Restoring strength and hope after spinal injury
HMRI researcher Dr Michelle Rank explains how exercise therapy holds the best promise to recover movement after a serious spinal cord injury.
Each year nearly 400 Australians sustain a spinal cord injury, with one in three injuries occurring in young people between 15 to 24 years old. Most spinal cord injuries are caused by motor vehicle accidents. Right now, around 12,000 Australians are living with a spinal cord injury, most (84%) of them men.
After a serious spinal cord injury, movement and feeling can be lost completely. Currently there are no medications available to help people walk again.
How severe a spinal cord injury is depends on the location and amount of damage to the spinal cord. Injuries to the neck will result in a paralysis of all four limbs (quadriplegia) and injuries below this level will result in different areas of paralysis from the legs up to the abdomen (paraplegia).
Spinal cord injury can also impact other bodily functions. Bladder and bowel control can be affected as well as the ability to breathe independently. The long-term effects of spinal cord injury can be devastating.
Many of us recall the recent exciting news about the continued recovery of Newcastle Knights player Alex McKinnon. After months of dedicated physical therapy since sustaining his spinal cord injury in March 2014, Alex is now able to stand.
His impressive recovery from a devastating paralysis to regaining strength and movement has been remarkable to watch. But how is it possible?
Emerging therapies like stem cells are very exciting but, for now simple, is best.
Exercise therapy can improve movement!
Specialised exercise training, usually in the form of therapist-assisted step training on a treadmill, is by far the most effective treatment currently available. It results in significant improvements in standing and walking after spinal cord injury.
Most people with spinal cord injuries have some undamaged nerves left around the site of the injury. Using laboratory models, our research has shown that exercise training encourages the remaining nerves to sprout and make a functional 'bridge' around the damaged area.
I also recently discovered that dedicated exercise therapy improves the communication across these nerve 'bridges'. For patients with a spinal cord injury, this means it is easier for messages from from the brain to reach the muscles they want to move.
The next step in my project, subject to funding support, is to try to identify what type of nerve cell in the spinal cord is most important for recovery, and most sensitive to exercise training. This will hopefully lead to targeted therapies that can increase recovery and reduce the amount of exercise therapy required.