TBI: Why is it important to understand it?

Unless it’s happened to you or someone you know, you may not fully comprehend traumatic brain injury, but understanding TBI is critical because it is an important public health problem, according to the Centers for Disease Control and Prevention.  TBI is an injury to the brain caused by trauma, not disease. It may be caused by a bump, blow or jolt to the head that disrupts the normal function of the brain. 

Common causes are gunshots, car crashes, assaults or slip and fall accidents. Severity may range from a mild TBI, which causes a brief change in mental status to a severe TBI, leading to an extended period of unconsciousness or amnesia. Severe injuries increase the risk of a greater number of and more severe complications.

According to staff at the Mayo Clinic, some people with TBI may experience seizures within the first week. Some serious TBI’s may result in recurring seizures, called post-traumatic epilepsy. Some people who have had TBI may also experience swelling and increased pressure on the brain from cerebrospinal fluid building up in the spaces of the brain called the cerebral ventricles. TBI may also cause a meningitis infection if skull fractures or penetrating wounds tear the layers of protective tissue called meninges that surround the brain. Blood vessel damage may also lead to stroke, blood clots or other problems. Nerve damage from a TBI to the base of the skull that damages nerves that emerge directly from the brain called cranial nerves may result in loss of facial sensation, sense of smell, loss of vision, swallowing problems.

Some of the common problems associated with TBI include changes in thinking (cognitive) skills, communication problems that may lead to frustration, behavioral changes, and emotional changes.
In Florida, approximately 370,000 people are living with a TBI-related disability, a statewide needs and resources assessment shows. By 2015, it is expected to rise to 435,350 people. Well Florida Council: Working Together for Healthy Communities authored the assessment with project partners: Brain Injury Association of Florida, Inc., Florida Department of Health, and Brain and Spinal Cord Injury Program.

Key findings show that children 0-4 years, young adults 15-24 years, and adults 65 years and older are at greatest risk for TBI. Falls were the leading cause of TBI in the state, and they were most common among the youngest and oldest age groups. Motor vehicle accidents were the leading cause of TBI-related deaths.
Resources listed in the assessment include Florida’s Trauma System, access to immediate and long-term rehabilitation and therapy, support groups and support networks, and access to information and resources. But if you have suffered a TBI due to someone else’s negligence, you may need additional legal help.

For more information, please contact a Florida personal injury attorney at (813) 471-4444, or visit
VanguardAttorneys.com.

Could Frequent Soccer Headers Result in Brain Injury?

Though soccer moms often juggle hectic schedules between checking homework, prepping food for the kids, and carpooling kids to games, they should also make time to be aware of the risk for brain injuries.
Researchers are continuing to look into the impact of frequent headers - which refers to when soccer players deliberately hit or field the soccer ball with their head - on the brain, even without concussions.
A new study of a small group of professional soccer players, who had trained since childhood, published in the Nov. 14 issue of the Journal of the American Medical Association, suggested that frequent headers that did not cause a concussion may still result in changes to the brain’s white matter.
The white matter of the brain contains many nerve fibers. And it is surrounded by a fat called myelin that acts as an insulator and increases the speed of transmission of nerve signals. The myelin gives it the whitish appearance. In comparison to the gray matter, it has been the “long-neglected half of the brain,” according to the Dana Foundation, a New York-based foundation that supports brain research.
“On average, elite male soccer players -- who often use their heads to direct the ball -- had a range of negative changes in white matter architecture compared with a group of competitive swimmers who were unlikely to have repetitive brain trauma,” according to Inga Koerte, MD, of Harvard Medical Schools Psychiatry Neuroimaging Laboratory in Boston, and colleagues, in MedPage Today.
Those differences were observed even though none of the participants in either group had a history of concussion, Koerte and colleagues reported in a research letter in JAMA. Although it is possible that frequent heading of the ball could explain the impairments in the soccer players, "differences in head injury rates, sudden accelerations, or even lifestyle could contribute," the authors wrote.
Two previous brain imaging studies presented last November at the annual meeting of the Radiological Society of North America (RSNA) in Chicago have shown risk for brain injury and cognitive impairment.
Researchers at Albert Einstein College of Medicine of Yeshiva University, a research-intensive medical school based in the Bronx, New York, and Montefiore Medical Center, the University Hospital and academic medical center for Einstein, conducted these studies. They used diffusion tensor imaging, an advanced MRI-based imaging technique, on 38 amateur soccer players, who had played the sport since childhood. While analyzing brain images of the most frequent headers during the past year, they found brain injury similar to that seen in patients with concussion, also known as mild traumatic brain injury.
“Our goal was to determine if there is a threshold level for heading frequency that, when surpassed, resulted in detectable brain injury,” said lead author Michael Lipton, M.D., Ph.D., associate director of Einstein’s Gruss Magnetic Resonance Research Center, medical director of MRI services at Montefiore.
Researchers found a threshold level of approximately 1,000 to 1,500 heads per year. Beyond that number of headers, they observed significant injury. “Heading a soccer ball is not an impact of a magnitude that will lacerate nerve fibers in the brain,” said Dr. Lipton in the media release. “But repetitive heading may set off a cascade of responses that can lead to degeneration of brain cells.”
Another study with the same set of 38 amateur soccer players examined neuropsychological function through tests of verbal memory and activities with mind-body coordination such as throwing a ball. The study found that players with the highest annual heading frequency performed worst on these tests.
“These two studies present compelling evidence that brain injury and cognitive impairment can result from heading a soccer ball with high frequency,” Dr. Lipton said. “These are findings that should be taken into consideration in planning future research to develop approaches to protect soccer players.”
Since soccer rules prohibit players from using their hands or arms to direct the ball except for the goal keeper, it doesn’t appear that the practice of heading the ball will be eliminated anytime soon, but additional research may help establish guidelines to limit the practice to a certain threshold of safety.
 

Head injury, pesticides combined may triple risk for Parkinson’s

Though previous studies have linked serious head injury and pesticide exposure to Parkinson’s disease, the combination of both may be an even greater risk, a new study shows.

The study led by researchers at the University of California at Los Angeles is published in the November 13 print issue of Neurology®, the medical journal of the American Academy of Neurology.

“While each of these two factors is associated with an increased risk of Parkinson’s on their own, the combination is associated with greater risk than just adding the two factors together,” said study author Beate Ritz, MD, PhD, UCLA’s Fielding School of Public Health, in a media release. “This study suggests that the physiological process that is triggered by a head injury may increase brain cells’ vulnerability to attacks from pesticides that can be toxic to the brain or the other way around, for example, chronic low dose exposure to pesticides may increase the risk of Parkinson’s after a head injury.”

The study involved 357 people who had Parkinson’s disease and 754 people without the disease, all of whom lived in an agricultural area in central California, according to the release.

Researchers asked participants to report any head injuries they had ever received with a loss of consciousness for more than five minutes. They used data on the use of the herbicide called paraquat collected by the state of California’s Pesticide Use Reporting system to determine exposure to the weed killer based on a 500-meter area around their home and work addresses.

From this data, they found that individuals with Parkinson’s were twice as likely to have had a head injury with loss of consciousness for more than five minutes, and that people with Parkinson’s disease were 36 percent more likely to have exposure to paraquat than those who did not have the disease.

The new study doesn’t prove that a traumatic brain injury or pesticide exposure causes the disease. What it shows is that having a head injury along with living near areas where the pesticide called paraquat is used may lead to triple the risk of developing Parkinson’s disease.

As many as one million Americans live with the progressive neurodegenerative disease that may cause tremors in the body - more than the combined number of people diagnosed with multiple sclerosis, muscular dystrophy and Lou Gehrig’s disease, according to the Parkinson’s Disease Foundation.

"I think all of us are beginning to realize that there's not one smoking gun that causes Parkinson's disease,” Dr. James Bower, a neurologist from the Mayo Clinic in Rochester, Minnesota, who wasn't involved in the new research, said in a Nov. 13 article from Reuters Health news wire. "There might be many paths to the ultimate development of Parkinson's disease."

He added that “. . . some people who are genetically predisposed might need just one ‘environmental insult’ - such as a blow to the head - to set them up for Parkinson's. Others who aren't naturally susceptible to the disorder could still develop it after multiple exposures.”

Hope through innovation: Brain-computer interfaces may aid paralyzed individuals

 Study participant Tim Hemmes (right) reaching out to his researcher, Wei Wang, M.D., Ph.D. (left), using a brain-controlled prosthetic arm. Also pictured: Research team member Jennifer L. Collinger, Ph.D. and Katie Schaffer.

Robotic-mind control, popularized in the 2009 epic science fiction film, “Avatar,” may not be as far off as we imagine it to be. Scientists have already been researching brain-computer interfaces [BCI] for years.

 A Nov. 11 article in MIT Technology Review shows that a newly developed carbon microthread may be the kind of long-lasting electrode needed to improve BCI. In preliminary studies, BCI have allowed paralyzed people to control robotic limbs or a computer mouse.

The new microthread, designed at the University of Michigan’s Neural Engineering lab, is only seven micrometers thick, about 100 times thinner than traditional electrodes used to study animal brains.

Andrew Schwartz, a researcher at the University of Pittsburgh who was not involved in the work, said in the article that it’s widely believed small fibers are “a good thing, because they seem to be ‘ignored’ by the brain.” But he also cautioned “that it could be difficult to insert such fine, flexible electrodes into brain tissue, and to secure them,” noting that recordings broke down in many of the animals studied.

Though these innovations are not exactly solid yet, they are breaking new ground, and it’s exciting to think about their potential for people suffering from spinal cord injuries that have left them paralyzed.

Back in 2008, a monkey at the University of Pittsburgh was able to feed himself a marshmallow using his brain to directly control a robotic arm. Since then, this research has expanded to human beings.

A little over a year ago, the Pitt Chronicle of the University of Pittsburgh showed how a BCI impacted 30-year old Tim Hemmes, who had been paralyzed due to a SCI from a motorcycle accident in 2004. With a mind-controlled prosthetic arm, he was able to reach up and touch the hand of his girlfriend, Katie Schaffer, “in a painstaking and tender high five,” the article published on Oct. 17 of last year stated. 

Surgeons placed a grid the size of a stamp on the motor cortex surface of Hemmes’ brain to control a robotic arm for the four-week trial period. The BCI picks up neural activity that can be translated by a computer processor to control computer cursors or assistive devices such as a prosthetic hand.

The research project funded by the National Institutes of Health in early 2011 received Popular Mechanics magazine’s 2012 Breakthrough Award. The magazine honored Hemmes, and the research team led by Wei Wang, M.D., Ph.D., assistant professor, Department of Physical Medicine and Rehabilitation, Pitt School of Medicine, at an invitation-only conference and gala awards ceremony in New York City last month. The project is also featured in the November issue of Popular Mechanics.

Gene required for nerve regeneration identified

Photo Credit: Rolls lab, Penn State University

Scientists at Penn State and Duke University have identified a gene that is associated with the regeneration of injured nerve cells. The journal Cell Reports published an online early copy of their findings on Nov. 1, and will also include the paper in the monthly issue of the journal on Nov. 29. 

The team of researchers found that a mutation in a single gene can entirely shut down the process by which axons – the parts of the nerve cell that are responsible for sending signals to other cells –re-grow themselves after being cut or damaged.

"We are hopeful that this discovery will open the door to new research related to spinal-cord and other neurological disorders in humans," said Melissa Rolls, an assistant professor of biochemistry and molecular biology at Penn State, who led the research team, in a Penn State news release. 

“Axons, which form long bundles extending out from nerve cells, ideally survive throughout an animal's lifetime,” Rolls explained. “To be able to survive, nerve cells need to be resilient and, in the event of injury or simple wear and tear, some can repair damage by growing new axons.”

Earlier research suggests that microtubules, intracellular "highways" along which basic building blocks are transported might need to be rebuilt as an important step in this type of repair. "In many ways this idea makes sense,” Rolls said. “In order to grow a new part of a nerve, raw materials will be needed and the microtubule highways will need to be organized to take the new materials to the site of growth.”

Based on this research the team investigated the role of microtubule-remodeling proteins in axon re-growth after injury, focusing on a set of proteins that sever microtubules into small pieces. A protein named spastin emerged to play a critical role.

The team used fruit flies as their model organism to test the role of spastin. They found that in fruit flies with two normal copies of the spastin gene, severed axons were able to regenerate. However, in fruit flies with two or even only one abnormal spastin gene, the severed axons were not able to regenerate.

"Now that we know that spastin plays an important role in axon regeneration and also that this gene is dominant, we have opened up a possible path toward the study of human diseases involving nerve-cell impairment," Rolls said. "In fact, our next step is to probe the link between hereditary spastic paraplegia (HSP) and axon regeneration."
 

Hope through research: New TBI studies uncovered

As of May 2010, the Defense and Veterans Brain Injury Center counted 178,876 traumatic brain injuries in the U.S. Military since 2000. Though the number of these injuries may seem devastating, scientists working on new discoveries to help prevent, detect, and treat blast injuries provide some hopeful news.

From mice trained to sniff out landmines, to new technology to detect blast injuries, to a dietary supplement derived from tobacco leaves that may help retain memory skills, scientists are finding new ways to combat these injuries. Researchers presented these findings at Neuroscience 2012, the annual meeting of the Society for Neuroscience, which was held in New Orleans, Louisiana, last month.

A widely acclaimed program that deployed specially trained rats to sniff out landmines inspired scientists to work on developing a genetic modification of mice, “transgenic mice,” that could increase their capacity to smell landmine explosives by 500 fold. This initiative is part of The MouSensor Project, to build a “biosensor” for landmine detection, which researchers presented at the annual meeting.

Funds from the National Institutes of Health supported this research.

A different study that looked at blast injuries came out of the United Kingdom where around 60 percent of the injuries to soldiers sustained in Afghanistan have been the result of explosive devices.

This study, which looked at the brains of 20 U.K. soldiers recently exposed to a blast, 40 non-blast TBI patients, and 40 age-matched controls, found that blast-related injuries appear more likely than non-blast injuries to damage the back lower region of the brain, which is responsible for motor control and other essential life functions. Since these injuries sustained in the brain’s “white matter,” which helps nerve cells communicate, cannot be accurately detected by conventional magnetic resonance imaging, scientists used an advanced form of MRI, known as diffusion tensor imaging, for this research.

In another study, supported by funds from the Department of Defense and the Roskamp Foundation, based in Sarasota, Florida, scientists found that a dietary supplement may improve spatial memory, which is the part of the memory responsible for recording information about one’s environment.

Fiona Crawford, PhD, the study’s senior author, and her colleagues studied a group of 96 mice, half of which had suffered TBI and half of which had not. Among the injured mice, half received a placebo and half received anatabine, which is an anti-inflammatory dietary supplement derived from tobacco leaves, or an experimental Alzheimer’s drug. After two weeks, the mice that received either the drug or the dietary supplement performed as well as the uninjured mice on a test that evaluates spatial memory.

“These studies are particularly outstanding for how they take some of the most complex and cutting edge science of our time and translate it into practical applications that can have an enormous, visible impact on people’s lives,” said Jane Roskams, PhD, University of British Columbia, an expert on brain repair, in a recent media release. “That one day a mere mouse might save a child from losing a limb while walking across an old mine field, or a simple dietary supplement could make life more bearable for a brain injury victim shows why the field of neuroscience is attracting so much interest these days.”

Underwear wired to prevent bed sores

Superman star Christopher Reeve, who had a spinal cord injury, died in 2004 after suffering a system-wide infection from a bed sore that led to heart failure and a coma.  These sores are common due to the immobilization SCI causes. But researchers are working on new technology to help end this epidemic.

Researchers presented Smart-e-Pants, underwear that looks like bike shorts, with a “built-in electronic system” that shocks the bottom to prevent the development of these bed sores, at Neuroscience 2012, the Society for Neuroscience conference’s recent annual meeting in New Orleans, Louisiana.

Bed sores, also called pressure ulcers, are painful open wounds, usually over bony areas of the body. The prototype underwear delivers tiny, intermittent electrical shocks, contracting the buttock muscles.

“The mini-muscle contractions generated by the underwear mimics the subconscious fidgeting of able-bodied individuals, stimulating blood flow and redistributing pressure away from the sitting bones,” according to the Oct. 15 media release that came out on the same day as the scientific presentation.

Of the 33 clinical care patients, none developed pressure ulcers during the two-month study period, Sean Dukelow, MD, PhD, of the University of Calgary in Canada, reported. The underwear delivered muscle-contracting stimulation four days per week for 10 seconds every 10 minutes, 12 hours a day.

Researchers plan to follow up this clinical trial with further efficacy studies. Funds from Alberta Innovates – Health Solutions in the Canadian province of Alberta supported the research.

This research is important because of the devastating human and economic cost of these wounds.

One in three people with SCI develop a pressure sore during the early days after the injury and between 50 and 80 percent at some later point, according to the Christopher and Dana Reeve Foundation.

These pressure ulcers can lead to increased risk of infection, hospitalization, and death. In the United States alone, 60,000 people each year die from complications related to pressure ulcers, statistics show. The economic cost is also staggering, estimated at $11 billion in the U.S. and $3.5 billion in Canada.

“Pressure ulcers can be terribly debilitating. Their incidence has not changed since the 1940’s, indicating that the current methods of prevention simply are not working,” Robyn Warwaruk Rogers, a research nurse at the University of Calgary, said in the media release. “Our hope is that this innovative, clinically friendly system will eventually make a difference in the lives of millions of people.”

Stewart Midwinter, who broke his neck paragliding last year, has noticed the added protection while sitting in a wheelchair for long periods of time as one the of the first patients to test the device, according to an Alberta feature story by Colin Zak published earlier this year. “I now face many challenges I hadn’t expected, and Smart-e-Pants give me some added peace of mind,” Midwinter said.

Scientists develop ‘brain-on-a-chip’ prototype

Technology is changing how scientists look at brain injuries. A “brain-on-a-chip” that looks like it came out of a sci-fi adventure movie may eventually show promise for studying the effects of brain injury.

On Oct. 22, Draper Laboratory announced that scientists at its nonprofit research and development laboratory located in Tampa along with the University of South Florida are working to develop a “brain-on-a-chip,” that may one day be used to study neurodegenerative diseases like Alzheimer’s or stroke.

A stroke or Alzheimer’s disease is not considered a traumatic brain injury because the term traumatic refers to the cause of the injury being traumatic such as a blast from a war zone, a gunshot, or a car accident, instead of the trauma people feel after being diagnosed with any brain injury. But this research may still be relevant for those who suffer TBI because research has shown that it is a risk factor for both.

It’s interesting that the impact of a small chip could be so far reaching. “Our device is designed to be the most biologically realistic model of brain tissue developed in the lab thus far,” said Anil Achyuta, principal investigator.  “We have the potential to revolutionize how scientists study the effects of drugs, vaccines, and specialized therapies like stem cells on the brain . . . In addition to screening drugs, we could potentially block vascular channels and mimic stroke or atherosclerotic plaque.”

Perhaps, even more intriguing for those with a TBI is that it could one day be used to study TBIs directly. “Furthermore, this platform could eventually be used for neurotoxicology, to study the effects of brain injury like concussions, blast injuries, and implantable medical devices such as in neuroprosthetics.”

The neurovascular unit is made up the specific brain and vascular cells that exchange nutrients, oxygen, and dispose of chemical waste to keep the brain functioning. Neurodegenerative diseases typically involve a dysfunction in the interaction between the brain and the circulatory system.

The “brain-on-a-chip” prototype attempts to mimic the neurovascular unit and represent a biologically realistic model of brain tissue by combining innovations in cellular brain science, tissue engineering, and microfluidics (microminiaturized devices with chambers for the containment and flow of fluids.)

Photo Credit: Draper Laboratory

As part of the research, basic brain cell types and vascular cells from rats were cultured on two specially designed micro-fabricated layers. Eventually, researchers plan on switching from rat embryonic cells to human cells. Their work will be under the umbrella of the Draper’s BIO-MIMETICS program, a DARPA funded project undertaken in collaboration with MIT, which aims to one day combine a networked system of micro-devices into a “human-on-a-chip” for the rapid testing of new drugs and vaccines.

“Severe traumatic brain injury remains a major health-care problem worldwide,” according to the Lancet, Volume 380, Issue 9847, Pages 1088 - 1098, 22 September 2012. “Although major progress has been made in understanding of the pathophysiology [the functional changes] of this injury, this has not yet led to substantial improvements in outcome.”

Hopefully, this new technology will lead to not only better understanding, but also development of new therapies to improve quality of life for those whose lives are catastrophically altered from brain injury.

Society for Neuroscience unveils new SCI treatments

“New findings could help speed recovery, alleviate pain associated with spinal cord injury,” according to the Society for Neuroscience. Their findings were revealed at Neuroscience 2012, their annual meeting.

The Society for Neuroscience is a nonprofit membership organization of scientists and physicians that study the brain and nervous system. The meeting was held in New Orleans, Louisiana earlier this month.

To understand their findings, it may help to know what neuroscience means. Neuroscience is the study of the nervous system to advance the understanding of human thought, emotion and behavior. It may also be helpful to look at the role that the spinal cord plays in the body. The spinal cord is a thick bundle of nerve tissue that is responsible for transmission of electrical signals sent to and from the brain. 

A SCI is any injury to the spinal cord caused by trauma which may range from car crashes to violent acts. No one expects a SCI, but research from the Shepherd Center, a nonprofit hospital based in Atlanta, GA, shows that each year an estimated 12,000 people sustain new SCI – that’s 30 new injuries a day.

“Spinal cord damage is debilitating and life-altering, limiting or preventing movement and feeling for millions worldwide, and leading to chronic health conditions and pain,” an Oct. 15 release from the Society for Neuroscience states. “The initial injury is usually compounded by a wave of immune activity that can extend the initial nervous system damage, and complications of SCI may include pain and pressure sores that compromise the quality of life.”

The new studies suggest innovative ways to ease complications of SCI and to hasten recovery:

• Nervous system tracts that are left intact but non-functioning following SCI appear to be reactivated through deep brain stimulation, speeding recovery of walking in a rodent model (Brian Noga, PhD, abstract 678.12).
• Painful and sometime life-threatening pressure sores due to immobilizing nervous system injuries may be prevented by underwear wired to deliver tiny electrical currents that contract the paralyzed buttocks muscles, mimicking the natural fidgeting of able-bodied people (Sean Dukelow, MD, PhD, abstract 475.09).
• Carbon monoxide’s anti-inflammatory effects appear to accelerate healing in rats with spinal cord injury, possibly by altering the balance of immune cells and limiting the damage caused by molecules called free radicals (Yang Teng, MD, PhD, abstract 450.11).
• Social contact appears to lessen the pain that follows peripheral nerve injury. A new mouse study correlates the healing social behavior with biochemicals in the brain and spinal cord (Adam Hinzey, abstract 786.04).

 “While the damage of SCI can appear to be immediate and dramatic, the biological events that lead to extensive nerve and tissue damage are complex, and injuries evolve over time,” said press conference moderator Jacqueline Bresnahan, PhD, of the University of California, San Francisco, an expert on nervous system trauma caused by SCI. “Today researchers are finding ways to intervene in the cascade of molecular changes that follow SCI. From understanding immune cell responses to the healing power of social contact, researchers are finding new ways to treat and rehabilitate patients.”

National Institutes of Health, as well as private and philanthropic organizations, supported this research.

The average person living with SCI may not want to get their hopes up too soon, but the history of science is marked by a long chain of advances that once seemed improbable if not impossible. 

Wounded soldier walks again without prosthetics

Specialist Christopher Burke served with his dad as a soldier in Operation Iraqi Freedom and Operation New Dawn, but his catastrophic injuries didn’t come on the battlefield. Instead he was immediately paralyzed from a sporting accident at home.

On a mid-tour break, he did a back flip while doing gymnastics that propelled him head forward inside the foam pit. The top of his head collided with the concrete wall inside the foam pit splitting his head open and paralyzing him by bursting his sixth cervical vertebra.

He is a survivor of a C-6 injury, a traumatic brain injury, and Brown-Sequard Syndrome, a rare incomplete lesion to one side of the spinal cord that results in impaired or loss of movement to the injured side.

A neurosurgeon told him he would never walk again without full prosthetics, but several months later he was walking short distances with only a cane. And two years later he was walking without any help. Lynda Burke, his mom, shared this inspiring story about her oldest son with brainandspinalcord.org.

“I believe that the spinal cord area along with the body as a whole is still a mystery and that what works for one person may not work for another,” Lynda wrote in an Oct. 4 email where she was asked her feelings about hope for recovery from spinal cord injuries.

When asked what the key was to her son’s recovery, she wrote: “Fighting every day to make something work, to make something move, to stay healthy and strong.”

Mindset was a critical part of this fight. “I believe the patients mental outlook has the most to do with them recovering, I say this because my son did not want to spend the rest of his life in a wheelchair, and thus he pushed himself every day and every moment to try to get something to move. We did not wait for therapy to come work with him, I stretched his hands, arms, legs and feet several times during the day . . . and he mentally knew he did not want to spend his whole life in a wheelchair.”

Lynda added: “Christopher’s hand therapist wrote his hand off in December 2010, but we were not happy with that, both of us refused to give up, and we continued to try to stimulate that hand and although it is still not back a 100 percent to what it was before his injury and may never be, he has more use of his hand than the therapist thought he would ever get and can hold a cup in it now.”

Christopher got his rehabilitation therapy on base at Fort Riley, KS. His therapy included pool therapy, twice a week, physical therapy, three times per week, occupational therapy, twice a week, and hand therapy, three times per week then twice per week until December when hand therapy ended.

He was in the U.S. Army since Aug. 2007, and he was medically discharged in May 2012. Since he’s been out of the Army he has moved to California with plans of beginning college this coming year at California State University, Northridge. In the meantime, he continues to rebuild the physical strength he lost from his injuries through physical therapy exercises to strengthen his left leg and work with flexibility and range of motion in his left hand. When asked how he’s doing today, Lynda wrote: “Amazingly well. He is walking full time now which is a true miracle. He still has bad days, but all in all he is doing wonderful.”

Locomotor training for SCI has split reaction

A spinal cord injury, caused by trauma rather than disease, may be devastating, taking away not only a person’s ability to walk, but also affecting cardiovascular function, muscle composition, bone and fat mass, and quality of life. Rehabilitation is aimed at helping people with an SCI regain their independence. Many people with an SCI do not regain their ability to walk even though it’s a primary goal of rehabilitation. Locomotor training is an emerging way to address this problem, but reaction to it has been mixed.

The training is an intense workout that allows an individual with an SCI to step train on a treadmill using full body weight support.  The participant is strapped to a harness that is connected to an overhead-motorized lift suspended over the treadmill. Once the treadmill starts moving, therapists move their legs, with the goal for the repetition to trigger what researchers are calling “muscle memory.”

The activity-based, rehabilitative therapy is based on the idea that mammals with spinal cord injuries can learn to step with their hind limbs on a treadmill when trained with sensory input associated with stepping. The theory is that comparable training may also promote recovery for human beings after an SCI.

The Christopher and Dana Reeve Foundation touts its benefits: “Recovery of walking and balance can occur even years after injury in people with incomplete spinal cord injury who participate in locomotor training,” states a September media release that includes results from 11 peer-reviewed studies funded by them and published in the September issue of the Archives of Physical Medicine and Rehabilitation.

The Foundation is named after “Superman” star Christopher Reeve, who became the face of spinal cord injury prior to his death in May 2004, and his late wife, Dana Reeve, who died of lung cancer in 2006, after championing his legacy. "The Christopher & Dana Reeve Foundation NeuroRecovery Network is the fruition of Christopher Reeve's vision and the legacy he left us - to provide locomotor training to as many people as possible across the country," says Maggie Goldberg, a spokesperson for the Foundation.

But debate continues: “Body weight–supported treadmill training (BWSTT) and robotic-assisted step training (RAST) have not, so far, led to better outcomes than a comparable dose of progressive over-ground training (OGT) for disabled persons with stroke, spinal cord injury, multiple sclerosis, Parkinson’s disease, or cerebral palsy,” an abstract of the May issue of Neurorehabilitation and Neural Repair states.

Still it is giving some people more hope. "It's just a great feeling to be up again,” says John Benedetto, in a testimonial about his participation in the Christopher and Dana Reeve Foundation NeuroRecovery Network, a network of rehab centers that deploy therapies such as locomotor training. The testimonial is on the Reeve Foundation’s website. Benedetto suffered a C6 SCI from a body surfing accident in July 2009, and he began the NRN program in December 2011. Prior to his accident, he was a runner and a baseball player, and he continues to participate in hand-cycling marathons. "I know that if I work hard and stay positive," says Benedetto, "I will continue to get stronger and become more independent."

But Tiffiny Carlson, a New Mobility.com blogger, is skeptical.  “The issue I have with locomotor training is that it's being touted as pretty miraculous. It isn't,”’ she wrote. “This isn’t a challenge; I’m sure there are a lot of incompletes who it’s helped walk again, but for the completes….can it really help us walk?”

An anonymous blogger that went by the name “Priority Seating” and responded to Carlson’s blog on New Mobility.com indicated that the biggest benefit of locomotor training may stretch beyond walking to quality of life issues by strengthening leg muscles, and improving bladder and bowel function.

Veteran Amputees Inspire Others to Accomplish Goals

Completing a marathon is a major accomplishment in itself. Completing a marathon after surviving a catastrophic injury, on the other hand, is a whole different story.

This past Sunday, October 7, nearly 40,000 people competed in the Chicago Marathon. Two of these competitors defied the odds and accomplished something many people would, at first thought, consider impossible. Traumatic amputation survivors Cpl. Ben Maenza and Special Forces Sgt. 1st Class John Masson raced on hand cycles.

Two years ago, both soldiers survived traumatic amputations after being injured by improvised explosive devices (IED) while servings overseas. Maenza lost both of his legs while Masson, a father of three, lost both legs and his arm below the elbow.  The two injury survivors met during their trip back to the U.S. for rehabilitation at the Walter Reed Medical Army Medical Center. They went through their recovery journey together and formed a bond which Maenza describes is unlike any other. They were there for each other through the low points, like battling bouts of depression, and the milestones, like learning how to walk again.

During recovery, they became involved with Achilles International, an organization that helps injured soldiers compete in running events. It was at that point that both Masson and Maenza decided they had to do something to show others that, no matter what kind of difficult times your experience; anyone has the capability to do great things.

They trained separately in their hometowns of Fayetteville, North Carolina and Nashville, Tennessee. However, both injury survivors were side by side in their hand cycles on race day, making everyone proud of their achievements.

These soldiers are a true testament to the power of perseverance and a positive attitude and we hope their story inspires others to go out and accomplish their goals.

 Read the orignal story by Fox News here.

Co-Op Cares

We started the Co-Op Cares program at Tampa General Hospital this past summer and we are extremely proud of the amount of success we’ve had in such a short period of time. All of the TGH staff has given us such a warm welcome and have really helped the whole program run smoothly.

We created Co-Op Cares because the days after a catastrophic injury can be the toughest part of recovery for survivors and their loved ones. The program is our little way of doing what we can to help others during this difficult phase. It has truly been an honor to work with the injury survivors recovering in the Level I Trauma Center of TGH and their family members keeping vigil.

Every week, we visit these patients to give them advice, prepare them for the next phase of recovery or simply just talk about every day things with them and their families (sometimes this is the best form of therapy). We also give each patient we meet with an Injury Co-Op backpack to help make the hospital stay feel as comfortable as possible. Each backpack includes:

·         A stress ball

·         A warm blanket for those cold waiting rooms

·         A recovery handbook

·         A guestbook for visitors to sign and leave encouraging words

·         Pen and Paper Pad

So far, we have met with seven SCI/TBI families who have all been extremely receptive of our program. The most rewarding part about the whole experience is that we get to track their recovery over the course of their hospital stay. It has been so incredible to celebrate milestones with the patients and their families because we’ve been there and we know how important these accomplishments are. We are so honored that these injury survivors have allowed us to be a part of their special moments and we can’t wait to see what the future holds!

Tampa Law Firm Swope Rodante Representing Family In Wrongful Death Case Against FINR

The Florida Institute for Neurological Rehabilitation has been the focus of controversy in recent weeks, after an investigation by Bloomberg uncovered a recurring theme of allegations of mistreatment, abuse, and fraud. As videos of FINR staff assaulting patients have surfaced in the past year, the traumatic brain injury treatment facility is on the receiving end of multiple lawsuits, including a suit filed by Allstate Corporation over claims that patients covered by the company’s insurance policies were forced to wash cars as part of their so-called therapy. FINR officials are also disputing claims by the Florida Agency for Health Care Administration that the facility had been housing at least 50 patients that did not have traumatic brain injuries. Insight into FINR’s questionable business practices and treatment of patients was first brought to light in 2005 when Tampa-based law firm of Swope, Rodante P.A. tried a case against FINR over the wrongful death of a patient.  A Wauchula jury found that FINR staff were negligent in causing the death of a brain-injured patient. 

In the face of these various accusations and lawsuits, FINR’s policies are being highly scrutinized.

Attorney Lisha Bowen successfully tried the 2005 Swope, Rodante, P.A. case against FINR. Her involvement with and considerable knowledge of brain injury and wrongful death cases has made her a leader in the investigation of tragic acts that have been committed as a result of corporate negligence.