According to a new study published in IEEE Transactions on NS&RE, it is possible to regain control in arms and hands after spinal injury. A group of researchers working at UoW combined physiotherapy with stimulation of cells of spinal cord in six patients who had lost control of their arms and hands. As a result of this therapy, these patients regained use of arms and hands and the positive outcome of the therapy lasted up to 6 months.
According to the lead researcher of this group at UoW, “We use our hands for everything — eating, brushing our teeth, buttoning a shirt. Spinal cord injury patients rate regaining hand function as the absolute first priority for treatment. It is five to six times more important than anything else that they ask for help on.” Statistics show that more than 15,000 Americans lose control of their upper limbs after injury related to spinal cord every year.
Earlier studies had shown positive results of electric stimulation in effort to regain control of lower limbs in patients suffering from spinal injury. The team at UoW developed patches which were non-invasive to apply and delivered electric stimulation on targeted spots on the spinal cord. The pool of patients recruited for this study suffered from spinal injury almost one and a half year ago and had some response to no response in their arms and hands.
In order to assess the role of nerve stimulation through skin patches, the study was divided into 5 months and over the course of time they were treated with a both nerve stimulation and physical therapy as well as one of the above. The study group was segregated on the basis of severity of their injury and then their therapies were changed to better assess the effects.
The gain of function varied between the participants but the therapy showed promising improvement in motor function in all of them. A senior author of this study commented on the results that, “Both people who had no hand movement at the beginning of the study started moving their hands again during stimulation, and were able to produce a measurable force between their fingers and thumb. That’s a dramatic change, to go from being completely paralyzed below the wrists down to moving your hands at will.”
In addition to these improvements, participants of the study reported that the therapy helped them regulate other important body functions such as bladder control, temperature regulation and maintaining a normal pulse. A follow up of these participants further affirmed that the effects of electrical stimulation and physical therapy remained for as long as six months after the therapy.
An expert working at Center for Neurotechnology said that the stimulation from these skin patches does not actually make the muscle move or cause it to move. The stimulation essentially makes the muscles ready for action when the body wants it to. Similar to this is the situation when a sprinter is primed at the start of the race so that he is in position for the sprint.
Therefore, when the body wants to move, the nerve connections around the spinal injury that have remained intact provide sufficient stimulus to the muscle to cause movement.
The research group is now preparing the launch of this study for helping spinal injury patients in the clinical settings. The aim of their next study is to develop a trial on an international scale where clinical studies will be conducted simultaneously and one of the sites for study will be UoW.
Researchers are hopeful that electrical stimulation of the spinal cord has shown promising results in studies being conducted all across the globe but they think the improvements that have been seen in the patients are not only because of the stimulation of the spinal cord. According to a co-leader of the research group, “It does take motivation. The stimulator helps you do the exercises, and the exercises help you get stronger, but the improvements are incremental. Over time, however, they add up into something that’s really astounding.”
This research was funded by the Center for Neurotechnology, the Washington State Spinal Cord Injury Consortium and the Christopher and Dana Reeve Foundation.