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Why the rats are walking and we aren't...a theory

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    Why the rats are walking and we aren't...a theory

    I've been thinking about this for some time so I thought I'd seek an opinion or two. Humor me.

    If you haven't already read I'm a huge supporter and proponent of exercise and exercise induced recovery.

    Without going into a long discussion of why, etc. I've decided to throw out this theory to the CC members, doctors, scientists.

    To oversimplify my question and theory I'll use rats and the general able-bodied population.

    Ok, you're a rat. You've had a spinal cord injury and you've undergone an experimental treatment. OEG, schwann cells, stem cells, nerve growth cocktail, OT [img]/forum/images/smilies/smile.gif[/img] - whatever. It really doesn't matter.

    Now, since you've undergone this experiment and are in the process of healing your rat instincts kick in. You're in survival mode. "Must forage for food, must find shelter, must seek safety" keep repeating over and over in your rat brain. Your injury is T1 so you have use of your hands (paws, claws).

    You see food across the cage so you crawl, as best as you can, over to it. You see shelter in the corner and you make your way into it. A giant human hand enters the cage, you're scared, and you try to hide. These are all survival instincts. Without being able to motor normally you're doing the best you can with what you've got. Eventually, days and weeks, you get stronger, you gain a little more function. You're working your little rat ass off to survive and lo and behold you're starting to recover. The scientist peers into the cage and tests you. Sure enough you're improving, better. Yeah, eureka, you're "cured"!

    Why were you cured, did you regain function? The experimental therapy? Your survival mechanisms have somehow compensated for your loss of your legs? Plasticity of your rat brain and spinal tract? Repetition of behavior (looking for food, etc)? Duration? Intensity? What?

    Conversely, you're you, a human with sci and you've also had an experimental procedure or not. You're dependent in some ways but generally with only your hands you're 98% self-sufficient. However, you're not in survival mode fighting for your life so to speak minute by minute, day by day. The doctors and OT/PT all teach you how to adapt to your life on two wheels vs. two legs. Noone and no-thing forces you to work "you're little rat ass off" to regain your lost function. Life rolls on. By not being forced to survive at our basic reptilian brain level we learn to live without - hence learned non-use. Is there a correlation for each and every sci regardless of level and severity of injury to our regaining any function? Must a C2 vent quad who wants off the vent in the most basic survival mode? Is that equal to a T10 para's motivation? Rats are instinctual whereas humans can reason. So, have we reasoned our way out of "survival" mode? In essence, have we given up too early because we weren't forced or encouraged to, in theory, forage for food, seek shelter and hide from danger?

    I'm not sure but I think there is some plausibility and potential behind this theory. What do you think? Should we be more like rats when it comes to trying to regain function? How do we get to survival mode when we really don't have to?

    [This message was edited by Phebus on 03-08-03 at 05:57 PM.]

    #2
    Phebus, I agree with your hypothesis. Rats don't know that they can't walk. They keep trying.

    Most people who do spinal cord injury research want the therapies they are testing to succeed. So, they tailor their models to succeed. Most of the regeneration studies were done with hemisections or overhemisections from which the rats readily recover locomotion without treatment. Of course, there are certain people who go for the whole hog, i.e. transect the cord, but no researcher (except for Kawaguchi and Cheng) has been able to get walking rats from a transected cord. Almost all the experiments are "proof of concept" studies and the papers seldom tell you how many animals did not walk or how many died along the way.

    I want to emphasize out that 5% of people with ASIA A will recover substantially, that 64% of people who get spinal cord injury are "incomplete" and they do recover a lot, and that the people who do not recover represent a minority of the spinal-injured population.

    This is, however, not to cast aspersions on the data that has been gathered to date. There is no doubt in my mind (or a majority of the scientists) that regeneration can and does occur. I am convinced that this will happen and we are making progress towards this goal.

    There are currently many people who are walking who would not have been walking except for the treatments that they received. We just need to get the treatments to a point that it works in a majority of people who have not recovered function and have chronic spinal cord injury.

    Incidentally, when we injure the rats with a 25 mm weight drop contusion model, only 5% walk within 12 weeks after injury.

    Wise.

    Comment


      #3
      Wise, thanks.

      And what about this observation. Does it have any correlation to exercise induced recovery?

      Every human who can walk, from babies to centurians, does so on a daily basis. Regardless if they engage in any other physical activity - everyone walks.

      However, how many of us practice walking every day? How come we don't all have the ability, whether in our homes or in a facility to practice walking every day - maybe a couple of hours?

      If we all had access to this (walking unassisted in a specially designed apparatus) whenever we desired I believe that many of us would see significant gains in our recovery/function without surgical or drug intervention.

      What is our (the human body's) potential for recovery if provided the opportunity?

      This is what I dream about and working on. A place where any one of us can go (24hr fitness concept) and work on our own recovery whenever and to whatever level we want. I think the results would be astounding if given the chance.

      Even more viable than PW or Neuro or SCI-Step.

      Comments? Thoughts? Suggestions?

      Comment


        #4
        phebus, I agree again. That is one of the reasons why I am spending so much time working on developing an inexpensive machine that people can use to walk at home. I think that it is not only important for many people to recover function but because I am worried that clinical trials testing regenerative and remyelinative therapies will not succeed without it. One of the reasons why the Beijing trial of OEG is not yet producing any (many?) walking patients may be because they have little or no rehabilitation or walking therapies. Wise.

        Comment


          #5
          Phebus,

          I concur as well. I believe what you say is true with incomplete injuries, but am more skeptical when it comes to complete [transection] injuries. I believe the whole nervous system is plastic and that, through extensive rehabilitation, latent pathways are awakened and, if needed, redundant ascending neurons can learn to function like descending neurons, and vice versa.

          -Steven
          ...it's worse than we thought. it turns out the people at the white house are not secret muslims, they're nerds.

          Comment


            #6
            "That is one of the reasons why I am spending so much time working on developing an inexpensive machine that people can use to walk at home."

            This is great and I cocur. The EasyStand 6000 is real close but doesn't appear to provide knee flexion. Is it possible the folks at EasyStand could be convinced to develop a device that would more closely approximate a natural gait?

            How far away do you think you might be from having an affordable home based gait trainer marketable?

            Comment


            • #7
              I agree with all of you and your theories, but I feel that a rat can become ambulatory more easily because their hind limbs don't have to support all of their weight. I would venture to guess that 60-75% of the weight is supported by their forelimbs. Bipedal ambulation has got to be much more complicated than a rat regaining partial motor function in its hind limbs. If humans were used to walking on all-fours before their injuries, perhaps they too could rely on crawling with their arms and regaining some function in their legs...I don't know. It's has to be better than permanently resting yourself in a wheelchair.

              Comment


                #8
                I'd guess to me, it all depends on what you define, each of us individually, as a cure. It is probably true that with enough therapy, that a large percentage of those would be able to walk again, maybe not pretty but walking just the same. Now when you start talking about lung function, hand function, sexual, bowel, bladder. . . Well that's when we are going to need the real science. I understand the point you're trying to make, but some of us need more science.

                If anyone knows of an exercise and/or therapy to get my Johnson working again, please post. [img]/forum/images/smilies/smile.gif[/img]

                Comment


                  #9
                  The easystand company is run by a CEO who has personal interest in such machines. It is really a standing machine that has been modified so that a person can move the legs while standing. I like it. Wise.

                  Comment


                    #10
                    Phebus - I think you are definitely on the right track! Are you still talking to the people at Craig? Have they been receptive to your ideas? Are you making any progress on that front?

                    Back in the 70's there was a university study done that explored the degenerative effects of immobilization on humans. I don't know all the details of the study, but I will try to summarize based on what I remember about a report that I saw:

                    Several average, healthy, college age males were first put through a series of physical and medical tests in order to establish baselines for each. Then they were subjected to six weeks of complete bed rest where they literally could not get out of bed. They ate, shit, pissed, read, watched television, etc., for six weeks, in a prone or semi-erect position; and they were not allowed to exercise.

                    At the end of the six weeks, none of the participants could stand unassisted, much less walk (no surprise there). It took all of them between six and nine months of intense reconditioning therapy to recover to the levels that were established in the preliminary testing.

                    The rest of this is my own viewpoint:

                    All of the participants began the study with no adverse health issues or traumatic injuries to deal with. And probably most important, these men all presumed that any lost function would ultimately be temporary.

                    Now, consider an acute SCI case where the immediate diagnosis is "no functional recovery." This is followed by prolonged periods of immobilization, inadequate nutrition, and overmedication, all of which inhibit all sorts of metabolic processes that are necessary for healing. Finally, all hope is removed... Fate sealed... You can draw your own conclusions.

                    I believe an intense conditioning program that incorporates the benefits of optimal nutrition and hydration, cardiovascular exercise, dynamic, weight bearing exercise, and repetitive motion exercise, offers huge potential for recovery from SCI. It should be standard protocol for those who seek maximum functional return and a mandatory precursor to any curative therapies that may become available in the future.

                    Dr. Young coined the term "rehabilitation revolution" in a separate thread. This movement needs to advance along with all the promising scientific research that is happening.

                    In times of crisis, visionary leaders must take brave, innovative actions, often violating the prevailing rules and precedents. The impossible must become the possible.
                    Know Thyself

                    Comment


                      #11
                      Many of these theories are similar to those of the trainer I work out with. I believe that fear is probably the largest factor which keeps many in their wheelchairs. Myself included. I can now walk anywhere I can go in my wheelchair, but because I wear kfo's, and canes, and it's a little hard, I don't instinctively get up and walk when I want to go to the kitchen, I still use my chair. However, I have now included walking from my house, down my ramp to my truck, then following my commute to the gym, I walk into the gym and train, then walk out of the gym and walk back into my house. But then I use the chair at home to cook or do things around the house. What's up with that? I am just scared to get rid of the chair, and tough it out even though I know it's not too difficult to do. But then this is my battle, and it's as much mental as physical.

                      Comment


                        #12
                        Posted by Carl R:
                        Now when you start talking about lung function, hand function, sexual, bowel, bladder. . . Well that's when we are going to need the real science. I understand the point you're trying to make, but some of us need more science.
                        Ageed. What is important to remember is that in certain cumstances, will and determination alone are not enough to overcome significant injuries. The rats that recovered useful function had what essentially amounts to incomplete injuries. As Dr. Young pointed out, only 5% of the rats with contusion (complete) injuries were able to recover, survival instincts and all.

                        Comment


                          #13
                          Rick, I had a post written but I decided to scrap it until tomorrow.

                          Seneca, there is NO DOUBT that we will need regenerative therapies to restore function such as Carl mentioned. However, even if 5% of the rats are recovering and if 5% of humans can recover that would be significant. But how many of us, you included, practice walking EVERY day to see or even explore the possibility of recovery?

                          You've eluded in the past to your discontent and sensitivity concerning "will and determination not being enough to overcome significant injuries" type posts/threads. We understand that it is not solvable through mental and physical gymnastics alone.

                          However, until you and everyone else can and has exhausted the possibility of exercise induced recovery you don't/won't know what your body is capable of.

                          Your attitude only makes it harder because you're approaching it with a negative bias without even trying or giving it credibility.

                          If you had gone through or were going through extensive pt/exercise recovery your comments might be reliable. But as far as I know you haven't or you're not currently engaged in any type of recovery program.

                          I'm not disagreeing with your and Carl's logic. Let's just say "don't knock it until you've tried it" and try and stay positive and on topic - please.

                          Comment


                            #14
                            Regarding excercise: Obviously it increases strength. I wonder what else it does. Since I started following Phebus' suggestions, (floor exercises,theraball, weights, trainer and WALKING) I have regained normal bowel function. After 2.5 years. I can now walk .33 miles on my treadmill. I've also been using creatine and find it really increases my strength. I know, I'm very lucky with my degree of injury.

                            gpbullock, I'm like you, using a chair around the house. Mainly because walking requires the AFO which isn't that comfortable. I also use canes for balance, this makes it hard to carry anything. I need to get out of this freaking chair!
                            Blog:
                            Does This Wheelchair Make My Ass Look Fat?

                            Comment


                              #15
                              Yikes. Phebus, I'm all for physical therapy and advanced rehabilitation techniques and I've said so over and over in posts here. I support access to rehab. for every newly injured SCI because I believe that it can lead to significant recovery and close to normal ambulation in those with incomplete injuries especially. I've supported the approach of PW (see my response in your thread) and the initiative others have taken to design their own exercise programs and I have encouraged "newbies" to stay in shape and be proactive about their care so I don't know how you can say that I've approached exercise based recovey theories with "a negative bias" in the past. I've never knocked the benefits of therapy.

                              What I believe is more along the lines of researchers like Drs. McDonald and Young who support extensive PT, that exercise is a required and necessary component to recovery but it may not be enough in cases where there's an old and/or very severe injury.

                              BTW, I can't practice walking because I have severe spasticity and muscle contraction in my knees but I am working on it in case you're wondering and I have recently seen a therapist and purchased a FES machine which I have also mentioned in many posts here.

                              If I had had access to a good rehab. program in 1978 when I was 8 (before the contractions, osteoporosis, scoliosis, atrophy etc. set in) and my CNS was still developing and extremely plastic, I have no doubt that I would have recovered significantly and would probably be walking.

                              [This message was edited by seneca on 03-09-03 at 09:28 PM.]

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