ChinaSCINet Update

[tomsonite]

Wise presented preliminary results almost two years ago, my understanding is that it does not work. See this video: https://www.youtube.com/watch?v=8VsK8lz6vZ8
Pay attention at minute 37:50

I hope at W2W more details will be presented.

Paolo

Many incompletes (C's and D's) who have very limited or in some cases, no walking ability at all, have either re-gained or vastly improved their ability to walk following intensive locomotor training. More often than not, these people's ASIA scores show no changes at all. So if we go by the logic you present Paolo, locomotor training "doesn't work" either, despite clear functional gains.

[tomsonite]

HOLD ON. So it is INVOLUNTARY walking? Is this correct? How can COMPLETES walk if they haven't had any motor changes? So they walk involuntarily, right? Someone clear my confusion, my head hurts from trying to figure it out.

In the video Dr Wise says the patients didn't have any motor changes, but some ended up walking. So this means it does work Paolo? Forgive me, I don't have a huge understanding of the science behind all this Paolo, if it's not too much hassle could you please briefly clear this up for me? Because all this now seems very misleading

Regards

Different spinal cord tracts are responsible for different functions. Voluntary control of bodily movements and reflexive control of movements are two different things. Most often the term "involuntary" walking means that people aren't choosing when and how to make steps - they just stand up, and the muscles go. It could be argued that this type of walking is not of any functional value, but to say there have been no changes in the subjects or that the procedure doesn't work is overkill.

[taymas]

Different spinal cord tracts are responsible for different functions. Voluntary control of bodily movements and reflexive control of movements are two different things. Most often the term "involuntary" walking means that people aren't choosing when and how to make steps - they just stand up, and the muscles go. It could be argued that this type of walking is not of any functional value, but to say there have been no changes in the subjects or that the procedure doesn't work is overkill.

Tomsonite,
I totally agree - it does "work" and has it's results. But could you elaborate on reflex vs motor control? So is it fair to say they are walking - but it's merely training their reflexes, and it is NOT voluntary on an individual muscle basis? You probably have a for better understanding than me.

For example, does this mean that if I had this therapy, I wouldn't be able to move my legs around in my wheelchair, like lift my leg to wear a sock? As Jim said COMPLETES are walking with or without aid. Although it would be better than nothing, my expectations were a tad high, dreaming of betting back on my motorcycle can

Can Jim or Wise also comment to clear this up?

Cheers

[Jim]

Hello Jim, thank you for share this info, I have a question for you? how many of them were treated with placebos?

There is no placebo in phase II trials because the purpose is to prove safety. If safety and efficacy is shown in phase II, placebo is used in phase III as you see in the chart.

HOLD ON. So it is INVOLUNTARY walking? Is this correct? How can COMPLETES walk if they haven't had any motor changes? So they walk involuntarily, right? Someone clear my confusion, my head hurts from trying to figure it out.

Tamas, I'm on vacation and don't have any time so read back in this thread where Dr. Young talks about the Central Pattern Generator, it's all explained there. It is hard to grasp why these subjects were able to gain assisted walking without motor control. I understood the theory but until I saw the videos of the walking vs the motor exams it wasn't clear.
This video was recorded before bowel/bladder improvement.

paolocipolla says:
Wise presented preliminary results almost two years ago, my understanding is that it does not work.

Paolo, what do you base the above statement on? How can you make this statement if you haven't seen the data?

[Tbone57]

[QUOTE=paolocipolla;1743050]Wise presented preliminary results almost two years ago, my understanding is that it does not work. See this video: https://www.youtube.com/watch?v=8VsK8lz6vZ8
Pay attention at minute 37:50

I hope at W2W more details will be presented.

Your basing this statement on a 30 second portion of the video. Did you watch the whole video from beginning to finish or just the part where Wise says he believes the strands may still be growing and haven't reached the target yet. I recommend you watch the whole thing and try to glean some more information from it, thats your assignment. Report back with some good news or Santa is not going to visit you this year.

[tomsonite]

Tomsonite,
I totally agree - it does "work" and has it's results. But could you elaborate on reflex vs motor control? So is it fair to say they are walking - but it's merely training their reflexes, and it is NOT voluntary on an individual muscle basis? You probably have a for better understanding than me.

For example, does this mean that if I had this therapy, I wouldn't be able to move my legs around in my wheelchair, like lift my leg to wear a sock? As Jim said COMPLETES are walking with or without aid. Although it would be better than nothing, my expectations were a tad high, dreaming of betting back on my motorcycle can

Can Jim or Wise also comment to clear this up?

Cheers

Taymas, when somebody walks, they don't voluntarily think to themselves to execute every movement involved. That is to say, when I walk, I don't think to myself "ok, I have to fire my glute, quad, and anterior tibialis on my stance leg, now I have to fire my anterior tib and gluteus while isometrically contracting my quadricep with a co-contraction of the hamstring to stabilize the knee while I brace my trunk musculature and fire my hip flexors and hamstrings as I propel my foot off the ground on my swing leg with my gastrocnemius muscle. Now I must extend my hip with my glutes on my stance leg while isometrically firing the hamstring on my swing leg..." The amount of individual muscles and movements involved in walking is absolutely nauseating. If every person had to think about every movement involved in every step they took, it would take hours to walk from the kitchen to the living room.

Instead, our brain simply says "walk over there" to the body. Pre-programmed reflexes in the spinal cord that every human is born with take care of the rest. Essentially, when someone wants to walk somewhere, all the brain does is turn on reflexes based in the spinal cord. That is what makes walking "involuntary". When I walk, I voluntarily decide that I want, but involuntary reflexes in my spinal cord determine how I walk.

It appears (and I haven't seen any data myself, but have been to a few of Wise's open houses) that the therapy that ChinaSCINet is testing is somehow capable of reconnecting the brain to these involuntary reflex centers in the spinal cord (the Central Pattern Generators). Thus, when one of the subjects is up in a rolling walker, they decide to take a step - then the muscles that produce that step fire "involuntarily", resulting in the leg getting pulled forward.

The other thing about walking is that it is not just dependent on the brain deciding to walk. In order for those involuntary reflexes to fire, there needs to be a LOT of sensory input from the body and the environment. There has to be weight bearing on the joints of the lower body, different limbs must be in different positions, etc. A combination of the brain deciding to walk, plus the body being in the correct position/alignment is what makes the body capable of stepping. It is actually completely different than what is involved with you trying to lift your leg up to put your socks on.

Hopefully you actually understand what I wrote. If you are simply sitting cross-eyed at your computer I apologize

[Eric.S]

its seems to be pretty simple what is being said. The body looks at walking as a single function and somehow Dr. Wise's therapy is able to restore this function but the not the single movement function for something like kicking or lifting the leg. I wonder why the complex multi component function would get restored before the simple functions?

it must be weird to walk uncontrollably..

[Barrington314mx]

This video was recorded before bowel/bladder improvement.

Enjoy your vacation while you are on it. But when you get time, can this be expanded on please if you can be more specific?

[paolocipolla]

[QUOTE=Tbone57;1743197]

Wise presented preliminary results almost two years ago, my understanding is that it does not work. See this video: https://www.youtube.com/watch?v=8VsK8lz6vZ8
Pay attention at minute 37:50

I hope at W2W more details will be presented.

Your basing this statement on a 30 second portion of the video. Did you watch the whole video from beginning to finish or just the part where Wise says he believes the strands may still be growing and haven't reached the target yet. I recommend you watch the whole thing and try to glean some more information from it, thats your assignment. Report back with some good news or Santa is not going to visit you this year.

I have watched the whole presentation first when it was on live streaming together with the other presentations, then I have rewatched it carefully more than once to make sure I didn't miss somenthing important.

Sorry I can't do better than that.

Paolo

[paolocipolla]

paolocipolla says:
Wise presented preliminary results almost two years ago, my understanding is that it does not work.

Paolo, what do you base the above statement on? How can you make this statement if you haven't seen the data?[/QUOTE]

Jim,

Wise in his presentation said there is no significant change in motor and sensory score. That for me means the treatment does not work,

Paolo