A man who was completely paralysed below his chest after a devastating car accident has been able to stand and take his first faltering steps on a treadmill after pioneering treatment to stimulate his spine electrically.
American Rob Summers was paralysed after a hit-and-run road accident in 2006 but is now the first patient in the world to respond significantly to a revolutionary treatment involving the electrical stimulation of the "dead" nerves in his spinal cord.
The electrical signals were designed to mimic the nerve impulses normally sent from the brain down the spinal cord to initiate the movement of the body's muscles. Mr Summers, 25, received the stimulation on a continuous basis as he underwent intensive physiotherapy and training exercises.
"This procedure has completely changed my life. For someone who for four years was unable to even move a toe, to have the freedom and ability to stand on my own is the most amazing feeling," Mr Summers said.
"To be able to pick up my foot and step down again was unbelievable, but beyond all that my sense of well-being has changed. My physique and muscle tone has improved greatly. Most people don't even believe I'm paralysed."
The treatment, called epidural stimulation, has taken 30 years to develop and is a way of bypassing the brain by teaching the spinal cord to control limbs independently. Mr Summers, who is normally confined to a wheelchair, was able to push himself upright and stand for several minutes. "I believe that epidural stimulation will get me out of this chair," Mr Summers said. He can take repeated steps on a treadmill and move his hips, knees, ankles and toes. He has also regained some sexual and bladder function, doctors reported yesterday in a study published in The Lancet.
"This is a breakthrough. It opens a huge opportunity to improve the daily functioning of these individuals ... but we have a long road ahead," said Professor Susan Harkema, of the Kentucky Spinal Cord Injury Research Center at the University of Louisville, one of the leaders of the research team.
Mr Summers was injured when a car mounted the pavement and hit him in Portland, Oregon. He suffered serious spinal damage, which left him paraplegic.
Five patients are taking part in the trial which follows promising results with animals. A key element of the treatment involves stimulating nerves with a 16-electrode implant inserted into the spinal cord. The signals mimic those which would normally be transmitted by the brain and an intensive regime of movement training is the other half of the therapy. Sensory inputs from the legs, combined with the electrical stimulation, help the spine's own neural network to reactivate muscles and joints.
"The spinal cord is smart. The neural networks are capable of initiating full weight-bearing and relatively coordinated stepping without any input from the brain. This is possible, in part, due to information sent back from the legs directly to the spinal cord," said Professor Reggie Edgerton, from the University of California, a leading member of the 11-person team of researchers.