By Dr Linda Renfrew, PhD in Physiotherapy
“We live in a time when the words ‘impossible’ and ‘unsolvable’ are no longer part of the scientific community’s vocabulary.”(Christopher Reeve, actor and activist)
In August 2018 Claire Lomas completed the Manchester marathon after 8 days, perhaps nothing astonishing you might say, but Claire, a former equestrian eventer, was paralysed from the waist down after a freak riding accident. She completed the 26.2-mile event with the help of a specially designed robotic ReWalksuit. Such bionic walking machines, also known as an exoskeleton, rely on motion sensors which propel the wearer’s legs forward by detecting shifts in balance and bodyweight. Leaning the upper body forward activates the sensor, stimulating motor pods which help rotate joints to move the legs forward during walking. Combining exoskeleton technology with functional electrical stimulation (FES), which electrically stimulates peripheral nerves to contract muscles and produce functional movement, provides the synergistic benefits of both mobility and muscle stimulation offering hope for recovery following paralysis as a result of spinal cord injury, stroke or other central neurological disorders.
The excitement around FES technology started in the early 80’s when Nan Davis a paraplegic student at Wright State University, got out of her wheelchair using a FES system and “walked” to receive her diploma, inspiring the film First Steps. Christopher Reeve, star of the Supermanmovie franchise, who later became tetraplegic following a tragic horse-riding accident, was a FES activist and regularly exercised using a FES cycling ergometer. Five years later when the doctors expected deterioration, he began to improve, suggesting neurological recovery.
The Christopher and Dana Reeve foundation continues to support ground breaking FES technology. FES is already used in the treatment of breathing, bowel and bladder function, whilst hand grasp and improving walking with FES come in various forms. A range of devices already exists such as the Odstock Dropped Foot Stimulator (ODFS) Pace,a simple foot drop stimulator which assists those with neurological foot drop, right through to microcomputer controlled functional neuromuscular stimulation systems like the Parastep, which enables independent, unbraced walking for those with spinal cord injury.
Research suggests that feedback from FES-stimulated activity even has the potential to improve rehabilitation by helping to reorganise the brain. Epidural stimulation, the latest research project in spinal cord injury, which involves a continuous electrical current being applied to the lower part of the spinal cord, has demonstrated unprecedented, potentially life-changing improvements in mobility for individuals living with longstanding spinal cord injury. The future is bright for exoskeleton and FES technology and it seems that superman’s legacy really has inspired some to achieve superhuman walking.