Original Post Published 2019 (see Updates here)
Continuous Walking training with Functional Electric Stimulation (FES) with weight support (where needed)
is a KEY to recover standing & walking for many paralyzed patients.
Neuro-plasticity can help only if this program is persistently performed
with a 2 to 3 hours of FES walking practice per day with 5 training’s per week, for at least 6 months.
For the New Walking Therapy, 2 major pieces of equipment are crucial.
First – Functional Electrical neuro-muscular Stimulation (FES) PARASTEP walking system to be used for walking practices.
Note: Here is Photo and also Link to YouTube video where you can see that I have already use and tested Parastep shortly in private clinics in USA. and I have witnessed stepping improvement after just few sessions.
Some SCI Incomplete patients can stand and some can make few steps on their own. For such a patients just Parastep and long, frequent walking training program should be sufficient even without weight support overground system.
For me and for many others – we would need one more piece of equipmen for quality Gai practice support.
Standing and overground walking WEIGHT support device to allow correct legs and body position and right pressure for stepping practice.
Important note – For this therapy, overground weight support system should be used – not treadmill weight support system – as patient need to self adjust walking & electrical stim rhythm.
Track gait system or Zero-G can be used here as well as the LiteGait 330 4Home system should be sufficient and up to this task.
Third – optional part of equipment (when is ready) – Programmable garment / pants – that transfers electric stim of Parastep to nerves & muscles – will speed it up the whole process.
Instead of placing individual electrodes on specific muscles every time when using Parastep, patient & therapist can use pants with electrodes already programmed for custom FES application and just plug it in.
I am very excited this therapeutic combo might be available relatively soon.
After my research I have contacted and connected people from Myant.ca and Sigmedics.com,
Realizing great opportunity of using this concept & therapeutic combo, both sides have decided to pursue this idea and enable this connection & create new therapeutic FES walking product.
This New Envisioned Walking Therapy presented here is customized for my situation according to my research and experience.
However this walking therapy is easy to customize for different patients and could help many people with Incomplete Spinal Cord Injury and also to other patients with specific movement impairment.
With a great results in research of different medication and enzyme application (AXER-204, NVG-291-R, CLP290) we will see in the future even more demand for modern therapeutic approach where this New Walking Therapy might play crucial role in recovering patients after years of inactivity.
My goal is to raise funds, buy equipment, organize and test this proposed therapy with equipment and in length & way proposed.
Cost of the proposed therapy to be high as all need to be hand picked and highly customized for the first run. Later price of the therapy can be significantly lower. This calculation is approximate according to my needs.
To get necessary equipment buy Parastep system and Weight support apparatus minimum CDN $ 30,000 for both devices need to be cashed out. Also, to pay hours and hours of psychotherapies through period of 6 months of intensive physio with this customized program, it is going to cost way more than equipment itself.
Total cost with equipment and 6 months of therapy can run from
more than $ 80,000.
Further Explanations of New Walking Therapy and updates
People with Incomplete Spinal Cord Injury (SCI) can restore walking but only if they actually try to walk again. To begin this process, they need to use special support devices to enable proper walking technique in order to put their body through repetitive walking therapy rounds.
Majority of SCI individuals need “Gait training”, this is based on a body weight support machine. Treadmill and harness system are also part of this package. There are several phases and modes of how walking can be done. This is based on the person’s capabilities to initiate stepping. For many, robot walkers as Locomat
and THERA-Trainer lyra or REHA G-EO system are necessary for beginning of this process.
Assistive walking with weight support – Click to see short Video
Some of us that can slightly initiate stepping but lacking intensity and control of movement and need Manual assistance of 2 “walkers” to move legs in rhythmic stepping pattern on treadmill. With this exercise stepping pattern is improving tremendously!/
Another progressive step is addition of Functional neuro-muscular FES stimulation (with or without a weight support) walking training . This type of system is known as Parastep- which was invented around a quarter century ago, and is highly underrated as a therapy tool for Incomplete SCI patients.
The way how Parastep works is simple – when patient try to move the right leg as at the same time press right button on the walker. Small wearable computer send tiny electric stim through 6 electrodes attached on each leg in programmed sequence. This stimulation generate muscle contraction exactly in order to make stepping motion with right leg. At the same time, muscles on the left leg receive signal to straight up and hold body weight on that side.
System Parastep is available from Sigmedics. Parastep is in use by many clinics in the USA. It can be used with and without weight support system that is sold separately.
Parastep, Walking FES as Therapeutic device would be more effective and much faster in application if improved with programmable FES garment.
Maybe the most important conclusion is that no walking therapy for SCI patients can be effective if is not performed in certain (1)frequency, (2)duration and (3)continuance with at least 4-5 trainings per week for 6 months!
Walking therapy is the only way to strengthen weak or to awake unused neuro-circuits and build (again) pattern based neural behavior that would further support patient walking rehabilitation.
Body-Mind connection, as patient need to highly focus on stepping and pushing, is also crucial element for faster rebuilding of walking neural pattern.
On the other side, failing to perform certain number of repetitions will prevent body to rebuild that neurological pattern.
With above exercises, patients improve very slowly and lose it in no time if stop exercising. This is known as Yo-Yo therapy effect.
Next level of walking exercises has more modalities and different devices that can support patient.
Some people that still need help with stepping might get assistance by robotic devices (Keeogo or Hal or any other full or partial Exoskeleton devices);
Walking therapy is so effective according to Special Hospital for Spinal Cord Injuries in Kunming in China. After decades of experience Specialists in Kunming Chine claim that their method : Continuous walking over ground with high walker and no body weight support in length: 6 hours per day, 6 days per week and 6 months based on “tight rope walking” method – apparently is helping many SCI patients to recover to independent living and walking.
Dr. Wise explain this walking technique on above photo. Research Papers available here.
All above statements, photos and videos from Assisted Gait walking and Parastep use are my own experience and can be repeated and proven
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Some References and Scholar articles related to FES (Functional Electric Stimulation) combined with weight support walking. First if you enter google search for “FES weight supported walking” you will find many results and all researchers agree that this type of physiotherapy has significant advantage over just FES bike therapy and over just weight supported treadmill exercise. (some references 1, 2, 3).
Some researches were working on FES walking system with implanted electrodes.
There are some products on the market as RT600 to combine FES and virtual stepping.
Also, maybe the most promising development would be combination of exo-skeleton with FES system, where exo-skeleton would replace need for weight supported system.
Indego / Parker were working on a such a device for some time.
Both FES walking systems, RT600 and expected Indego system, are and will be way more expensive than envisioned FDA approved FES walking Parastep system + (Myant pants when ready) + LiteGait weight support system proposed above.
My goal is to raise funds, buy equipment, organize and test this therapy with equipment and in length & way proposed. If shows successful, that I strongly believe, this combo therapy might be available immediately for less money than anything else on the market and will help many to regain their independence & their life back!