One of the greatest impacts on quality of life for people with spinal cord injuries (SCI) is the loss of bladder and bowel control. These are conditions known as ‘neurogenic bladder’ and ‘neurogenic bowel.’ Urinary catheterization and time consuming regimens of bowel management number among the not merely ‘inconvenient’ but medically necessary realities. These requirements bring other risks to the health of the individual such as potential infections. Loss of bladder infection, in particular, requires pharmaceutical intervention to encourage voiding so that bladder pressure does not cause urine to flow back up to the kidneys…another ‘unintended consequence’ that accompanies SCI. A new paper published today online in Scientific Reports (Scientific Reports | (2018) 8:8688 | DOI:10.1038/s41598-018-26602-2) describes the work of Dr. Charles Hubscher and his team at the University of Louisville’s Kentucky Spinal Cord Injury Research Center (KSCIRC). The key finding was improvement in bladder function using spinal cord Electrical Stimulation (scES).
Spinal cord injuries have devastating effects on affected individuals and, most often, lead to paralysis. Our research team has previously shown that epidural stimulation of the spinal cord combined with intense activity-based rehabilitative training can help in the recovery of voluntary movement and standing. So far, this recovery has only been demonstrated when the spinal cord stimulation was being applied. In this paper, we show the progressive recovery of voluntary movement control and standing ability without the use of spinal cord stimulation in one individual that received 3.7 years of different rehabilitative training protocols combined with spinal stimulation. In particular, this report shows the effects of training-induced adaptations of the spinal cord that allowed this individual to advance from no ability to move his legs to the ability to move his legs and stand without spinal stimulation. These findings show the extraordinary recovery potential of the human nervous system after severe spinal cord injury, and suggest future studies focus on better understanding the effects of different training components on spinal cord adaptations important for functional recovery.
EPIDURAL STIMULATION IN ADULTS
The Epidural Stimulation Program of the Kentucky Spinal Cord Injury Research Center (KSCIRC) conducts translational research to bring laboratory findings to clinical practice as quickly as possible. The program focuses on understanding how epidural stimulation to the lumbosacral spinal cord enables the recovery of autonomic nervous system function (internal organ regulation) as well as somatic nervous system function including voluntary movement, standing and walking. Our expert interdisciplinary team investigates the neural control of human movement and autonomic function after spinal cord injuries, and applies new knowledge to optimize spinal cord epidural stimulation as a therapeutic intervention. We also combine epidural stimulation with innovative recovery-based interventions to reveal and encourage the innate capacity of the spinal cord to recover function. Our commitment is to translate the knowledge gained in the epidural stimulation program to develop successful therapeutic interventions and improve overall quality of life for individuals with spinal cord injuries. Our mission is to cure paralysis.