Five men with complete motor paralysis were able to voluntarily generate step-like movements thanks to a new strategy that non-invasively delivers electrical stimulation to their spinal cords, according to a new study funded in part by the National Institutes of Health.

The strategy, called transcutaneous stimulation, delivers electrical current to the spinal cord by way of electrodes strategically placed on the skin of the lower back. This expands to nine the number of completely paralyzed individuals who have achieved voluntary movement while receiving spinal stimulation, though this is the first time the stimulation was delivered non-invasively. Previously it was delivered via an electrical stimulation device surgically implanted on the spinal cord.

In the study, the men’s movements occurred while their legs were suspended in braces that hung from the ceiling, allowing them to move freely without resistance from gravity. Movement in this environment is not comparable to walking; nevertheless, the results signal significant progress towards the eventual goal of developing a therapy for a wide range of individuals with spinal cord injury.

“These encouraging results provide continued evidence that spinal cord injury may no longer mean a life-long sentence of paralysis and support the need for more research,” said Roderic Pettigrew, Ph.D., M.D., director of the National Institute of Biomedical Imaging and Bioengineering at NIH. “The potential to offer a life-changing therapy to patients without requiring surgery would be a major advance; it could greatly expand the number of individuals who might benefit from spinal stimulation. It’s a wonderful example of the power that comes from combining advances in basic biological research with technological innovation.”

The study was conducted by a team of researchers at the University of California, Los Angeles; University of California, San Francisco; and the Pavlov Institute, St. Petersburg, Russia. The team was led by V. Reggie Edgerton, Ph.D., a distinguished professor of integrative biology and physiology at UCLA and Yury Gerasimenko, Ph.D., director of the laboratory of movement physiology at Pavlov Institute and a researcher in UCLA’s Department of Integrative Biology and Physiology. They reported their results in the Journal of Neurotrauma.

Further studies have been initiated. The hope is that further research can help determine whether non-invasive stimulation can restore function that will truly impact patient lives.

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Bill Fertig, director of United Spinal Association’s Resource Center, has witnessed a change in the approach to SCI research over the years. For example, in 2005 when Fertig started work with the SCI Resource Center, he recalls that some activity-based were considered outside of the mainstream medical community, and some felt such therapy programs unreliable. In the years since, research in this area has grown considerably.

Additionally, advances in basic research over just the past 15 years have centered first on stem cell therapies, political implications and all, repetitive motion therapies and now a focus on external stimulation, all to help improve physical function.

In terms of future developments, Fertig adds, “Of course no one knows what the future will truly bring, nor what will prove to be the most promising approach to further reestablishment of physical movement and enhancement of other bodily systems. But, it is clear that this transcutaneous stimulation success is but another encouraging waypoint in the quest to more fully rehabilitate after SCI/D brings about paralysis.”