Thomas Kiser, M.D.
The long-term goal of this research is to develop a Spinal Cord Injury (SCI) Mobilization Program for increasing the quality of life of SCI victims. We have designed parallel human and animal studies aimed at establishing the optimal treatment strategies for regaining certain functions, testing the effects of different therapies in humans while exploring novel potential palliative strategies on animals. This Project will assess the effects of both “early” rehabilitation effort and “late” rehabilitation effort in improving neurologic recovery and decreasing secondary complications. We recently found that motorized bicycle exercise training (MBET) reduced the hyperreflexia that accompanies SCI in completely transected animals. Such hyperreflexia is thought to produce spasticity, which becomes increasingly problematic in the chronic condition. We have developed and been granted a patent for a MBET system for use in humans. The first clinical application of this technology showed that, after MBET training, the habituation of the H-reflex, the electrical equivalent of the tendon tap reflex, was increased to normal levels. That is, the hyperreflexia was reduced and spasticity was eliminated. Bowel and bladder function also improved. The figure below shows that habituation of the H-reflex at 5 and 10 Hz rates of stimulation increased from an abnormal level of ~75% at the beginning of training, to the level in an intact individual (~25%) after 10-12 weeks. If MBET training is stopped, the habituation of the H-reflex returns to abnormal (hyperreflexive) levels within 3-4 weeks.
There is excellent potential for such information to translate into improved rehabilitation strategies and quality of life for the patient with SCI. The proposed research will generate pilot data in multiple important areas, while simultaneously developing multiple innovative technologies that may produce significant breakthroughs in the treatment of SCI.