With the help of an implanted device that delivers an electrical current to the lower spinal cord, four young men who have been paralyzed for years are now able to move their legs voluntarily. All four men were completely unable to move their legs before being implanted with the device, which sends the lower spinal cord a continuous electrical current similar to signals transmitted by the brain. The treatment, called epidural stimulation, delivers an electrical current of varying frequency and intensity to specific parts of the lumbosacral spinal cord, which is connected to dense bundles of nerve fibers that control movement in the hips, knees, ankles and toes. Life scientists from the University of Louisville, Kentucky, and the University of California-Los Angeles, both in the US, and the Pavlov Institute of Physiology in St. Petersburg, Russia, report the groundbreaking achievement in the journal Brain.

The achievement ‘offers a new outlook’ on recovery following spinal cord injury Lead author Claudia Angeli, an assistant professor at the University of Louisville’s Kentucky Spinal Cord Injury Research Center (KSCIRC), says two of the men “were diagnosed as motor and sensory complete injured with no chance of recovery at all,” and adds: “Because of epidural stimulation, they can now voluntarily move their hips, ankles and toes. This is groundbreaking for the entire field and offers a new outlook that the spinal cord, even after a severe injury, has great potential for functional recovery.” One of the participants, Rob Summers of Portland, OR, was the subject of an earlier study published in the Lancet in May 2011, which reported how the shock treatment helped him recover a number of motor functions so he could stand, step with assistance and move his legs voluntarily. This new breakthrough builds on that work. The Brain paper documents the effect of epidural stimulation in a total of four participants, including new tests on Rob Summers who was paralyzed after being hit by a vehicle. The other three men – Kent Stephenson of Mt. Pleasant, TX, Andrew Meas of Louisville, KY, and Dustin Shillcox of Green River, WY – were paralyzed as a result of auto or motorcycle accidents.

Participants able to move legs immediately after receiving stimulator implant The scientists say what is remarkable about this latest work is that the three new participants were able to move voluntarily as soon as the stimulator was implanted. They were surprised at the results – especially how quickly the men recovered. This made them think perhaps some of the voluntary movement control pathways may be intact after injury. The results were even better when electrical stimulation was coupled with physical therapy. The team noticed that the men were progressively able to move their legs with less stimulation, showing that the spine was learning and improving nerve function. As well as being able to move their legs and bear their weight, the participants are showing a wealth of other improvements in their overall health. These include increased muscle mass, blood pressure regulation, reduced fatigue and significant increases in self-reported well-being. In the first part of the video below, participant Kent Stephenson demonstrates voluntary training with stimulation and training with an ankle weight. In the last segment, Rob Summers tosses a medicine ball.