Trading Wheelchairs for Walkers: Promising New Therapy

[BirdeR]

Trading Wheelchairs for Walkers: Promising New Therapy

from WebMD Health

Gina Shaw, Medical Writer(Gina Shaw is a freelance medical writer based in Washington DC.)


http://sci.rutgers.edu/forum/images/smilies/biggrin.gif "One patient with spinal cord injury had been doing physical therapy for a year and still was not ambulatory," says Dr. Winchester. "He's a T-10 paraplegic. After 2 weeks on the harness, he's already started walking with crutches over ground."

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

A few months ago, Sherri Drakeford would never have dreamed she could walk on crutches. The 45-year-old mother of two had been hit with a double health whammy: After years of battling multiple sclerosis (MS), she was diagnosed with breast cancer. Drakeford had three surgeries and spent 12 weeks in the hospital, followed by 7 weeks of chemotherapy. What progress she had made in strengthening her body and fighting for mobility was erased by postsurgical weakness and months spent in bed.

http://sci.rutgers.edu/forum/images/smilies/biggrin.gif Then Drakeford's neurologist at the University of Texas-Southwestern Hospital in Dallas heard about an exciting new machine that had been brought in by Patricia Winchester, PhD, chair of the hospital's physical therapy department. The innovative treatment uses a combination of a treadmill and a suspension harness to help people with spinal cord injuries and other disabilities regain some of their ability to walk.

In September 1999, Drakeford began a rigorous training program on the treadmill. In a typical training session, Drakeford is strapped into the harness like a mountain climber. Then, Dr. Winchester wheels her up a ramp onto the treadmill. She's hooked up to a suspension system at the shoulders, and hydraulic lifts hold her upright. Then she takes one step, then another, and another. Two to three times a week since September, she has traveled to the medical center. She is improving her stamina, balance, and ability to support her own weight, week by week.

"For the first time in 4 years, I can walk on crutches," Drakeford reports ecstatically. "I showed my oncologist last week and he was stunned: I can't wait to show my neurologist. I can't walk a long way and I have to have someone spotting me, but never in my wildest dreams would I have thought I could walk on crutches at all."

Learning To Walk Again

http://sci.rutgers.edu/forum/images/smilies/biggrin.gif Essentially, the system retrains the body to walk. For patients with neurological deficits caused by spinal cord injury or MS (like Drakeford), poor muscle strength, decreased muscle tone, and poor balance make walking difficult. Treadmill workouts help to retrain the locomotive center in the spinal cord, which Dr. Winchester says is thought to control the step patterns of walking. The suspension harness allows patients to bear as much or as little weight as they can manage, gradually moving up to standing more and more under their own power.

"The number-one outcome is improving a person's function. Once they start walking, they will maintain the level they have achieved through therapy," says Dr. Winchester.

So far, Dr. Winchester has worked with a total of 13 patients using the treadmill-suspension system: six MS patients, six spinal cord injury patients, and one woman with a traumatic brain injury. She happily reports that every one of these patients is making progress.

http://sci.rutgers.edu/forum/images/smilies/biggrin.gif "One patient with spinal cord injury had been doing physical therapy for a year and still was not ambulatory," says Dr. Winchester. "He's a T-10 paraplegic. After 2 weeks on the harness, he's already started walking with crutches over ground."

The woman with traumatic brain injury has also experienced remarkable results using the treadmill and harness. Three years after her injury, she continued to experience such severe tremors that she couldn't even roll over in bed by herself. After 6 months of using the treadmill, says Dr. Winchester, "She's now independent in bed mobility, transferring independently from her bed to the wheelchair to the toilet, and she's now walking with minimal assistance with a rolling walker." On the treadmill, Dr. Winchester reports, the tremors aren't even visible any more.


Dr. Winchester's case reports of success with peer-reviewed reports from the University of Bonn, where weight-suspended ambulation was first used in this way. It has been used for some time to rehabilitate stroke patients. But Dr. Anton Wernig, a German researcher, was the first person to use the treadmill training for patients with spinal cord injuries. Previous studies showed that function in paralyzed animals improved with treadmill therapy, and their condition deteriorated once they stopped.

http://sci.rutgers.edu/forum/images/smilies/biggrin.gif Dr. Wernig, who dubbed the treadmill system "Laufband," has published reports of the system's success in several international neurology journals. "Many patients with chronic paralysis, still wheelchair-bound and not capable of walking without help from others, became independent and learned to walk for some distance without help," he writes in the August 1999 issue of the Journal of Neurotrauma. In cases of both acute and chronic paralysis, the German studies find that patients who participate in treadmill therapy fare better in achieving improved mobility--sometimes after years in a wheelchair--than do patients who pursue standard rehabilitation therapies.

http://sci.rutgers.edu/forum/images/smilies/biggrin.gif "Our hope is that if patients can learn to walk over ground independently, they won't have to rely on other people or wheelchairs for assistance," says Dr. Winchester. "My goal is not for them to walk on the treadmill the rest of their life, but for them to get improved enough to walk in their home and in the community setting."

Drakeford, for one, is a believer. A few weeks ago, she returned to the community gym where she can once again exercise independently. "It's given me the confidence that I can get up and walk again, at least in the walker and maybe on crutches," she says. "After 4 years, that realization just about blew me away."

http://sci.rutgers.edu/forum/images/smilies/biggrin.gif The treadmill system is now being tested on patients with varying degrees of paralysis at half a dozen centers in North America:


UT Southwestern.
UCLA Medical Center.
Cleveland Clinic.
Mississippi Methodist Rehabilitation Center.
Houston VA Medical Center.
Montreal Rehabilitation Institute.

http://sci.rutgers.edu/forum/images/smilies/biggrin.gif
--------------------------------------------------------------------------------
Reviewed by:
Beth Israel Deaconess Medical Center. Reviewed for medical accuracy by physicians at Beth Israel Deaconess Medical Center (BIDMC), Harvard Medical School.

[etexley]

Wow. I had no idea how effective suspended ambulation was. How much of the improvement is due to "locomotor training" and how much is due to the body healing, and the nerve pathways shutting down?

I'd bet there are many, MANY people with chronic SCI that can benefit from this therapy. OMGosh. So the question is, how can a person learn to do it on his/her own???

Eric Texley

[Chris Chappell]

Take a look at www.litegait.com (http://www.litegait.com)

or www.projectwalk.org (http://www.projectwalk.org)

Agreed, we should all be doing this.

BTW, CR credits his PT as critical to his health which he says is the best since his injury. He, at C3 gait trains (supported harness) three days a week. He was complete but now is able to feel touch in his legs and can move his index finger.

So whether you're complete or incomplete gaiting seems to be beneficial.

[rbyrd49100]

I read that someone else on here recieved a quote from Litegait for $250 a month for rental. I contacted them and recieved a quote for $350 per month. I guess it depends on which salesperson you talk with http://sci.rutgers.edu/forum/images/smilies/smile.gif

Maybe I could buy the harness and the treadmill, take Steve up to the shop ( I'm a machinist) and suspend him with the tow motor. It should work just as well, and maybe I could even convince him to change out some of ballasts on our lights whiule he is hooked up.

Even $250 would have been tough, but $350 no way. Unless Medicare covers it.

Russ Byrd

[foster]

thats what I did brought harness and got air hoist and made bar to hook harness on and away we go.we jack him up he loves it.

[Scorpion]

Call me crazy, but this whole assisted gait training sounds like a sham. I don't see how this is going to help me regain anything. If someone's incomplete and has some voluntary motor function MAYBE, but if the neural connections aren't there, me being in a giant baby-bungee swing overtop of a treadmill ain't gonna do squat. http://sci.rutgers.edu/forum/images/smilies/rolleyes.gif

And I don't have $350 a month to blow on a swing.

~Rus

"Life's a bitch, but I love her."

[etexley]

Then again, maybe your body has recovered some motor connections. But because the peripheral nerve system has shut down, you don't know they are there... To quote a famous person around here, "complete is not complete."

Eric Texley

[foster]

Eric we are doing this at home and I'm telling you it works after 3 half hours my son started to take steps himself not perfect but he was doing it.And we are going to check out project walk in a couple of weeks.

[etexley]

It will take years before this makes it to clinics because they are worried about being sued.

I wonder....if a clinical trial was done in which sub acute patients began supported ambulation immediately (ALL such patients) and comtinued into outpatient, how many patients would be walking? How much of paralysis is real, and how much is psychological programming? I understand that it takes time for bones to fuse and heal, but the things they were having me do (get in and out of a wheelchair) couldn't be any worse for fused bones than supported ambulation on a tread. I couldn't fully bare weight for a long time because of a bad break.

[This message was edited by Eric Texley on Mar 10, 2002 at 10:04 AM.]

[hemikid]

Found this to be interesting:

http://www.electriciti.com/spinal/

[rbyrd49100]

Hate to ask you this, but would you mind describing your treadmill set up in detail?:)

Russ Byrd

[Chris Chappell]

I know it sounds crazy, and it may not work for you or me but there have been numerous studies (check out some of BirdeR's posts) that have and are been/being done. Projectwalk is just one, also U of WA (Dr. John Mcdonald) - St. Louis is very involved in this. Do a search under 'gaiting' and you'll find additional research / testimonials.

Essentially, (anyone please correct me if I'm wrong) the theory, concept, as I understand it is (and yes it is, for obvious reasons, more successful in incompletes than completes) that before we're born we're hardwired (genetically) to walk, without being taught. Therefore by putting our legs in motion we may be able to trigger the pathways necessary to re-support ambulation and essentially re-route our walking signals to our brain.

With enough practice, who knows? BTW, this is what CR does 3x a week and he is feeling and progressing better than he ever has since his injury.

I think that overall, aggressive PT is very beneficial.

Hemikid. Old, very old, news. You may want to try doing a 'search' next time before posting. Chances are its been discussed. Good effort though.

[Scorpion]

Originally posted by Eric Texley:

Then again, maybe your body has recovered some motor connections. But because the peripheral nerve system has shut down, you don't know they are there... To quote a famous person around here, "complete is not complete."

My peripheral nerve system hasn't shut down, as evidenced my my spasms and spasticity. But moving my legs in walking motions isn't going to fix my spinal cord, as far as I can figure it. And how is this supposed to help a quad like me anyway? How is this supposed to fix my trunk muscles, chest, triceps, fingers, etc? I'm incomplete over 11 years (sensory), but I have a hard time believing this would benefit me more than just the weight bearing & circulstion. http://sci.rutgers.edu/forum/images/smilies/rolleyes.gif

~Rus

"Life's a bitch, but I love her."

[Scorpion]

Anybody know how many of these people were paras vs. quads?

~Rus

"Life's a bitch, but I love her."

[foster]

Russ we have a air hoist to lift my son up which I cut a hole through the ceiling and floor. Build a wood frame to hold the hoist. Have 1" tubing as a bar to hold harness with two eye bolts. A DP treadmill I got from family. Seems to work very well. Wife and I move his legs for couple minutes then he starts to take steps. They are not perfect we have to help plant his feet. We met a man in rehab who was injured at t12 or l1 not sure about 5 months ago who was in the trial he is walking with crutches after 54 times on the treadmill. Not perfect but he is walking. It is hard work for all of us but seems to worth it.

[BirdeR]

Ya know, I spoke to a woman on the phone two weeks ago who descibed her much similar set up at home.

It would seem that her father has set up a treadmill for her and she loves it! They had a treadmill...electric, and with arms on the sides...look in the papers people and see if you can't get a bargin on one that someone is trying to get rid of.......next her dad used an engine hoist.......seems they also had that as he is a garage-guru........the engine hoist has to be able to support your body weight......most do.....we have one that can lift up to 300 pounds.

Next they had to find the body harness.....I have heard that these can be purchased....but tend to be very pricey......so, her dad went to a local Amish man and described what they needed and the man made it for pennies! I also have been told that a cobbler may be able to make this or a leather craftsman......or just about anyone with serious sewing skills and the proper material.

The harness resembles a giant diaper of sorts (so this woman explained), it is attached to the engine hoist with "O" rings.....and that is about it......turn the treadmill on (lowest speed) and at first you will need alot of help with the feet,knees,legs...But she said she is taking the steps.....as was Jim.....all be it primative, slow, not-steady.....but practice and persaveriance...........That may be the key! http://sci.rutgers.edu/forum/images/smilies/wink.gif

[BirdeR]

Generally speaking, it can be said that the human brain controls the motor actions of the body. But it does so not solely, as recent studies have shown. Also the spinal cord proves to have maintained the capability of controlling
and evoking certain basic motor patterns e.g. of the lower limbs - a capability not readily recognizable under "normal" circumstances.

In case of spinal injury - provided that the cord remains to some, however small extent connected to the brain - these programs may - driven by information from the limbs - contribute to stepping . Thus limbs need to be set correctly - even when initially set passively by therapist - and all this needs to be trained
for weeks, agressively. If one wants to walk again, upright walking needs to be trained. The nervous system can learn, also the spinal cord can learn. It knows rules, the "rules of spinal locomotion".

The Laufband (treadmill) Therapy

It is exactly these capabilities of the spinal cord that the Laufband (LB) Therapy is primarily based on. By the way, LAUFBAND is another German
name for Tretmühle/treadmill, which sounds more appropriate than treadmill in connection with training patients.

The idea is to teach the part of spinal cord below the point of injury to take as much control as possible of the affected region and to possibly rearrange remaining voluntary activity.

During LB Therapy this is achieved in various series of trainings that at first consist basically in walking upright on a motor driven treadmill. The patients´ weight is supported during these trainings by a special harness
suspended from the ceiling, and initially they are aided by the therapists.

Naturally the therapists need to be highly trained to understand and properly apply the "rules of spinal locomtion". Thus the spinal cord is provided with "information" from the limb muscles (such as load, direction, speed etc.) and
prompted to react to them. And it learns to react to it, not in all but in considerable numbers of patients, by fitting in the missing "information", by completing the same movement it was prompted by. Then the cycle starts again: stimulated by movement the spinal cord generates new movement.

Unlike in training lower vertebrates, it has proven crucial to the effect of LB Therapy that there is some amount of voluntary motor ability left in the affected limbs. Naturally the more the better.

Once the harness is secured tightly and comfortably, the patient starts training on the treadmill. Assisted by therapists, and his/her weight supported by the harness, the patient stands on the treadmill, which is then set into motion. The goal of this part of the therapy is to prompt the spinal cord to react to the movement of the legs provoced by the movement of the treadmill.

With this reaction being persistant, the patient can develop his/her own walking scheme, which he/she then learns to control to a certain extent - depending strongly on the severeness of injury,(i.e. the remaining spinal connections between the brain and the limbs).

[TD]

I guess this means that all that time I spent in my pool learning to "walk" around the edge was not a waste of time after all. Summer is coming...time to go for a dip!! http://sci.rutgers.edu/forum/images/smilies/smile.gif http://sci.rutgers.edu/forum/images/smilies/biggrin.gif http://sci.rutgers.edu/forum/images/smilies/biggrin.gif http://sci.rutgers.edu/forum/images/smilies/cool.gif

"And so it begins."

[PWClient]

You really can retrain your muscles after injury. Your entire body has to get strong again to support your weight. Repetition is surely the key to retraining muscles to function again. I am seeing this in my son since going to Project Walk. It is really amazing. Check out their website at projectwalk.org

[Scorpion]

Originally posted by Scorpion:

Anybody know how many of these people were paras vs. quads?

~Rus

"Life's a bitch, but I love her."

[bruce]

I've been using a LiteGate at the University of Washington Hospital for 6 or 7 weeks now, since they got it. I was walking with a walker and a KAFO brace on my right leg before the LiteGate. Last week, after using the LiteGate 2 to 3 times a week since its arrival, I can now walk with crutches and an AFO only.

It's strengthened my hip flexors and my quads just above my knees. It's also improved the gait in my right leg--I can place my heel and use the leg more naturally than before. The strengthening alone has made it worthwhile.

[chastev8]

I was swimming at the only pool in that had a lift in my small town. When the weather became too cold I found a therapy that had a small indoor pool with a treadmill in it. I found out such a set up would cost about 10,000. I was thinking that it should be possible to lower the water level which would make more weight bearing, the same way they do it with the harness and all that business. In the water it requires the patient to work the finer muscles for control instead of relying on therapist for the gudance, and reduce momentum. I would think that it would be possible to find a treadmill that would go into most pools.

[Snowman]

Project Walk will soon be equipped with a LiteGait style apparatus. It is in the final stages of testing. It will suspend the client over a choice of 3 different types of exercise equipment: treadmill, spin bike, and an elliptical cross-trainer. We are looking forward to its arrival and the benefits it will bring to our clients.

To foster

Thanks for coming in to see us. We enjoyed having you and your son in our facility this week.

Eric

Project Walk (http://www.projectwalk.org)

[Sue Pendleton]

Scorpian, You may have to eat that sham. http://sci.rutgers.edu/forum/images/smilies/biggrin.gif Under trials there are 2 US trials of supported body weight ambulation therapy (SBW therapy). One by the Houston VA and the other at 5 centers by the NIH. Anton Wernig in Bonn and Volker Dietz in Zurich have done extensive work on this therapy since 1991-92. Dietz has even gotten complete paras to walk with only 40% of their weight supported. Wernig worked with real wheelchair bound, no independent standing, chronic injuries, one was 18 years chronic I believe. His goal was to have them walking free over ground. The vast majority of his subjects learned to walk and several were able to climb stairs. His work on the "rules of spinal locomotion" were a continuance of studies with cats start here in the US. Dietz began with a parachute harnass and a crane. Yup, a crane. http://sci.rutgers.edu/forum/images/smilies/cool.gif

When children are born they have a reflex called stepping that happens if you hold them up and towards a person or solid object like a wall. Infants will place their feet at a stepping stance on the person's chest or on the wall. The spinal cord does have some kind of memory or learning center. If not, why would a brain dead person still have spasms or other involuntary motions? It sure doesn't come from the brain..

[Snowman]

The treadmill and gait training basically get your body to remember how to walk again. It doesn't do anything for your arms, chest, fingers, etc. That is why any program must focus on the entire body, and getting as much of it functional as possible. Gait training will do nothing for your functional walking ability if your abdominals are pulling your head down to your knees. http://sci.rutgers.edu/forum/images/smilies/wink.gif

[foster]

Snowman thanks for having us at project walk. I can't believe the progress my son make in four days. He is able to lock his knees, starting to lift himself up from a keeling postion while holding on. The fun that he had. On the plane home he says he feels like he is missing a chance to recover by not being there. It is hard work but he really enjoyed it because he knew that ted, tammy, eric, adam, care alot about him and the others there. Before some people put this program down and say its a bs, go check it out they are unbelievable. The things we saw were amazing. If you want to recover this is the place you want to be. Tammy, ryan says thanks for the wall excise and he will be working very hard on them. As a father I can only say thank you project walk.

[KTC]

I have been reading on this site since it's inception but have not posted, though I did post on the site when it was a different name. My son was injured at age 16 in May 1998 and is incomplete C4. I have traveled around the country with him for various treatments and feel that of all the things he has been exposed to, the program at project walk sounds the most promising given what Christopher (my son) has to work with. We have tried or been a part of many things people have talked about on this forum that is offered in this country. When the time is right and we feel safe doing so, I'm sure we will be traveling to some other country to get a treatment also, we're just not ready for a surgery yet until something is more proven. It's very exciting to read about the people who have had the courage to have Dr. Kao and Dr. Cheng's treatments, I wish them all the luck in their recoveries.

I spoke with Dave at Project Walk and really like the way he thinks about treating SCI patients. I live two hours from San Diego where this program is. I will be taking my son in about three weeks when he gets home from college so that we can check it out and see if it's something that could help him. After talking with Dave it sounds very encouraging. I will post and let people know what I saw.

Foster, thank you for emailing me back. If you do have your son come out here for treatment then we may get to see you if Christopher decides to do this also.

Kitty

[Chris Chappell]

Hi. Hope all is well and progressing.

I've been looking through the posts trying to find the name of the facility, I think its in WI or MN, that is run by, I believe, a woman where the raised treadmill training (I think your husband's going or gone there?) is the standard form of therapy?

Am I making sense? Do you have a name or website link?

Thanks.

Onward and Upward!

[foster]

chris her mane is kathy hammer

[Maceyka]

Kitty,

Please do keep us informed. I'm very interested to find out more about project walk! Thank you in advance!

Maceyka

[Snowman]

http://sci.rutgers.edu/forum/images/smilies/wink.gif I hope you talked to Ted... as we currently do not have anyone named Dave working with us... http://sci.rutgers.edu/forum/images/smilies/wink.gif

Eric
Manager/Head Trainer
Project Walk (http://www.projectwalk.org)

[KTC]

Eric,
Well now you have me wondering. I called the number on your website and left a message. I received a call the next morning at home and I thought he said his name was Dave. Given the way my mind seems to work on some days, it doesn't surprise me that I got that wrong-I'm sorry. I will be calling back soon to set up a time for us to come visit. I will definitely remember your name.

Kitty

[Snowman]

Ted tends to mumble sometimes... he's from New Jersey soooo... http://sci.rutgers.edu/forum/images/smilies/biggrin.gif

[BirdeR]

Paralyzed Patients:

On Their Feet And Walking

By Ruth Winter, MS April 8, 2002


http://www.brainbody.com/newsletters/20020408.htm

What seemed impossible just a short time ago-getting the paralyzed on their feet and walking-is becoming a reality. There are two devices already in existence-the AutoAmbulator and the Lokomat

HealthSouth is a nationwide provider of in-patient and outpatient rehabilitation services. Two years ago, the company's CEO, Richard M. Scrushy and HealthSouth neurosurgeon, Dr. Swaid N, Swaid, watched quadriplegic actor, Christopher Reeve, test a crude manually-oriented walking contraption at UCLA. Soon after, Scrushy sketched what he envisioned as a device that would allow paralyzed patients to move their legs in a natural gait

Scrushy, Dr. Swaid and many researchers believe the spine is capable of re-learning movement after paralysis. Scrushy asked HealthSouth designer Gary West to develop the device he envisioned. West did and they named it The Auto Ambulator.

"The Auto Ambulator is all connected and synchronized to function just like the human body when walking," says Scrushy. "It is built to mimic natural human walking patterns to aid that spinal cord's re-learning."

Paraplegics can "walk" on the AutoAmbulator after being attached to a special harness that transfers them from their wheel chair using a telescoping arm that reaches over the treadmill. It is a complex machine, with software and computers linking the custom-built treadmill to motors that adjust to the walker's movements within microseconds. Programming allows the computer to know the exact position of the motors at all times.

"The main thing we wanted to achieve was to see if it would work. We've gone way beyond that now," says Scrushy.

HealthSouth is conducting feasibility studies on the AutoAmbulator under the direction of Dr. John McDonald, director of The Rehabilitation Institute of St. Louis. Doctors believe that in addition to reprogramming the spinal cord in paraplegics, the AutoAmbulator can increase blood flow, prevent osteoporosis (bone thinning), decrease muscle spasms, improve respiration and boost spirits.

Indeed, Doug Heir, attorney, president of the National Spinal Cord Injury Association, and winner of 285 Gold Medals, is happy with the machine. Heir broke his neck as a teenage lifeguard attempting to save a swimmer pretending to drown. He says: " It's an incredible feeling to stand again and to have your whole body moving..

"I forgot how wonderful it is to walk and take step, to stand tall, and not be confined to a wheelchair. The problem is that when my walking session is over, I have to sit back in my wheelchair, and I want to keep walking. Until there is a cure, this is the next best thin; I am using my entire body, not just my arms to ambulate. I have also received improved sensation in my lower extremities. After 21 years of not standing and moving my legs, walking on a treadmill is a tremendous joy. It is not only a great machine for therapy, but it is a great motivator to keep going and never give up."

HealthSouth's Dr. Scrushy says:" We are aggressively moving forward with the development of the AutoAmbulator, Our initial safety studies should be submitted for FDA approval by soon.. Once we receive final approval from the FDA, delivery of the product to facilities will begin in a matter of weeks." For more information, check www.hcalthsouth.com (http://www.hcalthsouth.com)

The Lokomat is a different "walking" machine for the paralyzed being tested . Dr. Zev Rymer, Director of Research at The Research Institute of Chicago (RIC), says that the device works as an exoskeleton (outside skeleton). "Robot joints" are at the hip and knee that guide the person's limbs inside the device along with a special treadmill. There are sensors to respond to range of motion that so that limbs are not overstressed.

Dr. Rymer points out that this machine will work only with paraplegics whose spinal cords still have some fibers that "communicate" even though they are unable to walk. He said most paraplegics fit into this category.

"'The machine helps to retrain the neural patterns of walking in the brain and spinal cord that have become dormant with disuse," he explains. "The sensory information fed to the walker's brain and body while in the machine does that."

Dr. Rymer says the Lokomat has been in use in Zurich, Switzerland for the past year and improvement has been notable in patients.

Dr. Susie Kim., a medical resident at RIC in physical medicine and rehabilitation, has been wheelchair-bound since she injured her spine four years ago in a surfing accident. She has been using the Lokomat and says: "It's amazing. It feels like I've been sitting during a very long car ride and now I am up and walking again. It is wonderful to be able to put weight on my muscles and bones again."

If you or someone you care for is paraplegic and want more information on the Lokomat , you can contact Dr. David Chen, Medical Director of Spinal Cord Injury and Program Director by e-mail at: dchen@rehabchicago.org.

[Chris Chappell]

How do more of us get access to this type of rehab?

Onward and Upward!

[Emi2]

Originally posted by Chris:

How do more of us get access to this type of rehab?

Onward and Upward!

Yeah... I want to know too. I tried to hook up with something similar here but I didn't qualify because I'm not ASIA C.

And who said that we weren't interested in cures?

"It is not easy to find happiness in ourselves, and it is not possible
to find it elsewhere."
--Agnes Repplier, writer and historian

[BirdeR]

Dr. David Chen is the director of the Chicago's program (LOKOMAT) - here is his email:
dchen@rehabchicago.org

This is the person that contacted us from Chicago:
David H. Zemon, MS,PT
Research Physical Therapist
Sensory Motor Performance Program
Rehabilitation Institute of Chicago
345 E. Superior Street
Room 1328
Chicago, IL 60611
EMAIL: d-zemon@northwestern.edu

ALSO TRY:
William Z. Rymer MD Ph.D.
Rehabilitation Institute of Chicago,
345 East Superior St.,Suite 1406
Chicago, Illinois, 60611
Voice (312) 238-3919
Fax (312) 238-2208
EMAIL: zevric@casbah.acns.nwu.edu

[BirdeR]

Location and Contact Information:

Bruce Dobkin
PHONE: 1-310-306-6500
EMAIL: bdobkin@ucla.edu
Ontario, Canada
University of Ottawa

Michele Badour
PHONE: 1-613-737-7350
EMAIL:mdadour@rohcg.on.ca
Quebec, Canada
Magill University, Montreal

Christine Garneau
PHONE: 1-514-340-2090
California
Rancho Los Amigos Medical Center, Downey,California

Claire Beekman
PHONE: 562-401-6244
EMAIL: cheekman@dhs.co.la.ca.us
Georgia
Shepherd Center, Atlanta

Ann M. Smith
PHONE: 614-293-3809
EMAIL: smith.270@osu.edu
Pennsylvania
Thomas Jefferson University Hospital, Philadelphia

Mary Call
PHONE: 215-955-6579
EMAIL: mary.call@mail.tju.edu
Pennsylvania
Six Franklin Plaza, Philadelphia,Pennsylvania,19102

Mary Schmidt
PHONE: 215-587-3151
EMAIL: mschmidt@mageerehab.org


~Supported Treadmill Ambulation Training after Spinal Cord Injury ~
Sally Holmes, M.D.
PHONE: (713) 794-7128
EMAIL: holmes.sally@med.va.gov
Texas
VAMC, Houston,Texas


~ FNS and Weight Support Treadmill Training for Gait Component Restoration ~
Janis Daly, Ph.D.
PHONE:(216) 791-3800
EMAIL: rir@po.cwru.edu
Ohio
VAMC, Cleveland, Cleveland,Ohio

[BirdeR]

Jim recently received a call (again) from David Zemon and he said that Jim is now eligable to be a part of this trial (LOKOMAT). He said it is for 8 wks./3 days a wk.

http://www.rehabchicago.org/about/news/index.php

http://www.hoise.com/vmw/01/articles/vmw/LV-VM-12-01-12.html

http://abclocal.go.com/wls/news/111301_hs_lokomat.html

Jim is still deciding if he will do this. We are 3 hours from Chicago. So figure 6 hour round trip travel time with only one hour of the therapy...3x a wk. I really hope he does this! He will call him Friday to give him an answer. We are planning a trip to Hammer Rehab. on Thursday and we will get Kathy's input.

Jim is doing very good by the way.....he is now walking with the walker and boots- no other assistance at all - up to 30-40 steps a day. He works out now like a mad man....3x a day. He has more movement and sensations below the injury site too!!! *REMINDER* it's going to be 1 year on the 24th of August since his surgery w/ Kao.

[This message was edited by BirdeR on Aug 13, 2002 at 07:07 PM.]

[This message was edited by BirdeR on Aug 13, 2002 at 07:13 PM.]

[chasb]

I originally found this in Feb 2002. However, I just recently found this site. So I though I would post it. My apologies if you have already read it.

Electrodes Help Partly Paralyzed Man Walk
By Merritt McKinney

NEW YORK (Reuters Health) - In a development that may offer hope to some people with spinal cord injuries, Arizona researchers report that a partly paralyzed man can now walk several hundred meters after having electrodes implanted in his lower back.

When used in combination with rehabilitation on a treadmill, the electric impulses delivered by the electrodes seem to have helped the spinal cord's circuitry ``relearn'' how to walk, according to Dr. Richard Herman of Arizona State University in Tempe.

The man still has to use a wheelchair, but he is able to walk on his own during his daily activities, such as trips to the bathroom and from the car to restaurants and shops, Herman told Reuters Health in an interview.

``There's a possibility that wheelchair-dependent people can walk again,'' Herman stated.

But the Arizona researcher stressed that the technique is not expected to benefit all people with spinal cord injuries. The man who was able to walk again had a so-called incomplete spinal cord lesion, Herman noted, meaning that his spinal cord had not been severed completely. After the injury, he still had some sensation in his legs, although he had no useful muscle strength, Herman explained.

Herman also noted that the treatment is in the very early stages. The researchers have since implanted the electrodes in a second patient, but the technique needs to be studied in many more patients, Herman said.

Herman and his colleagues report the results of the treatment in the February issue of the journal Spinal Cord. The patient was a 43-year-old man who was dependent on a wheelchair more than 3 years after having an injury that partially severed his spinal cord.

The man first underwent rehabilitation on a treadmill before electrode implantation. He was placed on the treadmill, but he was supported by a harness that bore most of his weight. Physical therapists worked with the man to walk at various speeds, and as he improved, he gradually supported more and more of his own weight.

Eventually, Herman said, the patient was able to walk about 1.5 miles an hour, which was an improvement, but still lagged behind the normal pace of an uninjured person, which is about 2.5 to 3 miles per hour. He was able to support only about 70% of his weight, which meant that he would have to rely on a walker to travel any considerable distance, according to Herman.

After the treadmill therapy, it took the man about 2.5 minutes to walk 15 meters, or about 50 feet.

But his walking abilities dramatically improved after a pair of electrodes were implanted in his lower back.

When the patient wants to walk, he places a disk on the skin over the electrodes, Herman explained. This disk receives signals from a remote device. These signals excite the circuitry in the spinal cord that is responsible for movement and rhythm, he said.

The activation of the electrodes slashed the amount of time it took the man to walk 15 meters, and he continued to improve with practice. About 6 weeks after he started using the electrodes, he could walk 15 meters in less than a minute. And after 4 months, he was able to walk 270 meters, or almost one-fifth of a mile.

``He's reached levels of function that we didn't anticipate,'' Herman said.

And walking has become nearly effortless for the man, Herman pointed out. The patient says his legs feel very light and he does not feel fatigued after walking.

The man still has to use a wheelchair, but the combination therapy has allowed him to be more independent in his daily life, Herman added.

The researchers have implanted the electrodes in a second patient and hope to treat a third in the future. At that point, the US Food and Drug Administration (news - web sites) will review the data, Herman said.

Eventually, the researchers would like to see if the combination of treadmill training and electrodes will benefit people with more severe disability, Herman noted.

SOURCE: Spinal Cord 2002;40:65-68.

[Chris Chappell]

Bumping this up for those of you looking for a New Year's resolution.

Onward and Upward!