Walking after spinal injury ‘a real possibility’ after Scots trial
THE doctor who led a groundbreaking Glasgow trial has said she believes a new therapy could lead to tetraplegic patients being able to walk again.
The results have shown that recovery from catastrophic spinal injuries is now a “real possibility”.
Participants were treated with a device that delivers electrical stimulation to the spinal cord above and below the section that has been damaged.
This damage results in signals that travel between the brain and body and control movement being interrupted and the treatment aimed to enhance the connection across the damaged part.
All the patients had been living with their injury for some time and had not experienced any improvement for a considerable period, in some cases many years.
NHS Greater Glasgow and Clyde was the only UK health board taking part in the worldwide trial of ARC-EX
Therapy.
Participants were required to have some strength in their hands to qualify for treatment.
Of those taking part, 72% showed an improvement and of those that didn’t, there was no further deterioration.
Dr Purcell, who led the UP-LIFT study involving five patients at the Queen Elizabeth National Spinal Injuries Unit, said: “These are all patients who have tetraplegic paralysis from the neck down to some degree or another. Overall, 72% of patients met the primary endpoint, which was an improvement and the others didn’t deteriorate. For one patient the device brought a significant impact on their ability to play the guitar and, while the study focused on upper limb and hand function, in some patients we also saw an improvement in blood pressure and temperature control, along with bladder and bowel function.
“The study looked at upper limb and hand function in chronic patients, but applied acutely in newly injured patients with standard rehabilitation, non-invasive spinal cord stimulation may have profound benefit. There’s no other treatment like this.”
She added: “One of my five patients was able to walk before the study and he spoke about how much his gait and walking pattern had improved.”
She said a “little bit of work” had now been done to establish if there is an improvement in patients who were able to walk before they took part.
She said: “We expect that this device in a large number of patients is going to result in some benefit in a lot of modalities – their leg movements, their arm movements, their blood pressure control, their bladder control.
“This opens the door for doing the work in patients who have got a spinal cord injury to look at their leg power and all the other aspects which can be affected.”
The UP-LIFT study, which was published in the journal Nature Medicine, was run by ONWARD Medical.
Asked if she believes the therapy has the potential to allow people with catastrophic spinal injuries to walk again Dr Purcell said: “I do.”
She added: “I’m jumping ahead in a way but we have demonstrated that this is safe [and] we’ve demonstrated that in patients who have stopped improving – and many were many years down the line from their spinal injury – we’ve demonstrated that they can improve more.
“I see in the longer term where we would be best applying this treatment in patients who have recently had a spinal cord injury and they are having physiotherapy and occupational therapy and that’s when their improvement is going to be at a maximum.
“If we can apply the treatment at this stage, that’s where I see it making the most gains for patients.”
Award-winning writer Melanie Reid was among the five people who took part in the Glasgow trial.
The former Herald journalist broke her neck and back in a horrific riding accident in 2010 on Good Friday and began writing a column for The Times three weeks later.
She said: “It’s a woman’s right to be able to put her hair up in a scrunchie, and the therapy allowed me to do that.”
“Your hands are so intrinsically taken for granted, but they are vital to so many aspects of someone’s quality of life. After many years in my chair, I’d learned just to accept my limits, so it was great just to think, ‘Yes, I can do more’. The benefits were real and I’m still feeling them more than two years after the study.”
The benefits were real and I’m still feeling them more than two years after the study