New Walking Therapy

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 Videoassisted-walk-01

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 the application 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.comad-parastep
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 over skin attached electrodes 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.
I am currently working to make this improvement possible by connecting
some parties of interest here.

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  3-4 trainings per week for 4-6 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-Kunming-rope-walkDr. Wise explain this walking technique on above photo

All above statements, photos and videos from Assisted Gait walking and Parastep use are my own experience and can be repeated and proven.
My own therapies and great progress of stepping initiations shown on 2 session by 1 hour per week of Assisted Gait walking therapy @ MacWheelers Gym  is unfortunately stalled as it is constantly hanging on yoyo thread with no chance to raise to the next level which would require increased frequency & intensity and eventually to move to FES walking  (Parastep) training.
December, 2019