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New treatment helps the paralyzed regain motion
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Avis Favaro, CTV Medical Specialist
Date: Sun. Nov. 23 2003 11:04 PM ET
A fascinating experiment is underway in the basement of a Toronto rehabilitation hospital, where a research scientist is working with the power of the human body to heal itself after an injury.
This is an experimental treatment, using a form of electrical stimulation that engineer Milos Popovic discovered by accident.
Dr. Popovic is an assistant professor at the Institute of Biomaterials and Biomedical Engineering, University of Toronto, and a research scientist with the Toronto Rehabilitation Institute.
Before coming to Canada, he worked in Switzerland on prosthetic electrical devices for the disabled. He discovered that when some patients were trained on the devices, their limbs recovered a bit of movement.
When he joined the Toronto Rehabilitation Institute three years ago, Popovic began to test the stimulation system on five stroke patients. A Walkman-sized device is used to stimulate the patient's nerves with electrical impulses. A therapist then pushes the limb in a repetitive fashion, teaching the brain that it can move that arm, leg or hand.
Popovic's team compared the five stroke patients to eight control patients who got standard physiotherapy.
None of the eight control patients improved after 12 weeks of treatment, and all five of the stroke patients on the stimulation treatment improved. Many got back 60 per cent of their lost function.
Mohammed Moallemia, 74, is a medical marvel after participating in the experiment. After a stroke, his right arm was frozen in an L-shape against his chest. Doctors predicted it wouldn't get much better.
But after 12 weeks of this unique therapy, he is able to turn the pages of a book with his hand, pick up a cup and feed himself. "I am back to normal," Moallemia said.
Dr. Adam Thrasher, clinical research fellow with the Canadian Paraplegic Association, says the treatment stimulates the nerves connected to the muscle tissue. "It sends a signal to the muscle saying 'contract' just as the brain would have done … so it's an involuntary contraction."
The repetitions work their magic. Eventually, patients seem to turn these involuntary movements into new learned movements.
In the spinal cord area of the research, a patient with an incomplete spinal cord injury who could not walk, is now walking with the aid of parallel bars and a physiotherapist.
"We train people like you would train kids to walk," Popovic says. "They will make many mistakes, but eventually they will train their neural network to perform this task."
The researchers are now trying to assemble a team of experts -- neurologists and other specialists -- to figure out what is really happening to these patients. Large-scale studies are being planned.
"We're beginning to understand that the brain can make new connections," Geoff Fernie, the vice president of research for Toronto Rehabilitation. "Exactly how this happens is the subject of a lot of research around the world, and here in Toronto, but I think there are huge implications."
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