Paralyzed people are beginning to walk with a new kind of therapy |

Paralyzed people are beginning to walk with a new kind of therapy

Jered Chinnock stands with the assistance of his therapy team at the Mayo Clinic in Rochester, Minn., on Sept. 18, 2018. Chinnock, paralyzed since 2013, can stand and take steps again thanks to an electrical implant that zaps his injured spine and months of intense rehab as part of a medical study at the clinic. From left are Margaux Linde, Megan Gill, Chinnock, Daniel Veith and Jonathan Calvert.

Kelly Thomas woke up in a Florida hospital four years ago with no recollection of the car accident that had robbed her of the ability to walk. Thomas, an active college student who had barrel-raced in rodeos, moved to Kentucky for a year to try out a research study that she hoped would retrain her spinal cord on how to walk.

In February, a trainer who had been scooting along the floor at Thomas’s feet, helping her move her legs and place her feet as she used a walker, stopped and stood up.

“What are you doing?” Thomas asked, alarmed.

“You’re doing it,” the trainer, Rebekah Morton, told her. “You don’t need me.”

Thomas hesitated, and then took a step on her own. Then another. She froze.

“I’m like, ‘That just happened.’ I’ve been working so hard for four years. I got emotional,” Thomas recalled.

Thomas, now 23, is one of several people with spinal cord injuries who are standing, taking steps and — in her case — walking without assistance, thanks to an experimental combination therapy. In a research study at the University of Louisville, Thomas and three others had a device surgically implanted on their spinal cords to stimulate electrical activity, accompanied by months of daily physical therapy. In the New England Journal of Medicine, researchers from the University of Louisville reported that two of the subjects could stand and take limited steps at the end of the study, and two were able to walk independently — Thomas and another patient, Jeff Marquis.

A simultaneous case report published in Nature Medicine reported that a single patient with a complete spinal cord injury at the Mayo Clinic was also able to take steps and walk with trainer assistance with electrical stimulation and intensive physical therapy.

“The history of spinal cord injury research is we have 50 years or more of essentially failed trials, with no positive findings,” said David Darrow, a neurosurgery resident at the University of Minnesota Medical School who was not involved in either study but has also been implanting a stimulator device in people with spinal cord injuries. “This is sort of a new era.”

Still more questions

Darrow said there are caveats to the newest studies, and a slew of unanswered scientific and medical questions. This is still a tiny number of patients, with variable injuries, so it is impossible to know how well the intervention will work in the broader population of people with spinal cord injuries. There are also plenty of questions about how the technique works, which will be untangled only as a broader community of researchers begins to study the approach in more patients.

But the results are a powerful proof of concept, built on a surprising case report by the Louisville research team in 2011. Researchers took a medical device developed to manage chronic pain and implanted it to stimulate the spinal cord of a paralyzed patient. After rehabilitation sessions, that patient learned to stand and regained some voluntary control of his leg movements.

Susan Harkema, associate scientific director of the Kentucky Spinal Cord Injury Research Center at the University of Louisville who pioneered the technique in people, said that the devices are implanted well below the site of the injury. This isn’t a case of patients regrowing some severed connection in the spine. Instead, Harkema sees these studies as heralding a gradual shift in how experts think of the spinal cord — as able to learn new ways to walk, with the right combination of training and electrical stimulation.

“The basis of this work is that the spinal circuitry is sophisticated and really has the same properties that the brain does in many ways, and in the context of this study, really what is shown is it has the capability of relearning to walk essentially in the right conditions,” Harkema said.

The hope is that as these techniques begin to be tested in more places and in more patients, the demand will drive the technology to be improved and tailored for the intervention. The researchers readily admit they are not engineers and hope to see a stimulator developed with this application in mind, instead of finding new purposes for an off-the-shelf device.

The technique will also need to be tried in more diverse people; the study subjects were in their 20s and early 30s, and it had been about two or three years since their injuries.

Carolyn Y. Johnson is a writer for The Washington Past.

TribLIVE commenting policy

You are solely responsible for your comments and by using you agree to our Terms of Service.

We moderate comments. Our goal is to provide substantive commentary for a general readership. By screening submissions, we provide a space where readers can share intelligent and informed commentary that enhances the quality of our news and information.

While most comments will be posted if they are on-topic and not abusive, moderating decisions are subjective. We will make them as carefully and consistently as we can. Because of the volume of reader comments, we cannot review individual moderation decisions with readers.

We value thoughtful comments representing a range of views that make their point quickly and politely. We make an effort to protect discussions from repeated comments either by the same reader or different readers

We follow the same standards for taste as the daily newspaper. A few things we won't tolerate: personal attacks, obscenity, vulgarity, profanity (including expletives and letters followed by dashes), commercial promotion, impersonations, incoherence, proselytizing and SHOUTING. Don't include URLs to Web sites.

We do not edit comments. They are either approved or deleted. We reserve the right to edit a comment that is quoted or excerpted in an article. In this case, we may fix spelling and punctuation.

We welcome strong opinions and criticism of our work, but we don't want comments to become bogged down with discussions of our policies and we will moderate accordingly.

We appreciate it when readers and people quoted in articles or blog posts point out errors of fact or emphasis and will investigate all assertions. But these suggestions should be sent via e-mail. To avoid distracting other readers, we won't publish comments that suggest a correction. Instead, corrections will be made in a blog post or in an article.