Non-Invasive Spinal Cord Stimulation Gets Paralyzed Legs Moving Again

schwit1 writes: A new technique called transcutaneous stimulation has allowed five men with complete motor paralysis regain the ability to move their legs voluntarily and produce step-like movements. The treatment requires no surgery and adds to prior work to help paralyzed people gain voluntary movement through electrical stimulation (one completed in 2011, the other in 2014). Gizmag reports: "The new treatment uses a technique called transcutaneous electrical nerve stimulation, which involves strategically placing electrodes on the skin of the lower back. While receiving stimulation, the men's legs were supported by braces that hung from the ceiling. At first their legs only moved involuntarily, if at all. But they soon found they could voluntarily extend the distance their legs moved during stimulation. They doubled their range of voluntary motion after four treatment sessions."

Comments

Looks promising

[The Real Dr John]

They have more work to do but this looks quite impressive considering. The patients had slight movement before the treatment, so there were functioning fiber connections, but the ability was minimal. After treatment, there was much greater control. An excellent start on getting this to work with some patients.

Re:Looks promising

[The Real Dr John]

The video linked to at the bottom of the article showed very slight movement when their legs were tethered to keep them suspended. It was very minimal, and would not be usable for any actual movement. But it indicate that some nerve fibers must still have been connected.

Re:Looks promising

[CaptQuark]

Transcutaneous electrical nerve stimulation (TENS) units are not new. I have been using one for 10 years to control lower back pain (with mixed results). What is interesting in this study is using a TENS unit with patients with complete motor paralysis to help rebuild/retrain nerve connections allowing them more voluntary control of their lower extremities.

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Re:Looks promising

[JimSadler]

This may be better than it sounds at first. Maybe a learning process can result in which the damaged nerve can improve the ability to communicate with the brain and tissues required for controlled movement. And if all else is of little value it might provide a good way to exercise the lower body to maintain strength and circulation in the tissues. So maybe what we have is to be considered on a scale with good at the bottom point and fabulous at the top point of the scale. I do wonder if some stem cell nerve tissue sort of thing could not be added in parallel with the existing nerve to enhance the neural pathway or why it is so difficult to do such things.

Limited Usefulness

[spineboy]

Unfortunately, these types of devices will always be of limited usefulness for most pre-existing spinal cord patients. Why? - because after only a few months, most muscles have had permanent wasting, and joints have begun to contract, often permanent as well. Bones have undergone significant disuse osteopenia. Unless the patient has Christopher Reeve type resources, then the day to day intensive PT to mobilize limbs does not occur.

Even in young healthy patients, even having a cast on for 2 months results in permanent muscle loss.

Br J Sports Med. 2006 Jun; 40(6): 552–553.
doi: 10.1136/bjsm.2005.020743
PMCID: PMC2465116
Calf muscle wasting after tibial shaft fracture
M Khalid, A Brannigan, and T Burke