Retraining the brain

Published: October 1, 2006  |  Source: bionessinc.com
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New device offers a glimmer of hope for victims of spinal injuries and stroke

Jeremy Doman picked up a little stuffed piggy, moved it a foot and set it down.

That’s what it looked like, anyway, to an observer sitting in on his therapy session. In truth, a contraption strapped around Doman’s forearm sent electrical impulses to his muscles, contracting them to pick up the toy and relaxing them to release it.

The Grants Pass man lost the use of his arms and legs in an accident on the Rogue River July 16. The device that therapists have been using to help him regain use of his hands and arms takes an old concept — electrical stimulation of muscles — and updates it with modern technology.

“It tries to teach your brain,” said Doman, who worked as a helicopter mechanic before his accident.

Doman was swimming with friends on the Rogue River near Argo and dove into the water where a patch of shade concealed a shelf of rock just below the surface. The impact damaged his spinal cord and left him a quadriplegic.

Therapists have used electric current for years to restore muscle function for victims of stroke and spinal injury, but the process was slow and cumbersome, said Jodie Dilansa, an occupational therapist at Providence Medford Medical Center who has been working with Doman. Therapists had to locate muscle “trigger points” for each patient and place a series of electrodes over them before they could pass a current through the muscles.

Most of the time a therapist had allotted to work with a patient was spent just setting up the wiring, Dilansa said.

The new Israeli-designed hand stimulator incorporates brace-like arm pieces and a curved piece of plastic that wraps around the wrist and rests on the fleshy base of the thumb. Five removable pads on the braces have built-in electrodes for the trigger points. Pads are supplied in several sizes so therapists can fit the device easily and quickly to most patients’ arms.

When an electrical current makes the muscles move, and the patient watches the movement and thinks about doing it, the brain begins to restore the damaged nerve path for the movement or build a new one.

“The feedback is visual,” said Dr. Cornelia Byers, who specializes in physiatry, the practice of restoring physical function for people who have been disabled by accident or disease.

A wireless control module allows the therapist to program how frequently the muscles will grasp and release, and the time interval between each function.

Unlike many pieces of cutting-edge medical equipment, the stimulator (marketed by Bioness Inc. of Santa Clarita, Calif.) is relatively inexpensive. It retails for about $6,000. Byers said the apparatus (marketed as the Ness H200) offers tremendous promise for stroke victims who have had limited restoration of hand and arm function.

“It’s a breakthrough device in a sense,” she said. “We have very few devices that have been shown to help with arm recovery after stroke.”

She cautioned, however, that the equipment has its limits. It’s unlikely, for example, to help stroke victims who have had no restoration of movement.

“If somebody hasn’t moved an arm at all for a year or 10, this isn’t the device that’s going to help them,” she said.

For Doman, though, the outlook is encouraging. In the two months since he started using the device he has regained enough use of his left hand and arm to do complex but mundane tasks such as scratching his face, eating French fries and brushing his teeth.

“It’s been a huge boost to our morale,” said his wife, Jennifer.

“It’s dramatically accelerated my hand movement,” he said. “When I first came in here, the thought of moving anything was pretty slim. I think it moved me along a lot faster.”

For more information on the device, see www.bionessinc.com on the Web.

By Bill kettler Mail Tribune
Reach reporter Bill Kettler at 776-4492