Paralysis Recovery

Three people paralyzed for years take steps again! Read More


Nobody has ever recovered from paralysis. Until now. Patients using epidural stimulation therapy have regained abilities once believed permanently lost when the spinal cord is injured. BEL13VE is funding the medical research at the Mayo Clinic required to make recovery possible for everyone living with paralysis. Please join us.

Together, we will get this done.


Epidural Stimulation New Results – 2018

Three people paralyzed for years take steps again

September 24, 2018

 

Three people whose legs have been paralyzed for years can now stand and take steps again.

Each patient received an implanted device that provides an electrical stimulus to the injured spinal cord and underwent months of intense rehab.

Jered Chinnock walks down a clinic hallway with his therapy team at Mayo Clinic in Rochester, Minn. on Sept. 18, 2018. Chinnock, paralyzed since 2013, is taking steps again thanks to an electrical implant that zaps his injured spine and months of intense rehab as part of a medical study at the clinic. From left are physical therapist Megan Gill, Chinnock, kinesiologists Daniel Veith and Margaux Linde, and doctoral candidate Jonathan Calvert. (AP Photo/Teresa Crawford)

Medical Research Milestone

These results were reported by two teams of scientists working separately. The procedure is not a cure.  When the spinal stimulator is switched off,they can no longer voluntarily move their legs.

But during one physical therapy session at Mayo Clinic, 29-year-old Jered Chinnock moved back and forth enough to cover about the length of a football field.

Severe spinal cord injuries leave the brain’s “get moving” instructions unable to reach the nerves that activate muscles. Previous researchhas tried other technologies, such as encasing patients in robotic-like exoskeletons or implanting muscle stimulators, to help move paralyzed limbs.

With this new approach, referred to as epidural stimulation, the three patients are taking steps under their own power — intentionally moving, according to the reports published Monday by Nature Medicine and the New England Journal of Medicine.

How does it work? One theory: Circuits of nerves below the injury site are dormant, but still living. Applying electrical current, in customized patterns, could wake up some of those circuits and, with rigorous rehab to revive the rusty connections, eventually enable them to receive simple commands.

 

Mayo Clinic Results – Journal Nature Medicine

“This study gives hope to people who are faced with paralysis that functional control may be possible,” said Dr. Kendall Lee, a Mayo neurosurgeon who treated Chinnock and co-authored the Nature Medicine report.

Lee and Kristin Zhao, who directs Mayo’s assistive and restorative laboratory, lead the research team that became the first in the world to successfully replicate and validate recovery results achieved using epidural stimulation.  Chinnock is the first patient in that Mayo study, and his success surprised them.

“The walking side of it isn’t something where I just leave my wheelchair behind and away I go,” Chinnock, of Tomah, Wisconsin, told The Associated Press. But, “there is the hopeful side of, maybe I’ll gain that — where I can leave the wheelchair behind, even if it is to walk to the refrigerator.”

Jered was paralyzed in a 2013 snowmobile accident, with no movement or sensation below his mid-back. He underwent 43 weeks of intense physical therapy and stimulator adjustments. At first, trainers positioned his knees and hips to help him stand, swing his legs and shift his weight on a treadmill.

But eventually, watching in a mirror, he learned to move his legs and propel himself forward with a walker, albeit with a trainer behind in case he loses his balance.

He can tell his therapists when he’s going to start, stop or speed up, Zhao said: “It’s very much a thoughtful, intentional movement.”

University of Louisville Results – New England Journal of Medicine

“Recovery can happen if you have the right circumstances,” said University of Louisville professor Susan Harkema, who co-authored the New England Journal study. The spinal cord “relearns to do things, not as well as it did before, but it can function.”

Four years ago, in April 2014, Harkema’s team made headlines when a four patients implanted with spinal stimulators — originally developed to treat pain — were able to wiggle their toes, move their legs and briefly stand. But they didn’t walk.

Harkema’s team continued working with epidural stimulation, and of four new paralyzed volunteers eager to test the approach, two eventually walked with assistance. In one training session in the lab, Jeff Marquis, 35, of Louisville made it almost the length of a football field without stopping for a rest.

“One day we were walking and they were helping me as usual and then they stopped helping me and I took maybe three or four steps in sequence,” Kelly Thomas, 23, of Lecanto, Florida, recalled. “My eyes got teary and I was like, ‘Oh my god. That just happened, I just took steps.'”

It’s not clear why the other two Louisville, Kentucky participants weren’t able to take independent steps. But that report illustrates an important caution about safety: One fractured a hip during a rehab treadmill exercise even while carefully supported and upright.

A Start. Much More Work Required.

The approach will need larger and longer studies not just to see if it can help other patients but to delineate risks. It’s also not known how much such care would cost, as researchers work to improve the stimulators.

The work is part of a quest to help people with spinal cord injuries regain function, and specialists say while it’s only been attempted in a few people, it’s a promising approach that needs more study.

“I’m really excited about this,” said Johns Hopkins University rehabilitation expert Dr. Cristina Sadowsky, who wasn’t involved in the new research. It tapped into “residual connections that are not being used” after a spinal cord injury.

Still, “not everybody who has a similar injury will respond the same,” cautioned Sadowsky, who directs spinal cord therapy at Baltimore’s Kennedy Krieger Institute.


Recovery Results

Epidural Stimulation Early Results – 2012 – 2017

For the first time, research has found a way for people living with chronic paralysis to regain what was lost. Until now, therapy has been limited to helping people live with what was lost.
Using a grant from the BEL13VE Foundation and other funding, in April 2017 Mayo Clinic became the first medical center in the world to replicate and validate paralysis recovery results achieved using epidural stimulation.

Jered is the fifth patient with results published in medical journals to use epidural stimulation therapy to regain abilities once believed to be permanently lost. According to the Mayo team, Jered’s results exceed anything achieved so far.

Starting in 2011 at the University of Louisville, Dr. Susan Harkema performed the first four successful epidural stimulation procedures on human patients with chronic paralysis. Rob Summers (at right in the picture above) was the first to undergo the procedure.

Four young men on wheelchairs smiling at the camera

Three years prior to replication study completed by Mayo Clinic, in April of 2014, Dr. Susan Harkema was featured on the Today Show and in numerous other national and regional news stories to talk about the stunning findings from her research on spinal cord injury recovery using epidural electrical stimulation.

Today Show Video: https://youtu.be/p05XhJbkA7c

Starting in 2011 at the University of Louisville, Dr. Susan Harkema performed the first four successful epidural stimulation procedures on human patients with chronic paralysis. Rob Summers (at right in the picture above) was the first to undergo the procedure.


Medical Journal Reports

Nature Medicine, September 2018

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“Neuromodulation of lumbosacral spinal networks enables independent stepping after complete paraplegia”

New England Journal of Medicine, September 2018

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“Recovery of Over-Ground Walking after Chronic Motor Complete Spinal Cord Injury”

Mayo Clinical Proceedings, April 2017

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“Enabling Task-Specific Volitional Motor Functions via Spinal Cord Neuromodulation in a Human With Paraplegia”

Mayo Clinic became the first medical center in the world to replicate and validate paralysis recovery results achieved using epidural stimulation.

Reports on a case of chronic traumatic paraplegia in which epidural electrical stimulation (EES) of the lumbosacral spinal cord enabled (1) volitional control of task-specific muscle activity, (2) volitional control of rhythmic muscle activity to produce steplike movements while side-lying, (3) independent standing, and (4) while in a vertical position with body weight partially supported, voluntary control of steplike movements and rhythmic muscle activity. This is the first time that the application of EES enabled all of these tasks in the same patient within the first 2 weeks (8 stimulation sessions total) of EES therapy.

Brain, A Journal of Neurology, April 8th, 2014

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“Effect of epidural stimulation of the lumbosacral spinal cord on voluntary movement, standing, and assisted stepping after motor complete paraplegia: a case study”

Exciting Recovery Research Results

A study published in the medical journal BRAIN found that four young men classified with a chronic motor complete spinal cord injury (just like Jack) were not only able to voluntarily move their legs in the presence of epidural electrical stimulation, but also regained voluntary movement in their hips, knees, ankles and toes.

Even more amazing, and unexpected, these first four research participants have also shown a myriad of improvements in their overall health, including increased muscle mass, improved regulation of their blood pressure, reduced fatigue, and they were able to bear weight independently…stand! They also each regained bowel, bladder and sexual function.

“The circuitry in the spinal cord is remarkably resilient. Once you get them up and active, many physiological systems that are intricately connected and were dormant come back into play,” said V. Reggie Edgerton, Ph.D., UCLA distinguished professor of integrative biology, physiology, neurobiology and neurosurgery and a contributor to this new research work.

These research results are truly amazing and inspire our foundation to keep pushing to bring a sense of urgency, awareness, and funding to spinal cord injury recovery.

Lancet, May 20, 2011

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“Effect of epidural stimulation of the lumbosacral spinal cord on voluntary movement, standing, and assisted stepping after motor complete paraplegia: a case study”

From the National Institutes of Health

National Institute of Biomechanical Imaging and Bioengineering

2015

Framework for a Research Study on Epidural Spinal Stimulation to Improve Bladder, Bowel, and Sexual Function in Individuals with Spinal Cord Injuries – Read Article

June 2016

Spinal cord stimulation helps paralyzed people move hands – Read Article