Research on paralyzed patients brings new treatment options for pain management and ambulation

The Department of Defense has awarded two Virginia Commonwealth University (VCU) scientists grants totaling more than $7 million for their research on the effects of virtual reality on chronic pain and the use of exoskeletons, plus epidural stimulation, to improve the quality of life for paralyzed people. The grants, announced in February, are for four years, with recruitment expected to begin in September. 

Using virtual reality to treat pain

A common misconception about paralyzed people is that they don’t feel pain in immobilized parts of their body. In fact, around 50 percent of those with spinal cord injuries suffer from neuropathic pain that is often described as burning, electrical and very uncomfortable and almost nothing works for it and even medication only offers some relief. Neuropathic pain has many similarities to phantom limb pain, where someone with an amputated arm, for example, feels pain in the hand that isn’t there. Visual illusion therapy, where a mirror trained on the remaining arm “shows” the missing hand, has proven effective in helping alleviate phantom limb pain.

Neuropathic pain in spinal cord injury is trickier but the same concept appears to apply. And researchers have had success using mirrors and projections to simulate a patient’s experience of watching himself or herself walk. Participants in the study go home with a small headset that fits over their eyes, programmed with individualized games and therapies, complete with a self-designed, first-person walking avatar.  The plan is to enroll 200 patients across three sites: VCU, the University of Alabama at Birmingham and the University of New South Wales in Australia. 

Exoskeleton+epidural stimulation study

A relatively new procedure called epidural stimulation, where doctors surgically implant a device into the spinal cord to supply electrical currents connecting nerve signals from the brain, has also shown promise. But the procedure can be invasive and expensive.

In an earlier study, researchers monitored the use of the exoskeleton on a patient who had had the epidural stimulation procedure and was surprised by the promising results after only 12 weeks of training. That’s where Central Virginia VA Health Care System comes in. They’ve developed a less invasive epidural stimulation process – a two-hour, non-surgical procedure similar to the epidural injection given to women in childbirth.

The DoD awarded the innovative team of researchers $3.7 million to study the exoskeleton’s use in concert with the new version of epidural stimulation — the first study of its kind. The research could ultimately lead to a standard treatment for spinal cord injury that increases cardiovascular health, bladder and bowel function and even returns some motor control. The plan is to enroll 20 veterans in this study.

You can read more about these two studies HERE.