Using old technique in new way to kick-start walking, sitting

It's called FES, or functional electrical stimulation. The technology has been around for several decades. But researchers like Dr. Adam Thrasher are determined to push it to new limits.

A postdoctoral research fellow at Toronto Rehab, Dr. Thrasher is developing new ways to apply FES to regain muscle use and restore or improve walking and sitting functions among people with paralysis from incomplete spinal cord injuries.

FES is applied with a Walkman-sized device, which stimulates the nerves that go into muscles with electrical impulses. This sends a signal to the muscles saying "contract" - just as the brain would have done.

"If we can even give people back a bit of function, that can make a huge difference in their lives," says Dr. Thrasher. He has seen several patients with limited walking abilities make big strides with FES. "I'm optimistic but these are still early days with this research."

Dr. Thrasher, the first Canadian Paraplegic Association Ontario Clinical Research Fellow, is working under the supervision of Dr. Milos Popovic, a Scientist at Toronto Rehab and Director of the Rehabilitation Engineering Laboratory.

Their research is exciting, says Dr. Thrasher, because it applies FES in a new way. "The problem with FES has been that you can use it to stimulate muscles but the person is dependent on the device, which must be implanted or attached. It's cumbersome and impractical.

"In our lab, we're coming at it from a different angle. We're trying to develop short-term interventions to use in a clinical setting to promote rehabilitation. And hopefully there will be some long-term effects."

Dr. Popovic and others have refined FES in such a way that their version stimulates nerves with electrical impulses and, after many repetitions, some patients "learn" to carry out the movements by themselves, without the device.

The lab has already had "good early results" using FES to help people to grasp objects. Clinical trials are underway for both the grasping and walking studies. "Further studies involving a larger number of people will establish whether or not this technique should be used routinely as part of the therapeutic process," says Dr. Thrasher.

"It's a challenging area of research. We're dealing with the highly complex central nervous system, and working with people who have severe disabilities. But that's why we're doing this research in the first place - to make their lives better."

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