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gpaleg
Instructor
| Joined: | Sat Mar 24th, 2007 |
| Location: | Washington DC, USA |
| Posts: | 1 |
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Posted: Sat Mar 24th, 2007 11:22 pm |
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| first without and then with. We did 6 weeks of regular BWSTT and then added E stim for 6 weeks
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jencmaine
Instructor
| Joined: | Sun Jun 11th, 2006 |
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| Posts: | 11 |
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Posted: Sat Mar 24th, 2007 03:15 pm |
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Ginny and all
Am I reading this correctly, the BWSTT was without FES???
Thanks
Jen Corbeil
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Ginny Paleg, MS, PT
Instructor
| Joined: | Fri Jul 14th, 2006 |
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| Posts: | 6 |
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Posted: Fri Dec 8th, 2006 04:00 pm |
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| This prospective, single-case study evaluated the functional recovery from Spina Bifida of a very young child (12-30 mos). The patient was motor and sensory complete. Her condition was classified as L5-6 American Spinal Injury Association (ASIA) Grade A and she had experienced no substantial recovery in the first year of life after repair by Dr. Ben Carson. Clinical experience and evidence from the scientific literature suggest that further recovery would not take place. The study began when the subject was 12 months old. She was able to roll and command crawl using her arms, but could not sit independently, or attain any other position. At 12 months of age she began 6 weeks of BWSGT without FES 3x/week for 8 minutes at .5 mph. The hypothesis was that patterned neural activity might stimulate the central nervous system to become more functional, as it does during development. Over a 3-year period (5-8 years after injury), the patient's condition improved from ASIA Grade A to ASIA Grade C, an improvement of two ASIA grades. Motor scores improved from 0/100 to 20/100, and sensory scores rose from 5-7/112 to 58-77/112. Using electromyography, the authors documented voluntary control over important muscle groups, including the right hemidiaphragm (C3-5), extensor carpi radialis (C-6), and vastus medialis (L2-4). Reversal of osteoporosis and an increase in muscle mass was associated with this recovery. Moreover, spasticity decreased, the incidence of medical complications fell dramatically, and the incidence of infections and use of antibiotic medications was reduced by over 90%. These improvements occurred despite the fact that less than 25 mm2 of tissue (approximately 25%) of the outer cord (presumably white matter) had survived at the injury level. The primary novelty of this report is the demonstration that substantial recovery of function (two ASIA grades) is possible in a patient with severe C-2 ASIA Grade A injury, long after the initial SCI. Less severely injured (lower injury level, clinically incomplete lesions) individuals might achieve even more meaningful recovery. The role of patterned neural activity in regeneration and recovery of function after SCI therefore appears a fruitful area for future investigation.
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