Blood pressure can be controlled without drugs after spinal cord injury, new research has revealed.
Spinal cord stimulators can bridge the body’s autonomous regulation system, controlling blood pressure without medication, the study found.
Led by Dr Aaron Phillips at the University of Calgary’s Cumming School of Medicine (CSM) and Grégoire Courtine, from the Swiss Federal Institute of Technology (EPFL), the study has been hailed as having “life-changing” consequences for people with spinal cord injury.
“The spinal cord acts as a communication line allowing the brain to send signals to tell the body such as when and how to move, as well as how to control vital functions, including blood pressure,” says Dr Phillips, co-principal investigator and assistant professor at the CSM.
“This communication line is broken after a spinal cord injury. We created the first platform to understand the mechanisms underlying blood pressure instability after spinal cord injury, which allowed us to develop a new cutting-edge solution.”
And the solution is already delivering rewards, with Dr Richi Gill, the study’s first participant in a series of clinical trials.
Dr Gill broke his neck three years ago in a boogie board accident while on holiday with his young family.
Getting mobile again with the use of a wheelchair is the first thing most people notice, he says. However, for those with a spinal cord injury, what is happening inside the body also severely affects their quality of life.
“What many people don’t realise is that a spinal cord injury prevents some systems within the body from regulating automatically,” says the 41-year-old.
“My blood pressure would drop drastically, leaving me fatigued, dizzy, and unable to focus. The condition can be life threatening, requiring medication for life.
“It’s exciting to see the science help push things forward. I’m excited that Calgary will be one of the sites for a clinical trial. Research made a positive effect on my life and I’m glad others will benefit, too.”
In the study, targeted epidural electrical stimulation (EES) of the spinal cord was used to stabilise haemodynamics, or blood flow throughout the body, allowing for vital organs to maintain an appropriate supply of blood.
The researchers discovered the exact placement on the spine for their stimulator, and the circuitry of the sympathetic nervous system underlying blood pressure control.
This new knowledge allowed for the development of a neuroprosthetic closed-loop communication system, to replace lost haemodynamic control.
“We are really excited that people with spinal cord injury are able to stop their blood pressure medication and get back to enjoying a full daily routine with improved blood flow to their brain and organs,” says Dr Sean Dukelow, clinician scientist at the CSM and author on the study.
“People feel more alert, are able to be upright and in their wheelchair without losing consciousness, and over the long-term we think this will reduce the risk of heart disease and stroke.”
Work is already underway to take the project forward into mainstream use, adds Dr Courtine.
“We are going to collaborate with a company called Onward to develop a neurostimulation system dedicated to the management of blood pressure in people with spinal cord injury,” he says.
Osteoarthritis: breaking the cycle
Medical technology company Ottobock shares its expertise on approaches to the condition.
Why is Cartilage Important?
Bones that come in contact with other bones are covered by cartilage at their contact points. Cartilage does not have blood vessels – it is supplied with nutrients through movement of the joint. That’s why regular exercise is so important!
Cartilage ensures that the joint surfaces move against each other in the most efficient way and with little friction. It absorbs shock, cushioning the joint, and distributes the forces acting on the joint.
If cartilage is damaged and its gliding properties are affected, it can no longer serve its purpose and the joints range of movement can become limited.
Typical Progression of Osteoarthritis
When osteoarthritis of the knee develops due to joint malalignment, an accident, advancing age, obesity or excessive strain, the damaged cartilage is no longer able to properly fulfil its function.
This results in pain and reduced mobility. The affected patient instinctively assumes a relieving posture to reduce strain on the knee.
However, this often leads to new problems in other places, such as the hip, and reduces the supply of nutrients to the cartilage, for which movement is required – sparking a vicious circle.
The cartilage develops cracks and begins to break down. At the same time, the bone thickens at the site of the damage.
When the cartilage layer is completely worn away, the affected bones come into direct contact and rub against each other causing joint pain and inflammation.
The thickest joint cartilage is located behind the kneecap (patella). This is an area of high stress. Osteoarthritis occurring in this area is known as patellafemoral osteoarthritis
Signs and Symptoms
There are several common symptoms that signal knee osteoarthritis. They can occur individually or together. However, with the initial onset, you may not notice any of these symptoms
When symptoms appear they usually occur in the following order:
- Cracking in the joint
- Pain during load bearing activities, such as carrying a heavy object
- Pain during every day activities, such as climbing the stairs
- Reduced mobility
- Swelling and inflammation
Joint specific exercises: with regular exercise mobility can be maintained and muscle strengthened, ensuring the cartilage is supplied with the nutrients it needs.
Temperature: with acute inflammation, cold relieves pain and reduces swelling. Heat relaxes the muscles and tendons and increases the flow of nutrients. Heat may only be applied when the joint is not inflamed.
Creams: various over the counter products are available at your local pharmacy including gels and creams that can help relieve pain.
Orthopaedic devices (braces and supports): these are applied externally to the knee, reducing pain and improving mobility.
Lifestyle: living a healthy lifestyle can help to combat osteoarthritis. A healthy diet and an active lifestyle reduces the chance of obesity, putting less stress and strain through the knee joints.
An orthotic fitting is a key component in the treatment of osteoarthritis. It can provide the following:
- Pain relief
- Support daily activities
- Support during activities that affect the joint, whether at work or during sports
Did you know?
An osteoarthritis patient takes an average of around 1,200 tablets a year to manage pain. But this can lead to damage to the stomach, bowel and liver.
An orthosis from the Agilium line is therefore a good alternative. It’s worth-while for anyone with knee osteoarthritis to test the effectiveness of the orthoses themselves.
The Agilium Line
The braces in our Agilium line are designed specifically to target the symptoms of osteoarthritis of the knee.
Each works in a different way to address the various characteristics of osteoarthritis of the knee. At the same time, we placed great emphasis on their comfort and suitability for daily use.
The Agilium Freestep, the Agilium Reactive and the Agilium Softfit are used to treat unicompartmental osteoarthritis of the knee.
The Agilium Patella is used for patients with patellofemoral arthritis.
The Agilium Freestep is used to treat OA, although it is not applied directly to the knee. Instead is worn on the foot, right inside the shoe! For targeted relieve, it alters the load-line of the knee – the point where the body weight impacts the cartilage.
The Agilium Softfit is a pull on knee brace with a textile base and single upright that stabilises and relieves the knee using a three point force system to offload the affected compartment (side) of the knee.
The Agilium Reactive also uses a three point force system to offload the affected compartment (side) of the knee. However, the innovative closure system in the upper calf provides comfort while sitting without compromising the stable position when standing.
The Agilium Patella combines a textile structure and stabilising component with a dynamic re-alignment mechanism enabling it to maintain the central alignment of the knee cap, reducing pressure behind the knee cap.
Find the appropriate brace with Agilium Select.
Visit our website or go to ottobock.com/agilium-select
Masturbation linked to stroke in medical case study
Doctors in Japan have reported how masturbation sparked a bleed on the brain of a 51-year-old man; as published in the Journal of Stroke and Cerebrovascular Diseases.
Doctors at the Nagoya City University Graduate School of Medical Sciences in Japan explained that the man attended hospital after orgasming, with the sudden onset of a searing headache that lasted for around a minute. This was followed by an intense bout of vomiting.
A CT scan showed an acute subarachnoid hemorrhage in the left hemisphere.
The researchers note that masturbation causes an increase in heart rate, blood pressure, and noradrenaline plasma levels – which are likely to contribute to the risk of splitting a blood vessel in the brain and result in a hemorrhagic stroke.
The man was treated with stents and coiling, two techniques used to bolster the blood vessel and maintain blood flow to the brain, and he went on to make a full recovery.
The study authors say that they found just two other cases of masturbation-linked strokes in other scientific literature.
The Japanese man survived and was discharged after nearly two weeks in hospital in an “excellent” condition.
Engineers develop ultrasound patch to monitor blood flow
Breakthrough could help to better predict stroke and other cardiovascular conditions earlier.
Engineers at the University of California San Diego have developed an ultrasound patch that can be worn on the skin. It monitors the blood flow through major arteries and veins deep within the body.
It is hoped that it could help clinicians diagnose cardiovascular conditions faster. It could also help to diagnose blockages in the arteries which could lead to strokes or heart attacks.
The ultrasound patch continuously monitors blood flow as well as blood pressure and heart function in real-time. Assessing how much blood flows through a patient’s blood vessels could help diagnose blood clots, heart valve problems and poor circulation in the limbs.
For many patients, blood flow is not measured during a regular visit to their doctors. It is usually assessed after a patient shows signs of cardiovascular problems.
The patch can be worn on the neck or chest and can measure cardiovascular signals up to 14 centimetres inside the body non invasively with high accuracy.
How the patch works
The patch is made of a thin, flexible polymer that sticks to the skin.
There is an array of millimetre-sized ultrasound transducers on the patch known as an ultrasound phased array.
These are individually controlled by a computer. Another feature is that the ultrasound beam can be tilted at different angles to areas in the body that are not directly below the patch.
It can operate in two modes. In one, all of the transducers can be synched together to transmit ultrasound waves which produce a high-intensity beam that focuses on one spot.
This can be up to 14cm deep in the body.
The other mode allows the transducers to be programmed to transmit out of sync producing beams at different angles.
In being able to manipulate the beams, it gives the device multiple capacities for monitoring central organs as well as blood flow with high resolution.
When the electricity flows through the transducers, they vibrate while emitting ultrasound waves that travel through the skin into the body.
When they penetrate a blood vessel, they encounter the movement of red blood cells flowing inside. The cell movement changes how the waves are transmitted back to the patch.
This change is recorded by the patch and creates a visual recording of the blood flow. It can also be used to create moving images of the heart’s walls.
Sheng Xu, professor of nanoengineering at the UC San Diego Jacobs School of Engineering said:
“This type of wearable device can give you a more comprehensive, more accurate picture of what’s going on in deep tissues and critical organs like the heart and the brain, all from the surface of the skin.”
Xu added: “This is a first in the field of wearables because existing wearable sensors typically only monitor areas right below them.
“If you want to sense signals at a different position, you have to move the sensor to that location. With this patch, we can probe areas that are wider than the device’s footprint. This can open up a lot of opportunities.”
The researchers say that the easy to use patch could allow patients to wear the patch and monitor the results themselves. It doesn’t depend on a technician to read the results
The next stage
The patch is not yet ready for clinical use. The researchers are currently working on a way to make the electronics wireless as it currently needs a power source and benchtop machine.
Image credit: Nature Biomedical Engineering
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