Pintern Blogs

Natalie Trask, Spinal Cord Injury Research at the Fraizer Rehab Facility in Louisville Kentucky, Week Two

Hi everybody, this is week two of my internship at the Fraizer Rehab Facility in Louisville Kentucky. This week was similar compared to last week. I continued observing the same patient and attending both physical and occupational therapy sessions. On Wednesday I got to observe an engineering test process for head control braces made for children with spinal cord injuries, who lack head control. The engineers brought in three different prototypes that they have been constructing for the past few months and had a few SCI patients test these braces. They also had some typical kids tests these braces as well, just to make sure they were not too constraining and still allowed for some mobility when needed. I also read many case studies this week focusing on spinal cord stimulation. There is one type of stimulatation in particular that stands out though, and that is called transcutaneous spinal cord stimulation. The word trans means to go through something and the word cutaneous is fancy for skin. So this type of stimulation is placed on the back of the spinal cord and the electrical signal then travels though the skin to reach the sensory nerves in the back of the spinal cord. This allows for the sensory nerves to become more awake or more readily available. This then allows the motor nerves which are located in the front of the spinal cord to become more aware of the activity based therapy that is occurring at the same time as the stimulation. An example of this activity based learning could be walking on the treadmill, or moving their legs while in a gravity neutral position, which I will discuss in the next paragraph. While all of this is going on the patient is asked to use their brain and intentionally tell their legs to move in that walking position, this can also be referred to as descending drive. This is done to use those nerve pathways that might still be present, they are just faint or very few due to the spinal cord injury. This method of stimulation could potentially allow these nerve pathways to regain some function. On Friday I observed a test that was done in a gravity neutral position. This is where the patient is laying sideways with the top leg held up by a brace hanging from the ceiling and the bottom leg resting on a narrow, thin plank, that is suspended from the ceiling as well and looks very much like a cross country ski. The patient is also connected to a stimulus to help the muscles function. The physical therapists and researchers move the legs in a walking postition and then record how the legs move or function after the therapists have stopped assisting the leg’s movements. The patient is held in this suspended position to reduce the effort required to move the lower limbs against gravity. This test is kind of like the experience on the treadmill that I discussed in last weeks blog. But in this gravity neutral position each muscle can move seperately/independently instead of on the treadmill where more muscles are required to work together to actually allow the body to walk. On Friday night we went to a Dive-In movie night at the Lakeside pool where we watched The Rise Of Grue. This was a fun and unique experience. Then on Saturday, my host family took me to a soccer game at the Lynn Family Stadium to watch the Louisville soccer team play against the Las Vegas Lights. It was a super fun game to watch and Louisville won the game 1-0. My host mom and I also got matching Louisville City shirts to support the team. We also walked across the bridge that connects Kentucky and Indiana and towers above the Ohio river. On the Indiana side we ate dinner at this great Mexican restaurant. Overall, it was once again a great week and I am so grateful for this amazing experience.