Spinal cord stimulation and physical therapy have helped a man paralysed since 2013 regain his ability to stand and walk with assistance. The results were achieved in a US research collaboration between Mayo Clinic and UCLA.
With an implanted stimulator, the man was able to step with a front-wheeled walker while trainers provided occasional assistance.
The study began in 2016 and included 22 weeks of physical therapy, after which an electrode was surgically implanted. The implant sits in the epidural space — the outermost part of the spinal canal — at a specific location below the injured area.
It connects to a pulse generator device under the skin of the man’s abdomen and communicates wirelessly with an external controller. After recovering from surgery,the man returned to the lab for rehab sessions and stimulation adjustments for the next 43 weeks.
In a 2017 Mayo Clinic Proceedings paper, the authors reported their initial observations as they replicated research done at the University of Louisville.
Those early findings showed that, within two weeks of the stimulator being turned on, the man could stand and intentionally make step- like movements while suspended in a harness. The research team then tried to determine
if the man could stand and walk with assistance. During 113 rehabilitation sessions, the researchers adjusted stimulation settings, trainer assistance, harness support and speed of the treadmill to allow the man maximum independence. The research demonstrated
that the man was able to walk over ground using a front-wheeled walker and step on a treadmill placing his arms on support bars to help with balance. However, when stimulation was off, the man remained paralysed.
In the first week, the participant used a harness to lower his risk of falling and to provide upper body balance. Trainers were positioned at his knees and hips to help him stand, swing his legs and shift his weight. Because the man did not regain sensation, he initially used mirrors to view his legs, and trainers described leg position, movement and balance.
By week 25, he did not need a harness, and trainers offered only occasional help. By the end of the study period, the man learned to use his entire body to transfer weight, maintain balance and propel forward, requiring minimal verbal cues and periodic glances at his legs.