Paraplegic Man stands, Steps With Assistance and Moves His Legs Voluntarily

A team of scientists at the University of Louisville, UCLA and the California Institute of Technology has achieved a significant breakthrough in its initial work with a paralyzed male volunteer at Louisville's Frazier Rehab Institute — the result of 30 years of research to find potential clinical therapies for paralysis. The study is published today in the British medical journal The Lancet.

The man was completely paralyzed below the chest after being struck by a vehicle in a hit-and-run accident in July 2006. Today, he is able to reach a standing position, supplying the muscular push himself. He can remain standing, and bearing weight, for up to four minutes at a time (up to an hour with periodic assistance when he weakens). Aided by a harness support and some therapist assistance, he can make repeated stepping motions on a treadmill. He can also voluntarily move his toes, ankles, knees and hips on command.

These unprecedented results were achieved through continual direct "epidural electrical stimulation" of the subject's lower spinal cord, mimicking signals the brain normally transmits to initiate movement. Once that signal is given, the research shows, the spinal cord's own neural network, combined with the sensory input derived from the legs to the spinal cord, is able to direct the muscle and joint movements required to stand and step with assistance on a treadmill.

The other crucial component of the research was an extensive regime of locomotor training while the spinal cord was being stimulated and the man suspended over the treadmill. Assisted by rehabilitation specialists, the man's spinal cord neural networks were retrained to produce the muscle movements necessary to stand and to take assisted steps.

Leading researchers on the 11-member team are two prominent neuroscientists: Susan Harkema, of the University of Louisville's Department of Neurosurgery, Kentucky Spinal Cord Research Center and Frazier Rehab Institute, a service of Jewish Hospital and St. Mary's HealthCare in Louisville; and V. Reggie Edgerton, of UCLA's Division of Life Sciences and the David Geffen School of Medicine at UCLA.

Joel W. Burdick, a professor of mechanical engineering and bioengineering at Caltech, developed new electromechanical technologies and computer algorithms to aid in locomotion recovery in spinal cord injury patients.

The research was funded by the Christopher and Dana Reeve Foundation and the National Institutes of Health. Harkema is director of the Reeve Foundation's NeuroRecovery Network, which translates scientific advances into activity-based rehabilitation treatments. Edgerton is a member of the Reeve Foundation's Science Advisory Council and its International Research Consortium on Spinal Cord Injury.