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.