STEPS: Hospital studies walking therapy for children with
By Kathleen Longcore
The Grand Rapids Press
Amy Valderas gets teary just watching her 7-year-old son
walk across a room.
could watch him for hours, because when he was small they
said he might never walk," Valderas said.
prematurely at just 26 weeks, Jaime Garcia suffered cerebral
palsy -- permanent brain damage that affected his limbs
Since then, he has had multiple surgeries and lots of
therapy at Ken-o-sha Park Elementary in Grand Rapids.
And he's not only walking, he tries to run.
also is part of a new research study at Mary Free Bed
Hospital &Rehabilitation Center which might be
able to smooth out his unsteady gait.
knowledge gleaned from other studies -- including groundbreaking
work at UCLA -- therapists will assess how children with
cerebral palsy walk before and after eight weeks of regular
therapy and again after eight weeks of a trial therapy
called supported treadmill training.
study uses training similar to that in research presented
in Grand Rapids earlier this month by Susan Harkema, an
assistant professor of neurology at UCLA and a researcher
at the university's Human Locomotion Research Institute.
and others in her field have exploded long-held theories
about how people walk by proving that some people paralyzed
from spinal cord injuries can learn how to stand and walk.
California research, with a team that includes neuroscientists,
engineers, computer programmers, and a physical therapist,
gets funding from the National Institutes of Health, the
National Multiple Sclerosis Society, and the Christopher
Reeve Paralysis Foundation.
recent presentation at a spinal cord symposium sponsored
by Mary Free Bed was a homecoming of sorts -- she is a
Jenison High School graduate.
said for decades, scientists believed people walked because
the brain sent messages through the spinal cord to motor
nerve cells, which sent signals to the muscles in the
legs and feet. Under this theory, if spinal cord injury
cut off the message from the brain, the person could no
what animal studies and now human research have shown
is that a healthy spinal cord below the area of injury
can be trained to remember how to send walking signals.
animal research we saw that the spinal cord itself has
the capacity to re-learn how to take steps," Harkema
said. "So we thought the spinal cord might be able
to operate without signals from the brain,"
studies have shown that locomotion -- the act of standing
and taking steps -- helps the spinal cord send appropriate
messages to motor neurons.
experiments suspend paralyzed patients in a harness above
a treadmill. Harkema's team found three things helped
the spinal cord remember: near normal weight load on the
joints, manually moving the ankles, knees and legs, and
setting the treadmill at a normal walking speed.
can re-train the spinal cord with appropriate sensory
cues from the muscles," Harkema said. "Even
though (the paralyzed person) can't perceive it or feel
it because of the disconnect to the brain, the spinal
cord can still perceive it."
act of stepping seemed to stimulate the spinal cord, and
paralyzed patients who started stepping with manual assistance
were soon taking steps on their own.
patients who could not voluntarily flex their knees and
ankles when they were at rest could flex them -- a movement
necessary to walking --when they were stepping on a treadmill.
This means voluntary control of the legs does not predict
a patient's ability to walk.
said the research proves the spinal cord is not just a
conduit for locomotion signals from the brain.
spinal cord takes care of the details of movement,"
she said. "And, if we can understand how it does
that, we can get closer to the silver bullet" --
a cure for paralyzing spinal cord injury.
remains to be seen whether Harkema's discoveries can be
translated to therapies for children like Jaime who have
permanent brain damage.
a previous limited study at Mary Free Bed, nine weeks
of supported treadmill training improved children's endurance,
heart rate and oxygen intake. But the study was too small
to be conclusive, said Lisa Beard, a physical therapist
with a master's degree from Grand Valley State University.
And the study, which was designed at GVSU, had no control
then the study has been tweaked, with controls added,
said Beard, who did the previous study as part of a pediatric
good results from Harkema's lab in California give Valderas
reason to hope her son's gait can be improved. And she
jumped at the chance to enroll him in the Mary Free Bed
makes things easier for me because he's so determined.
He's a fighter, and he's come a long way," she said.
Original source: http://www.mlive.com