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    #16
    Thanks Jim! Regarding the Rifton, if there are other capable cheaper options do you happen to have information/links to share of them?

    And yes i was asking about what results were achived of only having 6 months of walking?. Specifically i'm curious if it's worthwhile to do similar training and what the odds are of possibly achieving sustainable results which would mean getting to the point where one can walk without needing assistance? I know most showed some signs of lower limb movement at 6 weeks in most of the groups? Did that also apply to those groups that only received walking? And if the walking only groups did achieve some recovery what percentage achieved some movement after 6 weeks and after 6 months?

    thanks!
    Last edited by crispy1981; 29 Jul 2020, 2:43 PM.

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      #17
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        #18
        Originally posted by crispy1981 View Post
        Thanks Jim! Regarding the Rifton, if there are other capable cheaper options do you happen to have information/links to share of them?

        And yes i was asking about what results were achived of only having 6 months of walking?. Specifically i'm curious if it's worthwhile to do similar training and what the odds are of possibly achieving sustainable results which would mean getting to the point where one can walk without needing assistance? I know most showed some signs of lower limb movement at 6 weeks in most of the groups? Did that also apply to those groups that only received walking? And if the walking only groups did achieve some recovery what percentage achieved some movement after 6 weeks and after 6 months?

        thanks!
        I'm not sure what a cheaper alternative would be for a rolling walker.

        The first 4-6 weeks are only standing in a standing frame. Once able to stand 3 hrs in the morning, and 3 in the afternoon, they begin in a rolling walker like the Rifton. The therapists have to do the hard work in the beginning. It takes months to regain voluntary movement.

        The trial in which the subjects were randomized to untethering surgery + walking, and only walking, a small % were able to walk with the walker and someone locking out their knees with a rope. More than 40% did regain bowel and bladder function. I don't have a PowerPoint from that trial with the exact % 's. I'm pretty sure the %'s are higher, def not lower.

        It is potentially very beneficial for chronic completes to take part in intensive walking. Remember, in our upcoming trial, 9 of the 27 subjects will be randomized to the walking only group (6 months). After the trial, this group will be offered the cells, and an additional 6 months of walking training.
        We think this group will have the best results.

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          #19
          Hi again Jim, thanks for your insight and support!.

          For clarity on your response:

          For those that only received walking therapy only a small percent recovered some walking but they required the assistance of someone locking their knees - none could walk indepedantly (with only a walker and no one locking their knees)?
          So without surgery one might conclude the recovery is not sustainable because the small percentage that recovered some walking were not able to walk independently? And as Dr Wise pointed out in this recent webinar the bowel and bladder recovery requires continued walking to retain the recovered function?

          Yes, i hope i'm selected for the trial (if Covid ever ends) and am in the group that gets walking therapy twice!

          thanks!
          Last edited by crispy1981; 31 Aug 2020, 1:09 PM.

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            #20
            Jim, thanks for your insight and support!.

            For clarity on your response:

            For those that only received walking therapy only a small percent recovered some walking but they required the assistance of someone locking their knees - none could walk indepedantly (with only a walker and no one locking their knees)?
            So without surgery one might conclude the recovery is not sustainable because the small percentage that recovered some walking were not able to walk independently? And as Dr Wise pointed out in this recent webinar the bowel and bladder recovery requires continued walking to retain the recovered function?
            Yes, i hope i'm selected for the trial (if Covid ever ends) and am in the group that gets walking therapy twice!
            thanks![/QUOTE]


            The trial that consisted of walking training only or untethering + walking training, 40% made it to level IV but no further. For those who recovered bowel/bladder, I don't know if they lost those functions when they stopped walking.

            The trial that included cell injections + walking training, 15/20 made it to level IV or better. The graph below is from the published paper. Look at the bottom left, 'KLS' is the Kunming Locomotor Score for each trial subject. It shows KLS level before/after cell injection/6 months of training. (Hard to read: I>II, I>II, I>IV, I>IV .....).

            Look at the SCIM (Spinal Cord Independence Measure) scores. This really shows the benefit of the therapy.
            SCIM- http://scale-library.com/assessment_...scalage=adulte

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              #21
              Very helpful! thanks Jim!

              Yes, these graphs have a lot of useful info that i did not notice during the open house presentations!

              The graph you posted is for the group that DID receive cell injections correct?
              So the answer to my original inquiry is doing 6,6,6 without cell injections will not very likely result in level 5 walking hence would always need someone to assist. My goal was to hopefully achieve level 5/not need assistance while waiting for a chance at cell injection. But it does appear only 2 of that group were able to get beyond level 4.

              Perhaps there is a way to devise something that could lock the knees for us.
              This video depicts some elastic cords that might help. https://youtu.be/FQmjrwx0KTI

              I have the clarity now. Thanks!
              Last edited by crispy1981; 4 Sep 2020, 1:36 PM.

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                #22
                Wow that is great data. crispy1981, isn't a KAFO designed to lock knees?
                "I have great faith in fools; self-confidence my friends call it." - Edgar Allen Poe

                "If you only know your side of an issue, you know nothing." -John Stuart Mill, On Liberty

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                • SCI-Nurse
                  SCI-Nurse commented
                  Editing a comment
                  Yes, but a KAFO locks your knees completely. It does not allow a normal gait pattern of the hip and knee both flexing in the swing-through phase of the gait. It requires you to advance the leg by unweighting it completely and using hip hike to get that leg forward. This would not be consistent with the gait pattern control center that Dr. Young talks about stimulating.

                  (KLD)
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