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View Full Version : Electric jolts help spinal patients regain use of hands



Uncle Paul
02-20-2011, 10:50 PM
CTV.ca News Staff
Date: Thu. Feb. 17 2011 7:25 PM ET
A new treatment that delivers tiny bursts of electricity to paralyzed muscles in people with spinal cord injuries appears to actually "revive" the muscles and restore hand movement.
The discovery was made almost by accident.
Researchers at the Toronto Rehabilitation Institute were working on a technology they call functional electrical stimulation. The therapy delivers multiple sharp shocks per second to the forearms of patients with incomplete spinal cord injuries, in an effort to make muscles move in a patient's limb.
The researchers had expected that FES therapy would be used over the long term through a home-based electrical stimulator to help patients with their hand function.
But they discovered that after just 40 treatments, many patients didn't need the electrical stimulator anymore. Their hands and arms had re-learned how to pick up objects and hold them voluntarily.
Some patients saw such big improvements, they were able to perform everyday activities such as dressing and eating tasks that they otherwise would have needed a caregiver to provide.
"This has real implications for people's quality of life and independence, and for their caregivers," says the study's lead author, Dr. Milos R. Popovic, a Senior Scientist at Toronto Rehab and head of the hospital's Neural Engineering and Therapeutics Team.
The research team has now documented the experience of patients who have used the therapy in a study posted online in the journal Neurorehabilitation and Neural Repair.
The study involved 24 patients who had had an incomplete spinal cord injury within the previous six months and who could not grasp objects or perform many activities of daily living.
All received conventional occupational therapy five days per week for eight weeks. Nine were randomly chosen to also receive an hour of FES therapy daily, while 12 patients had an additional hour of conventional occupational therapy only. (Three patients did not complete the trial.)
The patients who underwent the stimulation therapy had "significantly reduced disability and improved voluntary grasping," the authors write.
Patients who received only occupational therapy saw a "gentle improvement" in their grasping ability, but the level of improvement achieved with FES therapy was at least three times greater, according to the Spinal Cord Independence Measure, which evaluates degree of disability in patients with spinal cord injury.
Popovic says even a few years ago, no one thought that stimulating nerves and muscles in the hands and arms would lead to any long-term changes.
"What we now know is that through some interventions like this, you can actually change the way the brain operates to relearn the tasks that have been lost as a result of injury," he told CTV.
Anthony Burns, the medical director of the spinal cord rehabilitation program at Toronto Rehab, says the findings are exciting.
"The reality is to date we have not had a lot of specific interventions to offer, which that has been part of the frustration for clinicians who have been involved in the field," he says.
The research team stresses that FES therapy wouldn't replace conventional occupational therapy; it would augment it.
They now want to study how long the effects of the therapy last. They also want to know whether it will work in patients with older incomplete spinal cord injuries. Another study has already begun seeking to answer that question.