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Paraplegics walking again?

Dr Ross Walker
Thursday, November 15, 2018

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Around a month ago, I gave a talk in Beijing on the Future of Medicine. One of the key points to this talk was the future of bionics and also of stem cell therapy. I suggested the strong possibility of people with spinal injuries being able to regrow new nerves in the damaged spinal-cord, allowing them to walk again.

A recent report from Switzerland published in two journals Nature and Nature Neuroscience, using electrical stimulation is bringing medicine closer to this extraordinary breakthrough. Three men with cervical spine injuries from years previously have been able to walk again with this new technique. Even more extraordinary was the fact that they could still move their legs once the electrical stimulation used as treatment was switched off.

Proprioception is the sense of body position and it appears that this is vital when using electrical stimulation. The electrical stimulation must have the right combination of the very precise location of the damaged nerves and also precise timing of pulses, which do not interfere with proprioception.

This new technique, known as the STIMO method, uses what is known as burst stimulation to have robust control over the activity of motor neurones. It basically mimics what occurs naturally in the spinal cord when motor neurones are stimulated. After five months, voluntary muscle control was improved and the three men involved in the study showed no fatigue in the leg muscles and were walking hands-free for more than a kilometre during the rehabilitation process. It appears that these very intensive sessions triggered what is known as “activity dependent plasticity” in the nervous system and thus reorganised nerve fibres. Strangely, this appeared present even when the electrical stimulation was switched off.

A spinal cord injury is clearly one of the most devastating conditions that can affect any human being and can occur at any age. Well over a third of these types of injuries are related to motor vehicle accidents, just over 30% from falls, 14% from violence and 8% from sports and other recreational activities. Any new therapies available for this condition are, of course, vitally important and major breakthroughs. With the giant leap forward in computing over the past few decades, the ability to develop smaller devices with much greater accuracy and fidelity, we will see electromagnetic therapy in its various forms becoming more prominent in medicine.

Whether it be some form of regenerative medicine, such as stem cell therapy, or these huge advances in electrical stimulation, any treatment that allows previously wheelchair bound people to walk again can be considered close to a miracle.

Published: Thursday, November 15, 2018

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