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  • ืชืžื•ื ืช ื”ืกื•ืคืจ/ืชHillel Kobrovski

ื—ื“ืฉื ื•ืช ื‘ืชื—ื•ื ื”ืจืคื•ืื”: ืฉืชืœ ื—ืฉืžืœื™ ืฉืžืืคืฉืจ ืœืžืฉื•ืชืงื™ื ื‘ืขืžื•ื“ ื”ืฉื“ืจื” ืœื”ื–ื™ื– ืืช ืจื’ืœื™ื”ื ื•ืœืœื›ืช

ืขื•ื“ื›ืŸ: 18 ื‘ื™ื•ืœื™ 2021

ืžื—ืงืจ ืจืคื•ืื™ ืคื•ืจืฅ ื“ืจืš ื•ืžืขื•ืจืจ ืชืงื•ื•ื” ืขื•ืœืžื™ืช ืœืžืฉื•ืชืงื™ ื’ืคื™ื™ื :


ืžื—ืงืจ ืฉืคื•ืจืกื ื‘ืžื’ื–ื™ืŸ The new england journal of medicine ืžื“ื•ื•ื— ื›ื™ 3 ืžื˜ื•ืคืœื™ื ืžืฉื•ืชืงื™ื ื‘ืจื’ืœื™ื”ื ื”ืฆืœื™ื—ื• ืœืœื›ืช ื‘ืืžืฆืขื•ืช ืงื•ืฆื‘ ืฉื”ื•ืฉืชืœ ื‘ืขืžื•ื“ ื”ืฉื“ืจื” ืฉืœื”ื .



ื”ืฉืชืœ ื”ื—ืฉืžืœื™ ืฉืฉื•ืœื— ืื•ืชื•ืช ื—ืฉืžืœื™ื™ื ืœื ื•ื™ืจื•ื ื™ื ื‘ืขืžื•ื“ ื”ืฉื“ืจื” ื•ืžืืคืฉืจ ืœืžืฉื•ืชืงื™ื ืœื”ื–ื™ื– ืืช ื”ืจื’ืœื™ื ื‘ื›ื•ื— ื”ืžื—ืฉื‘ื” ื•ืœืœื›ืช

ื–ื” ืื•ืžื ื ืžื—ืงืจ ื‘ืชื—ื™ืœืช ื“ืจื›ื• , ืื‘ืœ ื‘ื”ื—ืœื˜ ืžืขื•ืจืจ ืชืงื•ื•ื” ืœืžื™ืœื™ื•ื ื™ ื ื›ื™ื ื‘ืขื•ืœื.


ื‘ืกื•ืฃ ื”ื›ืชื‘ื” ื™ืฉ ืคื ื™ื™ื” ืฉืœ ื‘ื™ืช ื”ื—ื•ืœื™ื ืชืœ ื”ืฉื•ืžืจ ืœื”ืฉืชืชืฃ ื‘ื ื™ืกื•ื™ , ื–ื” ืคื•ื ื” ืœืื ืฉื™ื ืขื ืคื’ื™ืขื•ืช ื‘ืขืžื•ื“ ื”ืฉื“ืจื” ืฉืžืฉื•ืชืงื™ื ื‘ื’ืคื™ื™ื ื”ืชื—ืชื•ื ื•ืช ืคื—ื•ืช ืž 3 ืฉื ื™ื ื•ืžืขื•ื ื™ื™ื ื™ื ืœืขื‘ื•ืจ ืชื”ืœื™ืš ืฉืœ ื ื™ืชื•ื— ืœื”ืฉืชืœืช ืงื•ืฆื‘ ื•ืœืื—ืจ ืžื›ืŸ , ืชื”ืœื™ืš ืฉืœ ืฉื™ืงื•ื ืžืžื•ืฉืš ืœืคื ื•ืช ืœื‘ื™ืช ื”ื—ื•ืœื™ื.


ืœืคื™ ื”ื›ืชื‘ื” ื‘ืืชืจ ื”ืžื“ืขื™ ื”ืชื”ืœื™ืš ืœืื—ืจ ื”ื”ืฉืชืœื” ืžื™ื•ืขื“ืช ืœืื ืฉื™ื ืฉื ืคื’ืขื• ื‘ืขืžื•ื“ ื”ืฉื“ืจื” ืคื—ื•ืช ืž 2.5 - 3 ืฉื ื™ื ืœืื—ืจ ื”ืคื’ื™ืขื” , ื”ื”ื—ืœืžื” ื“ื•ืจืฉืช ืื™ืžื•ืŸ ื•ืคื™ื–ื™ื•ืชืจืคื™ื” ืฉืœ 85 ืฉื‘ื•ืขื•ืช


ย 

ืžืชื•ืš ื”ื›ืชื‘ื” ื‘ืขื™ืชื•ืŸ ื”ืจืคื•ืื™ \ ืžื“ืขื™ :

Recovery of Over-Ground Walking after Chronic Motor Complete Spinal Cord Injury

  • Claudia A. Angeli, Ph.D.,

  • Maxwell Boakye, M.D.,

  • Rebekah A. Morton, B.S.,

  • Justin Vogt, B.S.,

  • Kristin Benton, B.S.,

  • Yangshen Chen, Ph.D.,

  • Christie K. Ferreira, B.S.,

  • and Susan J. Harkema, Ph.D.

Summary

Persons with motor complete spinal cord injury, signifying no voluntary movement or sphincter function below the level of injury but including retention of some sensation, do not recover independent walking. We tested intense locomotor treadmill training with weight support and simultaneous spinal cord epidural stimulation in four patients 2.5 to 3.3 years after traumatic spinal injury and after failure to improve with locomotor training alone. Two patients, one with damage to the mid-cervical region and one with damage to the high-thoracic region, achieved over-ground walking (not on a treadmill) after 278 sessions of epidural stimulation and gait training over a period of 85 weeks and 81 sessions over a period of 15 weeks, respectively, and all four achieved independent standing and trunk stability. One patient had a hip fracture during training. (Funded by the Leona M. and Harry B. Helmsley Charitable Trust and others; ClinicalTrials.gov number, NCT02339233.)

Supported by the Leona M. and Harry B. Helmsley Charitable Trust, University of Louisville Hospital, and Medtronic.

Disclosure forms provided by the authors are available with the full text of this article at NEJM.org.

This article was published on September 24, 2018, at NEJM.org.

We thank our research participants for their courage, dedication, motivation, and perseverance that made these research findings possible; Richard Seither, Brittany Castaneda, Katelyn Smith, Katie Pfost, and Dylan Pfost for their support of the research participants; Camilo Castillo, Darryl Kaelin, Yukishia Austin, Lynn Robbins, and Hye Conner for medical oversight; Nicole Knapp, Megan Greenwell, Natasha Stoneking, and A.J. Walden for data acquisition and analysis; Steven Gruneisen for data analysis; and our entire research staff for administrative, engineering, and additional research support.


ื”ืžื—ืงืจ ื”ืžืœื ื‘ืืชืจ ื”ืจืคื•ืื™ ื“ื•ืจืฉ ืžื ื•ื™ ืžื™ื•ื—ื“ ืœืืชืจ.


https://www.nejm.org/doi/full/10.1056/NEJMoa1803588?query=featured_home

24 ืฆืคื™ื•ืช0 ืชื’ื•ื‘ื•ืช

ืคื•ืกื˜ื™ื ืื—ืจื•ื ื™ื

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