E-Stim, Again

Following up on the E-Stim Exoskeleton post from Feb. 16, about electrical stimulation (e-stim).  What is it and how does it work?

In rehabilitation, Electric Muscle Stimulation (EMS) is a way to urge muscle response.  Patches with wires are put directly on targeted muscles.  Electrical impulses are then sent from a machine in order to make those muscles contract.  E-stim can be a way to effectively build or maintain muscle tone.  There is another type of electrical stimulation called Transcutaneous Electrical Nerve Stimulation (TENS), primarily used for treating chronic pain.  Functional Electrical Stimulation (FES) is the therapeutic application of e-stim.  Some people use FES bicycles at home after a SCI.

The ability to use e-stim depends on precisely how and where an injury to the nervous system occurs.  Damage to lower motor neurons (LMN, as opposed to upper motor neurons) compromises muscle innervation, meaning that e-stim isn't necessarily an option for muscle rebuilding or maintenance.  With LMN trauma, again depending on the cause and type, voluntary muscle movement and reflexes are lost.  E-stim may not cause any muscle contraction if LMN damage is a factor.  (This has been the case for me so far.  One therapist said it was a 50/50 chance that e-stim would work after a SCI.  But keep reading.)

I've read in passing that e-stim must be begun very early on after the injury, and that if it is not utilized at all within the first two weeks or so, then those particular peripheral nerves quit firing in response.  Whether that's true I can't say.  In my limited experience, when they say it can't be done, it's still worth the try!  Studies on the use of FES for spinal cord injury rehabilitation are ongoing.

TetraStem Press Release

A new topical treatment is making the news (albeit low-key) for its potential in spinal cord injury recovery.  TetraStem is created by Phillips Company and reportedly converts your own cells into stem cells.  According to the press release, which details the ongoing recovery of a young woman named Miranda, Phillips Co. is interested in finding others who would like to be involved in the trials process for TetraStem.
Research like this tends to take a backseat to traditional pharmaceuticals, in part because your personal stem cells belong to you and cannot be patented.
Something to think about!

E-Stim Exoskeleton

Clinical trials at UCLA are putting together an exoskeleton and electrical stimulation (e-stim).  E-stim encourages the body to take part in helping the robotic exoskeleton, and allows for the potential to recover - meaning this sort of device may be more functional than traditional exoskeletons, because it will be useful for therapy, as well.

Recovery Video: Going Forward

A personal update: walking forward with only ankle sport-braces in this video.  I'm still working to drop long leg orthotics.  This has been the official bracing sequence: from bilateral locked KAFOs (Knee-Ankle-Foot Orthotics locked at the knee, as Franklin D. Roosevelt used) to unlocked KAFOs to modular KAFOs/ AFOs (Ankle-Foot Orthotics without locks and with very mild knee support).  In a past video, I showed walking backwards with the same combination of ankle support wraps.  Because walking in different directions requires different muscle groups, intervals of both have been an important part of recovery since the very beginning (see previous videos on my YouTube channel).  It's much harder than it looks!