Pushin' On: UAB Spinal Cord Injury Model System Digital Newsletter Volume 36 | Number 2

Pushin’ ON VOL 36 | NUM 2 2018 UAB Spinal Cord Injury Model System Digital Newsletter Headline News The University of Alabama at Birmingham Spinal Cord Injury Model System (UAB-SCIMS) provides Pushin’ On twice annually as an informational resource for people with spinal cord injury (SCI). UAB-SCIMS Program Director: Amie B McLain, MD Pushin’ On Editor: Phil Klebine, MA 529 Spain Rehabilitation Center 1717 6th Avenue South Birmingham, AL 35233-7330 Phone: 205-934-3283 TDD: 205-934-4642 Fax: 205-975-4691 WWW.UAB.EDU/SCI [email protected] /UABSCIMS /UABSCIMS /UABSCIMS The contents of this publication were developed under a grant from the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR grant number 90SI5019). NIDILRR is a Center within the Administration for Community Living (ACL), Department of Health and Human Services (HHS). The contents of this publication do not necessarily represent the policy of NIDILRR, ACL, HHS, and you should not assume endorsement by the Federal Government. ©2018 University of Alabama Board of Trustees. The University of Alabama at Birmingham provides equal opportunity in education and employment. In previous issues of Pushin’ On, we’ve highlighted the amazing progress by researchers at University of Louisville in Kentucky. They have helped a handful of people paralyzed after spinal cord injury to move and walk again under limited conditions. In a recent publication in the New England Journal of Medicine, the team added new insights into the ongoing research. The published results were that two of the four participants (both AIS grade B) were able to walk over ground with a common walker after intensive physical training with electrical stimulation of the lower spinal cord. The other two (AIS grade A) achieved some components of independent stepping on the treadmill with body-weight support but not over-ground walking. None of the four participants could do these actions in trials when the stimulator was off. Motor and sensory scores for three participants did not change from the scores before implantation. In one participant, however, the motor score improved from 23 to 24 and the sum of the sensory scores from 83 to 86. Here’s a video with the patients and researchers. The University of Louisville in Kentucky has sparked a new line of research. Two other publications also highlight results in electrical spinal cord stimulation. A resent publication in Nature Medicine highlighted results by researchers at Mayo Clinic and UCLA. A man had a spinal cord neurostimulator implanted below the injury (T6 AIS grade A). After rehab, the man is able to stand alone and make independent steps while holding onto the walker when the device was turned on. He walked 111 yards, took 331 steps, and spent 16 minutes walking with assistance. Here’s a video with the patient and researchers. A resent publication in Nature Neuroscience highlights results by researchers at École polytechnique fédérale de Lausanne (EPFL) in Switzerland using a new electrical stimulation method. This team was able to mimic in real time how the brain naturally activates the spinal cord. This was done with a large electrode array that was able to stimulate various parts of the spinal cord and control different groups of muscles at the same time the brain was attempting the same actions. It seems the timing and where the neurostimulation happens play a big part in making muscles move as desired. After months of training, they got three people with spinal cord injuries to walk and to even move their legs without any electrical stimulation at all, although crutches or walkers were used. They also reported at least one of the participants has even been able to take multiple steps without holding onto anything at all. But, what is even more important, it looks like nerves actually grow and make new connections when the timing matches what the brain wants to do. Here’s a video with the patients and researchers.