Method for restoring gait in individuals with chronic spinal cord injury

• US 20020115945A1
• Filed: 01/08/2002
• Published: 08/22/2002
• Est. Priority Date: 01/11/2001
• Status: Active Grant

• Current Assignee: Dʼluzansky, Stephen C., James D. Sweeney, Jiping He, Richard M. Herman
• Original Assignee: Dʼluzansky, Stephen C., James D. Sweeney, Jiping He, Richard M. Herman
• Inventors: DʼLuzansky, Stephen C., He, Jiping, Herman, Richard M., Sweeney, James D.
• Granted Patent: US 7,065,408 B2
• Time in Patent Office: Days
• US Class Current: 601/15
• CPC Class Codes: A61H 1/0262 Walking movement; Appliances for aiding disabled persons to walk A61H3/00 takes precedence
• CPC Class Codes: A61H 2201/10 with further special therapeutic means, e.g. electrotherapy, magneto therapy or radiation therapy, chromo therapy, infrared or ultraviolet therapy
• CPC Class Codes: A61H 3/00 Appliances for aiding patients or disabled persons to walk about apparatus for helping babies to walk A47D13/04; orthopaedic devices for correcting deformities of, or supporting, limbs A61F5/0102; exercising apparatus for the feet or toes A63B23/10; stairways or ramps E04F11/00
• CPC Class Codes: A61H 3/008 Using suspension devices for supporting the body in an upright walking or standing position, e.g. harnesses drawing-out devices A61H1/0218
• CPC Class Codes: A61N 1/3604 for correcting spinal deformities, e.g. scoliosis
• CPC Class Codes: A63B 22/02 with movable endless bands , e.g. treadmills other training appliances for running on the spot A63B69/0028

Abstract

A method for restoring functional ambulation in subjects with incomplete spinal cord injuries which includes partial weight bearing therapy followed by epidural spinal cord stimulation (ESCS) to facilitate partial weight bearing therapy and over-ground walking. Electrical epidural stimulation (EES) is generated by an implanted device during partial weight bearing therapy on a treadmill. The subject is then transitioned to full weight bearing gait training on a treadmill with EES to over-ground gait training with EES and a walker, and finally to full weight bearing independent stepping over-ground with EES with or without an assistive device.

Claims

1. A method for restoring functional ambulation in subjects having incomplete spinal cord injuries comprising the steps of:

a. Providing partial weight bearing therapy until a subject reaches a plateau in locomotion rhythm generation; and

b. Electrically stimulating the spinal cord with an implanted stimulation device.

2. The method of claim 1 wherein the step of providing partial weight bearing therapy further comprises the step of achieving partial weight bearing gait performance on a treadmill with or without one or more therapists moving the subject'"'"'s legs.

3. The method of claim 2 wherein partial weight bearing gait performance includes transition on the treadmill from one weight bearing/treadmill rate level to another.

4. The method of claim 3 wherein the subject is transitioned across a number of therapeutic levels upon meeting a predetermined set of criteria.

5. The method of claim 4 wherein the predetermined set of criteria include an alternating gait with no more than 50% asymmetry, no assistance by a therapist for 3 sixty second periods on the same day for three consecutive days, and a breakdown of the gait performance criteria at a higher weight/treadmill rate condition.

6. The method of claim 2 wherein partial weight bearing gait performance includes final gait performance which determines eligibility for stimulation.

7. The method of claim 6 wherein final gait performance is determined at a specific degree of weight bearing and treadmill rate that continually produces breakdown of the gait over a four week period.

8. The method of claim 1 wherein the step of electrically stimulating the spinal cord includes the steps of:

a. Surgically implanting a spinal cord stimulating device in the subject; and

b. providing gait training with electrical epidural stimulation generated by the stimulating device.

9. The method of claim 8 wherein the step of providing gait training with electrical epidural stimulation comprises the steps of:

a. providing partial weight bearing gait training on a treadmill with electrical epidural stimulation (EES) to investigate stimulus patterns;

b. transitioning from partial weight bearing gait training on a treadmill with EES to full weight bearing gait training on a treadmill with EES and over ground with EES with a walker to further refine stimulus patterns; and

c. achieving full weight bearing independent stepping over ground without a harness with EES.

10. The method of claim 9 wherein the step of achieving full weight bearing independent stepping is done with or without an assistive device.