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Article Date: 04 Jun 2008 - 4:00 PDT
New research shows that a non-ambulatory (unable to walk or stand) child with a cervical spinal cord injury was able to restore basic walking function after intensive locomotor training. The study, published in Physical Therapy (May 2008), the scientific journal of the American Physical Therapy Association (APTA), evaluated the effects of locomotor training in a 4 ½ year-old-boy, who had no ability to walk following a gunshot wound sixteen months earlier.
"Every standard clinical evaluation conducted on this child indicated that he would not regain the ability to stand or walk," said Dr Andrea L Behrman, PT, PhD, Associate Professor in the Department of Physical Therapy, University of Florida and APTA spokesperson. Dr Behrman, the lead author of the study, observes. "This study is significant in that it shows that a severely injured spinal cord may be retrained." But, Dr Behrman cautions that, while this is a significant step in the right direction, not all children with severe spinal cord injuries will benefit from this type of treatment or have the same results.
Locomotor training refers to a process developed out of a partnership with scientists in which the patient is put in an environment to practice "walking" movements over and over again. Over the course of 76 sessions, the child was placed in an overhead body weight support system and suspended over a treadmill while three trainers helped simulate walking by moving his legs in a stepping pattern. "With this system, the patient is partially supported, allowing the trainers to facilitate stepping and standing movements," Dr. Behrman explained. She cautioned that many rehabilitation facilities lack the equipment and staff skills to provide this kind of intense therapy, but that her study clearly shows what can happen when available. "We are optimistic that this study will give hope to individuals with spinal cord injuries as well as to their families," she said.
Dr Behrman noted that one month into locomotor training, voluntary stepping began and the child eventually progressed from having no ability to using his legs to moving with a rolling walker. The child is now fully ambulatory with a walker and attends kindergarten using a walker full-time. Although he has balance difficulties, requiring the use of a walker, Dr. Behrman said that, in time, a walker may not be necessary.
Dr Dena R Howland, OT, PhD, Associate Professor in the Department of Neurological Science at the University of Florida's College of Medicine, and a co-principal investigator for this study, notes that the complete support of the patient's family was a huge part of his therapy success. "The fact that the physical therapists were able to get the child to the level of functional ability that they did most likely would not have been achieved without the perseverance and commitment of this boy's family," she said.
Dr Behrman added that research findings from studies such as this serve to change and guide clinical practice for the physical therapy profession. "Identifying patients who have the potential to benefit from locomotor training or other therapies is an important step in clinical decision making," she said.
Physical therapists are health care professionals who diagnose and manage individuals of all ages, from newborns to elders, who have medical problems or other health-related conditions that limit their abilities to move and perform functional activities in their daily lives. Physical therapists examine each individual and develop a plan of care using treatment techniques to promote the ability to move, reduce pain, restore function, and prevent disability. Physical therapists also work with individuals to prevent the loss of mobility by developing fitness- and wellness-oriented programs for healthier and more active lifestyles.
The American Physical Therapy Association is a national organization representing physical therapists, physical therapist assistants, and students nationwide. Its goal is to foster advancements in physical therapist education, practice, and research. Consumers can visit http://www.findapt.us to find a physical therapist in their area, as well as http://www.apta.org/consumer for physical therapy news and information.
American Physical Therapy Association
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Currently, BabelFAmily is financing two promising research projects aimed at finding a cure for Friedreich's Ataxia. Whenever you make a donation to us or purchase a copy of "The legacy of Marie Schlau", this is where all funds raised will be devoted to:
1) Gene Therapy for Friedreich's Ataxia research project:
The project is the result of an initiative of Spanish people affected by this rare disease who are grouped in GENEFA in collaboration with the Spanish Federation of Ataxias and the BabelFAmily. The Friedreich’s Ataxia Research Alliance (FARA), one of the main patients’ associations in the United States now joins the endeavour.
2) Frataxin delivery research project:
The associations of patients and families Babel Family and the Asociación Granadina de la Ataxia de Friedreich (ASOGAF) channel 80,000 euros of their donations (50% from each organisation) into a new 18-month project at the Institute for Research in Biomedicine (IRB Barcelona). The project specifically aims to complete a step necessary in order to move towards a future frataxin replacement therapy for the brain, where the reduction of this protein causes the most damage in patients with Friedreich’s Ataxia.
The study is headed by Ernest Giralt, head of the Peptides and Proteins Lab, who has many years of experience and is a recognised expert in peptide chemistry and new systems of through which to delivery drugs to the brain, such as peptide shuttles—molecules that have the capacity to carry the drug across the barrier that surrounds and protects the brain. Since the lab started its relation with these patients’ associations in 2013*, it has been developing another two projects into Friedrich’s Ataxia.