People who are paralyzed often have serious problems from lack of muscle tone in the legs leading to more problems and an earlier death.
Not only is blood clots a problem, but the muscle tone in the legs helps the heart pump blood better. Without the muscle tone, more of the blood tends to pool in the legs. A leg massage isn't going to make much, if any, difference on this issue.
One of the goals of functional electrical stimulation of the muscles is to improve muscle tone and reduce the load on the heart.
Another approach that is/was being experimenting with involves suspending people above a conveyor belt and having a therapist move their legs in stepping motions. In a normal, functional human being, a good deal of the job of directing a walking motion is carried out in the spinal cord with the brain acting to give higher level control but not dealing with the fine details.
The idea is to train the regions of the spinal column that are involved with stepping motions to allow the person to take on more and more of their weight and get exercise by walking on the treadmill.
If you get a chance, check out the work done in this area by a Doctor Susan Harkema. If I remember correctly, she was at UCLA when I first noticed her work. She is now at the University of Louisville.
From [url]http://insiderlouisville.com/news/2011/05/20/u-of-l-paralyzed-man’s-spinal-cord-neural-networks-retrained-completely-changes-his-life/[/url]:
Quote:
Susan Harkema, Ph.D., of the University of Louisville’s Department of Neurosurgery, Kentucky Spinal Cord Research Center and Frazier Rehab Institute, is part of an 11-person team who’ve combined multiple technologies and therapies, an approach that restored a 25-year-old former Oregon State baseball player’s ability to walk.
Rob Summers was struck by a vehicle in July 2006 and the hit-and-run accident left him completely paralyzed below the chest.
...
He can remain standing, and bearing weight, for up to four minutes at a time – up to an hour with periodic assistance when he weakens.
Aided by a harness support and some therapist assistance, he can make repeated stepping motions on a treadmill. He can also voluntarily move his toes, ankles, knees and hips on command.
The results were achieved through electrode implants continually directing epidural electrical stimulation of the patient’s lower spinal cord, mimicking signals the brain normally transmits to initiate movement, according to the U of L report.
Once that signal is given, the research shows, the spinal cord’s own neural network – combined with the sensory input derived from the legs to the spinal cord – is able to direct the muscle and joint movements required to stand and step with assistance on a treadmill.
The other crucial component of the research was an extensive regime of “locomotor training” while the spinal cord was being stimulated and the patient suspended over the treadmill.
Locomotor training uses three different rehab regimes including manually taking the patient through the walking process in hopes of getting the spinal cord and brain to “rewire” past the injury.
Assisted by rehabilitation specialists, the patient’s spinal cord neural networks were retrained to produce the muscle movements necessary to stand and to take assisted steps.
This is the kind of thing I was interested in while working on my (uncompleted) doctorate. It didn't help that my committee chair who was very interested in such such left and the committee chair I ended up with was completely uninterested in it.
20 Sep 2012, 12:15 pm
