New treatments give spinal injury patients hope for future



Minneapolis Star Tribune

Brandon Loney can't move his legs, but once a week, he sure does run.

Suspended by a harness from the ceiling at Courage Center in Golden Valley, Minn., the 23-year stares ahead at a mirror while two volunteers move his stocky legs across a treadmill. A third volunteer straddles the treadmill and keeps Loney balanced. A fourth controls the machine and rotates in when the others get tired.

For Loney, paralyzed from the neck down in a 2009 diving accident, the exhausting "locomotor" therapy helps his body fight infections. It keeps his muscles strong.

And maybe it will keep his body ready for a treatment breakthrough that can give him back lost mobility.

"I'm trying to stay as fit as I can," the former hockey player said, "and hopefully be a good contestant when they do come up with something."

Hope like that was once drummed out of spine injury patients, in part because doctors saw the despair that set in when patients clung to the notion of a recovery that never came.

But at some point after the paralyzing injuries to actor Christopher Reeve in 1995, that philosophy changed.

"We used to always say we're working around this (injury)," said Dr. Karl Sandin, physician-in-chief at the Sister Kenny Rehabilitation Institute in Minneapolis. "Now, it's more nuanced."

New treatments are starting to defy old notions about rehabilitation, and exercise has become the key. Patients who used to be left dormant are now being told to get in shape for the day if -- some even say when -- a meaningful treatment comes along.

It's a delicate balance between today's realities and motivation for tomorrow, said Dr. Gary Goldish, director of the Spinal Cord Injury and Disorder Center at the Minneapolis Veterans Medical Center.

Susan Fink was told she would never walk again after a cross-country skiing accident 12 years ago. Today, the 61-year-old walks with a walker around her home, but uses a power wheelchair everywhere else. Three times a week, she rides an exercise bicycle at Sister Kenny, using electrical stimulation to coax her leg muscles to move and pedal.

There was a time, Goldish said, when exercise therapy was reserved for patients who could pull themselves up on parallel bars and was viewed as a waste of time for those who couldn't.

But doctors now believe that exercise can coax dormant muscles to send nerve signals toward the brain and to signal to the spinal cord that it needs to repair itself, Sandin explained.

That idea gained broader acceptance because of Reeve, who used his Hollywood celebrity to challenge doctors to focus more on recovery. He was among the first to use locomotor therapy following his injury in 1995.

Typically, two-thirds of a patient's recovery will take place in the first two months. Reeve defied those odds through diligent therapy and his pursuit of experimental treatments in the U.S. and Israel.

He remained on a ventilator until his death in 2004. But five years after his injury, he gained motion in his left hand that astounded doctors.

"Reeve was the exception to the rule, and he started a whole movement," Goldish said.

Locomotor therapy has since spread, and Loney said he is a willing guinea pig. He was among the first to use the locomotor at the Courage Center and the first to use a new device by which he moved his legs in a bicycle motion by turning a crank with his arms. The first time, he couldn't turn the crank at all. Recently, he completed 200 revolutions.

Loney prays daily for a cure, but isn't waiting for one.

Like Fink, he already has exceeded a doctor's early prognosis -- in his case that he would need a ventilator to breath for the rest of his life. He is completing a business degree at Gustavus Adolphus College and starting a clothing business, Live Life, to sell inspirational apparel.

But if a cure comes along, Loney plans to be ready.

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