Neuromodulation method for improving mobility in paraplegics

Severe spinal cord injury can cause the total or partial loss of descending tracts from the brain motor structures to the lumbar spinal cord that is responsible for the activation of lower limb muscles. The result is the loss of control over voluntary movements and the ability to stand and walk. Independently from the spinal cord injury, there are locomotor centers within the lumbar spinal cord with the inherent property to control stepping-like movements that still exist below the lesion level. Under the mentorship of Prof. Milan R. Dimitrijevic, our cooperation of Viennese mathematicians, neurologists, and physiatrists has been able to prove that lumbar spinal cord stimulation with electrodes implanted in the epidural space (inside the vertebral canal but outside of the spinal cord) could produce functional lower limb movements in individuals with complete absence of brain motor control. We could demonstrate that the human lumbar locomotor circuitries responded to the non-patterned electrical stimulation with the generation of stepping-like alternating flexion and extension movements as well as with standing-like extensor patterns. However, the invasive nature of the placement of epidural electrodes has limited this method of spinal cord stimulation to be widely used in rehabilitation practice. In our recent work, we developed a novel method of spinal cord stimulation that utilizes surface electrodes and stimulators which are routinely used in physical medicine. Based on our scientific research results and with the close involvement of Prof. Dimitrijevic in the context of "Translational Brainpower", we aim at further advancing our non-invasive technique in the direction for neuromodulation of lumbar cord functions to facilitate functional motor activities, including standing and stepping in paralyzed people. Our interdisciplinary approach will be integrating neurophysiological methods and computational sciences, a unique design that we have successfully applied in the past seven years to search for basic knowledge while providing a benefit to the studied patients. Locomotor training on a treadmill is presently an accepted method for improving the recovery of walking in individuals after incomplete spinal cord injury. Yet, recovery of walking is not routinely attained. To further enhance rehabilitation of locomotor capabilities, the availability of a clinical system for spinal cord stimulation based on our simply applicable surface-electrode technology can become an important assistive device for retraining of standing and walking.

Severe spinal cord injury can cause the total or partial loss of descending tracts from the brain motor structures to the lumbar spinal cord that is responsible for the activation of lower limb muscles. The result is the loss of control over voluntary movements and the ability to stand and walk. Independently from the spinal cord injury, there are locomotor centers within the lumbar spinal cord with the inherent property to control stepping-like movements that still exist below the lesion level. Under the mentorship of Prof. Milan R. Dimitrijevic, our cooperation of Viennese mathematicians, neurologists, and physiatrists has been able to prove that lumbar spinal cord stimulation with electrodes implanted in the epidural space (inside the vertebral canal but outside of the spinal cord) could produce functional lower limb movements in individuals with complete absence of brain motor control. We could demonstrate that the human lumbar locomotor circuitries responded to the non-patterned electrical stimulation with the generation of stepping-like alternating flexion and extension movements as well as with standing-like extensor patterns. However, the invasive nature of the placement of epidural electrodes has limited this method of spinal cord stimulation to be widely used in rehabilitation practice. In our recent work, we developed a novel method of spinal cord stimulation that utilizes surface electrodes and stimulators which are routinely used in physical medicine. Based on our scientific research results and with the close involvement of Prof. Dimitrijevic in the context of "Translational Brainpower", we aim at further advancing our non-invasive technique in the direction for neuromodulation of lumbar cord functions to facilitate functional motor activities, including standing and stepping in paralyzed people. Our interdisciplinary approach will be integrating neurophysiological methods and computational sciences, a unique design that we have successfully applied in the past seven years to search for basic knowledge while providing a benefit to the studied patients. Locomotor training on a treadmill is presently an accepted method for improving the recovery of walking in individuals after incomplete spinal cord injury. Yet, recovery of walking is not routinely attained. To further enhance rehabilitation of locomotor capabilities, the availability of a clinical system for spinal cord stimulation based on our simply applicable surface-electrode technology can become an important assistive device for retraining of standing and walking.