By Kristen M. Pratt
On the Cutting Edge The age of the bionic man has arrived. "Bionic" may be an exaggeration, but according to a September 27, 2001, article in the Lexington Herald-Leader, Rod Bobblitt, who has a severe spinal cord injury that left him without feeling from the chest down, had a functional neuromuscular stimulation system implanted in February that has enabled him to stand and use a walker to ambulate brief distances. The lead researchers-James Abbas, PhD; David Gater, MD, PhD; and Susan McDowell, MD-at the University of Kentucky Chandler Medical Center, Department of Physical Medicine and Rehabilitation, are testing the system. The system was implanted in Bobblitt's abdomen and has eight electrodes that connect to his upper legs and lower back. The system is activated with an external switch and sends electrical stimulation to the muscles, which then contract-allowing him to stand. Abbas stated in the Lexington-Herald article, "The muscles can only take about 90 seconds or 2 minutes of stimulation before Rod gets fatigued. In addition to using the device to practice standing at home, he also has an exercise program designed to help strengthen his leg muscles, which haven't been used much over the years." The article reports that the University of Kentucky aims to begin implanting the systems on a larger patient population in 1 to 2 years. Definitely hopeful news for people with spinal cord injuries who desire more independence and higher function. But in the article, "Realistic Optimism," by Anne-Caroline Dupont, PhD (page 22), on the use of functional electrical stimulation in improving paralyzed-muscle function, she warns that unbridled hope for miracles can be damaging. She writes, "In this stage of development, however, we must avoid excessive enthusiasm for complex applications. I have often listened to an acquaintance excitedly tell me that a paraplegic had walked on TV. This person did not realize that it had been done in the controlled environment of the laboratory, when the patient was supported by either a body harness or parallel bars. This does not mean that it can be done in the streets. More patient awareness of what is realistically feasible would be welcome." Rehab professionals who work with the spinal cord-injured population must walk the line between providing encouragement and instilling false hope for unattainable goals. The next few decades do offer exciting promise for what new technology and engineering can accomplish to increase function in people with spinal cord injuries and strokes. I, as I am sure all those involved in physical medicine and rehabilitation do, eagerly anticipate the unfolding of this amazing research. —Kristen Pratt Machado is no longer Editor of Rehab Management. Please address any correspondence to Sarah Schmelling, Senior Editor, at cwolski@medpubs.com.
