In the ever-evolving world of technology meets medicine meets cerebral palsy, comes two very interesting stores about young people who are learning to walk with the aid of devices that look more like they belong in a science fiction movie.
The first story comes from WCBS in New York and features 13-year old MacKenzie Maher, unable to walk since birth due to cerebral palsy. A big breakthrough in her quest to walk came courtesy of a high-tech machine called a Lokomat. MacKenzie participated in a 6-week clinical trial at Shriner's Hospital in Chicago. The Lokomat is a robotic device that "walks" her body with all the appropriate movements for several hours a day. The patient is attached to the harness and leg straps prior to a computer controlling the movement of her legs on a treadmill. The computer controls the speed and the harness forces her legs to mimic natural motion. The repetitive motion re-trains the muscles to proper movement and strength without the miscommunications that typically happen when MacKenzie's brain tries to tell her legs what she wants them to do. After time, the therapy retrains the nervous system to bypass damaged areas and restores healthy neuromuscular function.
The stated benefits of Lokomat therapy are 1) the ability to maintain a consistent walking pace, allowing the therapeutic exercise to be sustained for long periods of time 2) improving circulation, strengthening muscles and improving muscle tone 3) strengthening bones that are otherwise at risk of osteoporosis from lack of use.
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The Lokomat, patented by Hocoma, a Swiss company, received FDA approval in 2002 and is therefore covered by some insurance programs. At the time of the CBS story, there were 6 Lokomats in the United States.
The second story revolves around 18-year old Austin Hammer, a young man who suffers from spastic diplegia, who has seen major improvements from the use of a specialized compression suit that was initially designed for use by the Soviet space program to preserve and maintain healthy muscle tone during extended stays in the zero-gravity of space stations. The suit, known as the Euro-Ped Therapy Suit, features a vest, shorts, knee pieces, shoes and a headpiece, all connected to elastic, bungee-like cords. The computer-controlled tension mimics the natural elongation and shortening of healthy human muscles and natural movement. Like the Lokomat, one to two hour, daily sessions of repetitive, machine-controlled walking is enough to retrain muscles and motor skills. Continued therapy at the Euro-Peds National Center for Intensive Pediatric Physical Therapy in Pontiac, MI has given Austin the ability to walk short distances unassisted, something he couldn't previously do.
In the United States, this form of therapy is still in the "investigational" stage and therefore, probably not covered by insurance. However, qualifying patients with cerebral palsy can be accepted into clinical trials at no cost to the patient. At the time of the article, there were 4 other clinics other than the Pontiac, MI Center that offered the Euro-Ped Therapy Suit.
Both systems require that patients meet certain qualifications prior to use. They need to have at least some sensation and movement in at least one of the major muscle groups of the leg. Patients with conditions such as high blood pressure, seizures, diabetes, heart disease, unhealed pressure sores, severe osteoporosis may be deemed poor candidates for this type of robotic therapy.
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