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    World Leader in Spinal Cord Research and Treatment
    Dr. John McDonald will establish new center for spinal cord restoration
    For Immediate Release: November 01, 2004
    Baltimore - One of the world's leading spinal cord researchers, Dr. John McDonald, will join the staff of Kennedy Krieger Institute to establish a program to serve patients with spinal cord injury and paralysis.

    The physician who helped the late actor Christopher Reeve recover some sensation, movement and moments of independence from his ventilator, Dr. McDonald founded and served as director of the Spinal Cord Injury Program at Washington University School of Medicine in St. Louis. At Kennedy Krieger Institute, he will serve as director of the new Spinal Cord Research Center.

    The new Spinal Cord Research Center at Kennedy Krieger will aid patients with paralysis regain feeling and movement through innovative "activity-based restoration," a treatment and research-based model. Traditional spinal cord injury rehabilitation programs have focused on helping patients learn ways to compensate for disabilities thought to be irreversible. With activity-based restoration, therapists assume that patients may be able to actually recover function. The method relies on the principle that the nervous system requires patterned neural activity to maintain and generate spinal cord cells.

    Dr. McDonald and other specialists believe that by simulating normal movement, the resulting neural activity can help regenerate cells and help their patients' bodies "remember" how to move. Dr. McDonald also expects that, in addition to aiding patients injured in accidents, these techniques could be used to help those with disorders like spina bifida, where the spinal cord injury happens at birth or earlier.

    "Our clinical approaches have shown that function in individuals who are paralyzed can actually be restored through vigorous physical activity," Dr. McDonald says. "I could have brought my expertise to any institution in the world, but I chose to join Kennedy Krieger Institute because of their unprecedented interdisciplinary treatment and research."

    Kennedy Krieger is the world-renowned neuroscience institute for children and adolescents with disorders of the brain and spinal cord, both congenital and acquired. Dr. McDonald's work will complement current research and treatment programs at the Institute and greatly enhance the care of children in its rehabilitation programs, including those recovering from traumatic brain and spinal cord injuries, cerebral palsy and other motor disorders.

    Dr. McDonald received his combined M.D. and Ph.D. in neurosciences in 1992 from the University of Michigan. He completed research fellowship training at Kennedy Krieger Institute in 1993 and residency training at Washington University School of Medicine before joining the faculty there in 1996.

    Dr. McDonald's research, which focuses on the mechanisms of spinal cord injury and repair as well as restoration of function, has been recognized by the National Institutes of Health, the International Neurotrauma Society, American Academy of Neurology and other organizations.

    "John McDonald is a world-renowned scientist and a compassionate physician," said Gary W. Goldstein, president of Kennedy Krieger Institute. "His ability to translate complex neuroscience into effective treatments for children with paralysis and spinal cord injury holds great promise for so many of the children we serve - and for children from around the world."

    Kennedy Krieger Institute is an internationally recognized organization dedicated to improving the lives of children and adolescents with developmental disabilities. Each year, more than 11,000 children are served through inpatient and day treatment programs, outpatient clinics, home and community services and school-based programs.

    In addition to providing this broad spectrum of services for children and families affected by autism, cerebral palsy, genetic disorders and many other conditions, Kennedy Krieger is also home to a team of scientists and investigators who are contributing to the understanding of how these disorders develop and pioneering new interventions and earlier diagnosis. In addition, Kennedy Krieger staff annually trains hundreds of medical specialists who apply their knowledge in communities around the world


    Nothing significant here. Glad you're happy.


      Schmeky, I think Jeff is happy b/c it'll be close in location to him.



        You're correct. But, supported ambulation activity based recovery came from Germany back in the 80's. McDonald is flogging a very old horse. Besides, most insurance limits this form of rehab and few individuals can privately pay for this "cure".


          I still think that ambulation therapy is more like a maximizer of what you have left as opposed to the regenerator is is trumped to be. Wouldn't have someone figured this out in the last 200 or so years, and if it has nothing to realistically offer a low level complete SCI, then how effective can it be with others? I mean, intense, repetitive treadmill workouts does not seem very scientifically revolutionary. But I'd never doubt Dr. McDonald on his passion and devotion to cure paralysis.

          sherman brayton
          sherman brayton


            I have traveled all over this state and everybody say sorry thgree years you will have to learn to deal with it. Well I'm not and Dr.Mcdonald shares that same attitude and thats all I ask for.

            Scott is right. It seems if somebody has one good thing to say or report it is followed by 10 or so negative people. You people can keep that attitude but it will never get you anyware.



              Ditto what Brayton said.


                Schmeky and Brayton,

                I am sorry, I don't agree with your assessments of the role of ambulation training. The report that as many as 80% of people with incomplete spinal cord injury can learn to walk through intensive training is truly a remarkable and unexpected finding. How does the spinal cord do this? There are still many unanswered questions concerning what the intensive training is doing. One possibility is that retraining the locomotor pattern generator is essential for recovery of ambulation. A second possibility is that intensive training is resulting in new connections being formed in the lower spinal cord that allows very few axons to initiate and control walking. A third possibility is that the training is stimulating regeneration to occur in the spinal cord.

                Many laboratory studies have shown that cats can be trained to walk even with transected spinal cords. There is now evidence from human studies that stimulation of the L2 locomotor pattern generator can markedly accelerate progress in recovering ability to ambulate efficiently during the training. One fascinating study that has been repeated by several laboratories is that one can cut the left half of the spinal cord, wait a week then cut the right half of the spinal cord, and cats will recover ability to walk voluntarily from such lesions that have eliminated all long tracts between the brain and spinal cord. This suggests that walking can be controlled indirectly through shorter networked pathways in the spinal cord.

                I would not dismiss this research so cavalierly. It is important to understand the mechanisms by which recovery occurs so that we can accelerate it. It is a good thing that Johns Hopkins is investing into this area of research and I think that this center will provide important advances for the field.



                  I have a complete Asia A T7 injury?

                  What would be the possible outcome of suspended treadmill training and stimulation of the central pattern generator in my case? I was told very early on "you're completely paralysed from T7 - there is no hope and there never will be."


                    Chris2, you have been on the cure forum long enough to know that clinicians who claim that there will never be any recovery from spinal cord injury are wrong. They don't know the research and they are not aware of the progress in the field. Those that are aware and have spent time doing research do not share this opinion.

                    While exercise may not give you voluntary control of your limbs, it does stimulate the neural circuits and muscles below the injury site to be active. Many studies have shown that intensive locomotor training can improve reflexes and rhythmic walking behavior in animals. This is an important step in preparing your lower spinal cord for regeneration.

                    Regeneration alone is not enough if the neural circuits below the injury site are shut off. Likewise, muscle atrophy and bony loss below the injury site will be obstacles to recovery as well. For that reason, the exercise programs that people have devised are, in my opinion, an essential part of regenerative therapies.



                      Dr Wise, referring to the fact that supported ambulation programs are rather expensive and never proposed to complete SCI patients, I wonder if there is any way to manage 'on our own'. I am ASIA B [but only very few and weak muscles below injury site], T10/T12, I walk with long braces and walker almost everyday and occasionally walk on a treadmill. I feel that treadmill is an excellent step forward in my rehabilitation as the walker becomes 'too easy'. But that could also create irreversible problems with my shoulders which were broken during the accident. I already have a treadmill at home but wonder if there is a way that I can equip the room in such a way that I be able to have my shoulder supported. Ever heard of such program carried out at home ? Is that realistic / recommendable, with medical support to get started ?


                        Wise, I went through such a program at McGill almost 20 years ago. Approx 4 months post injury I was evaluated at the hospital I was staying in for the program. The criteria was that I was incomplete. I am an incomplete c7 t1 with functioning arms. I couldn't move a muscle in my legs. I was put in a parachute harness and graduate students moved my legs while on the treadmill while videoing my progress over the years with reflective markers on my joints to monitor improvements in my gate. My spacticity was very bad so I was given clonadine and cyproheptadine which did result in a small improvement.

                        I did this for approx 5 years. My severe spacticity eventually turned into walking without braces. I also used the treadmill at home and McGill later gave me an electric stimulator which I placed behind my knee and zapped each leg which helped be bring it forward more stronly and enabled me to walk faster and farther.

                        I progressed to a walker (100 ft) and even to crutches for short distances (20 ft). All the time I still could not move my legs unless I was walking and weightbaring. I could not walk in a pool because I needed more weight on my legs or I couldn't take steps.

                        After about 6 years and trying a variety of ankle braces for better stability, I gave up because it was never functional.

                        So based on my experience, I know first hand that for some people, treadmill training does return some ability to walk. I would just hate to see too much of the small resource pie go to intesive physical therapy because I belive it is only a small part of a cure for "some people". Walking was almost more of a circus act than actually improving my lifestyle.

                        But, I would do it all over again and wish I hadn't stopped. Who knows where I'd be today.


                          So far Chris2's clinicians are correct in my book. He nor I and countless others have recovered nothing, and the more years that go by are just firming this in cement!
                          Fact: I was told personally from the head of the treadmill ambulation program at UC-Irvine that it would be USELESS for me to do it!

                          let's look at the word USELESS. This word usually coincides with HOPELESS. So much for revolutionary advancements when these advancements are deemed USELESS for complete low level paraplegics with a chronic SCI. I have rightfully earned the right to be cynical, negative, and suspicious.

                          sherman brayton
                          sherman brayton


                            sherman, are you sure that you have "recovered nothing" after your injury? That is a very different claim from not recovering everything. Who did you speak to at UC Irvine? I am puzzled. Did you speak to Ozzie Steward? Wise.


                              Tucker, thank you so much for sharing your experience. At McGill, they have been leaders in research to train locomotor function in the lower spinal cord. What you describe is indeed my impression, that the training do produce changes in the lower spinal cord so that walking can occur, albeit without voluntary control. So, the key now is to combine this training with a regenerative therapy. I am afraid that regenerative therapies alone would not be enough to restore locomotor function. About five years ago, I argued strongly for more locomotor training research at the National Advisory Board of Medical Rehabilitation Research at NIH. We need to have the capability to study this question rigorously. It would be such a shame if we are able to regenerate the spinal cord but don't do the training necessary to restore locomotor function. At the present, we still don't know how much and what kind of training is necessary, whether it is useful to do the training before the regeneration or after the regeneration. In fact, the recent clinical trial funded by NIH suggests that a wide variety of training (includng overground walking) can restore locomotor function to people with incomplete spinal cord injuries.

                              By the way, that is the goal of regenerative therapies... isn't it? To make people "more incomplete". So, learning about how people with incomplete spinal cord injury respond to locomotor training will give important insights into how people with partly regenerated spinal cords will respond to the training.