Tag: University of Louisville
Medicine, engineering work together to build custom tool for successful therapy
Children with spinal cord injuries have experienced remarkable results in recovery at the University of Louisville and Frazier Rehab Institute through locomotor training, a therapy designed to help them recover the ability to sit, stand and even walk. In locomotor training, the child is suspended over a treadmill and his or her feet are moved by trainers in a stepping motion. This taps into capability of the spinal cord to help the child regain movement and trunk control.
Severe spinal cord injuries (SCIs) — often called complete injuries by clinicians — are ones where no readable signal from the brain reaches the spinal cord beneath the trauma, resulting in total paralysis. The possibility that a patient with this type of severe injury might regain movement was once considered so remote that rehab has traditionally seemed a waste of time.
And yet, in a handful of patients spanning multiple levels of severity, movement is being regained.
University of Louisville researchers are finding ways to help those who suffer catastrophic spinal cord injuries battle other health problems related to their injury.
The program was home to someone who went from full traumatic spinal injury, to being able to walk again
Two research participants living with traumatic, motor complete spinal cord injury are able to walk over ground thanks to epidural stimulation paired with daily locomotor training. In addition, these and two other participants achieved independent standing and trunk stability when using the stimulation and maintaining their mental focus.
The research, conducted at the Kentucky Spinal Cord Injury Research Center at the University of Louisville, was published online early and will appear in the Sept. 27 issue of the New England Journal of Medicine.
Patients with severe spinal cord injury (SCI) often experience chronically low blood pressure that negatively affects their health, their quality of life, and their ability to engage in rehabilitative therapy.
“People with severe spinal cord injury – especially when it occurs in a higher level in the spine – have problems with blood pressure regulation to the point that it becomes the main factor affecting quality of life for them,” said Glenn Hirsch, M.D., professor of cardiology at the University of Louisville (UofL). “Some cannot even sit up without passing out. They are forced to use medications, compression stockings, or abdominal binders to maintain an adequate blood pressure.”
Activity-based training has resulted in unexpected benefits for individuals with severe spinal cord injury. Researchers in the Kentucky Spinal Cord Injury Research Center at the University of Louisville have discovered that the training, designed to help individuals with SCI improve motor function, also leads to improved bladder and bowel function and increased sexual desire.
Research participants receiving activity-based training conducted by KSCIRC at Frazier Rehab Institute initially reported improvements in bladder, bowel and sexual function anecdotally. Charles Hubscher, PhD, professor and researcher at KSCIRC, has documented those changes in research published today in the journal PLOS ONE.
A research participant at the University of Louisville with a complete spinal cord injury, who had lost motor function below the level of the injury, has regained the ability to move his legs voluntarily and stand six years after his injury.
A study published today in Scientific Reports describes the recovery of motor function in a research participant who previously had received long-term activity-based training along with spinal cord epidural stimulation (scES). In the article, senior author Susan Harkema, Ph.D., professor and associate director of the Kentucky Spinal Cord Injury Research Center (KSCIRC) at the University of Louisville, and her colleagues report that over the course of 34.5 months following the original training, the participant recovered substantial voluntary lower-limb motor control and the ability to stand independently without the use of scES.
Newswise — Balance is an essential component of daily life, something many of us take for granted. But not everyone can. In the United States alone, there are about 300,000 people living with spinal cord injury (SCI) and some 12,000 new SCI cases each year, most of them young adults, 80% of them men. The recovery of motor functions—walking, standing, and balance—after a SCI is slow and limited, can be highly variable, and can take months or even years. The cost of care for SCI patients is enormous—annually over $3 billion. Studies have shown, however, that activity-based interventions offer a promising approach, and Sunil Agrawal, professor of mechanical engineering and of rehabilitation and regenerative medicine at Columbia Engineering, is at the forefront of research efforts to improve recovery through the development of novel robotic devices and interfaces that help patients retrain their movements.
Locomotor training is helping Emmalie, who was unable to walk after suffering a spinal cord injury, take steps, sit up on her own and improve her range of motion. Andrea Behrman, PhD, professor in the UofL Department of Neurosurgery, researches locomotor training in children at UofL.
“It turns out the spinal cord is really really smart. And it may be as smart as the brain,” Behrman said. “The brain gets information, listens to it, reads it, responds, integrates it and generates an outcome. When (the researchers) found that out, they said ‘I wonder if anybody can use this information in rehabilitating people with spinal cord injuries?’ And the answer is yes.”