movements in unison with fluctuations of a wave displayed on a computer monitor.
There is still a lot of work to be done. However, the study is a wake-up call for how doctors perceive motor spinal cord injuries. Findings from the study offer enough proof to challenge currently held beliefs about such injuries.