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Researchers at the University of Washington reportedly helped six Seattle area participants regain some hand and arm mobility by using physical therapy combined with a noninvasive method of stimulating nerve cells in the spinal cord.
Almost 18,000 Americans experience traumatic spinal cord injuries every year, with many of them being unable to use their hands and arms, unable to do everyday tasks such as eating, grooming, or drinking water without help. The research team published their findings in early January 2021 in the journal IEEE Transactions on Neural Systems and Rehabilitation Engineering. The increased mobility achieved lasted at least three to six months after treatment had ended.
Spinal cord injuries can be caused by a variety of circumstances, such as car accidents and truck accidents, and almost always present a variety of complications. Just like the brain, the spinal cord cannot regrow new cells. Therefore, victims of spinal cord injuries are often left to deal with lifelong disabilities, including paralysis from the neck down (quadriplegia) or paralysis from the waist down (paraplegia).
Lead author in the study, UW senior postdoctoral researcher in electrical and computer engineering who completed this research as a doctoral student of rehabilitation medicine in the UW School of Medicine, Dr. Fatma Inanici, explained: “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.”
Inanici shared that she didn’t expect to see an immediate response at first. “As a rehabilitation physician, my experience was that there was always a limit to how much people would recover. But now it looks like that’s changing. It’s so rewarding to see these results.”
After a spinal cord injury, many patients do physical therapy to help them attempt to regain mobility. The UW team combined stimulation with standard physical therapy exercises, without the need for surgery. Instead, the stimulation involves small patches that stick to a participant’s skin like a Band-Aid, which are placed around the injured area on the back of the neck where they deliver electrical pulses. A series of different, separate studies have shown that implanting a stimulator to deliver electric current to a damaged spinal cord could help paralyzed patients walk again.
The first month, the researchers monitored the participants’ baseline limb movements each week. The next month, they put participants through intensive physical therapy training, three times a week for two hours at a time. And for the third month, participants continued physical therapy training but with stimulation added. The researchers turned on the device, but the participants continued doing the exact same exercises they did the previous month, progressing to slightly more difficult versions if they improved.
In the last two months of the study, the participants were divided into two categories. The participants with less severe injuries received an additional month of training alone, followed by a month of training plus stimulation. Then the patients with more severe injuries received the opposite — training and stimulation first, followed by only training second. While some participants regained some hand function during training alone, they all saw improvements when stimulation was combined with training.
Senior author Chet Moritz, a UW associate professor of electrical and computer engineering, rehabilitation medicine and physiology and biophysics, explained the improvements: “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, some participants noticed other improvements, including a more normal heart rate and better regulation of body temperature and bladder function. Moreover, the team followed up with participants for up to six months after training and found that these improvements remained, despite no more stimulation.