A device that stimulates the spinal nerves with electrical pulses appears to boost how well people recover from major spinal cord injuries, doctors say.
An international trial found that patients who had lost some or all use of their hands and arms after a spinal cord injury regained strength, control and sensation when the stimulation was applied during standard rehabilitation exercises.
The improvements were small, but were described by doctors and patients as life-changing because of the impact they had on the patients’ daily routines and quality of life.
“It actually makes it easier for people to move, including people who have total loss of movement in their hands and arms,” said Prof Chet Moritz in the Department of Rehabilitation Medicine at the University of Washington in Seattle.
“The benefits gradually accumulate over time as we couple this spinal stimulation with intensive therapy of the hands and arms, so that there are benefits even when the stimulator is turned off.”
Rather than being implanted, the Arc-Ex device is worn externally and uses electrodes placed on the skin near the part of the spinal cord responsible for controlling a particular movement or function.
The researchers believe that electrical stimulation helps nerves that remain intact after the injury to send signals and eventually partially restore communication between the brain and paralyzed body part. More than half of patients who suffer spinal cord injuries still have some intact nerves crossing the injury site.
Melanie Reid, a journalist and author who was left with very little function under her armpits after breaking her neck aged 52 when she fell from a horse 14 years ago, told the British section of the trial Scotland participated. After the trial, which involved two months of rehab and a further two months of rehab with stimulation, she got some grip in her left hand which was “useless”.
“My left hand is much stronger,” she said. “I’ve got some grip back in it. I can flip a tablet or a phone in my left hand, I can unbuckle a seat belt with it, and I can … put my hair back in a ponytail, which I couldn’t do before,” she said.
“Everyone thinks so [with a] spinal cord injury, all you want to do is be able to walk again. But if you are tetraplegic or a quadriplegic, working hands are most important. There are no miracles in spinal cord injury, but small gains can be life-changing.”
The Up-Lift Trial, reported in Nature Medicine, enrolled 65 tetraplegic patients in 14 countries. Of 60 who completed the trial, 43 showed improvements in strength and function and 52 reported improvements in quality of life. The device, manufactured by Onward Medical, a firm co-founded by a researcher on the study, Grégoire Courtine, may be approved in the US this year and soon after in Europe.
Dr Mariel Purcell, who led part of the Up-Lift trial at the Queen Elizabeth National Spinal Injuries Unit in Glasgow, said the treatment had been shown to be safe and “of some benefit” for patients whose injuries exceed ‘ experienced a year ago. “In newly injured patients with standard rehabilitation, non-invasive spinal cord stimulation can be of great benefit,” she said. “There is no other treatment like this.”
Another patient, Sherown Campbell, who participated in the trial at Craig Hospital in Colorado, was paralyzed by a neck injury while wrestling a friend in 2014. He regained some range of motion shortly after the accident. rehab but experienced more gains in the trial. He improved his typing speed from 25 to 33 words per minute and can now help more around the house with cooking and doing activities with his children. “Seeing benefits at this point in my injury is really big,” he said.
Prof Courtine said the trial “demonstrates the principle” and that the researchers will now investigate whether it can help other functions such as walking. “This is not a cure, it’s important to emphasize that, but we are at the beginning of a journey that makes recovery from spinal cord injury a real possibility,” he said.
