According to the Spinal Cord Injury Information Network, about 250,000 Americans are living with a spinal cord injury (SCI). Roughly 11,000 new cases occur each year. The rates of SCI are highest among males and those 16 to 30. The leading causes are motor vehicle accidents (accounting for 47.5 percent of cases), falls (22.9 percent of cases) and violence (13.8 percent of cases). Sports injuries account for 8.9 percent of SCIs. An important cause of sports-related SCI is diving injuries. About 850 SCIs each year are the result of diving accidents - usually from diving into shallow water. Roughly one-third of the injuries occur in home pools.

The spinal cord is the main communication conduit for messages between the brain and the rest of the body. Traumatic injury to the head, neck or back can cause bruising or tearing of the tissue and nerve fibers in the spinal cord. The damage disrupts the flow of communications to/from the brain and the area of the body from the point of injury and below. Paraplegia is the loss of feeling and/or movement in the legs and lower parts of the body (like the chest, stomach, hips, legs and feet). Tetraplegia (formerly called quadriplegia) is the loss of sensation/movement in all four extremities as well as the head, neck, shoulders and upper chest. It is associated with SCIs in the neck area.

SCIs can also be classified by the degree of motor and sensory function remaining. Patients who have a complete SCI have a total loss of feeling and movement. A patient with an incomplete SCI retains some degree of sensation or movement.

Rehabilitation for Children with SCI

The National Library of Medicine estimates about five percent of spinal cord injuries occur in children. John McDonald, M.D., a neurologist with the International Center for Spinal Cord Injury at Kennedy Krieger Institute, says while children can have devastating injuries, they have a greater capacity to recover than adults, partly because their nervous system is still developing. Children are also often more motivated to take charge of their rehabilitation and recovery.

At Kennedy Krieger Institute, spinal cord injury specialists are using a technique called functional electrical stimulation (FES) to help children with SCI recover and optimize their function. The patient sits on a special exercise bicycle fitted with a miniature computer. Electrodes are attached to the muscles on the patient's legs and buttocks. A computer delivers electrical signals in the same pattern used by healthy muscles as they contract to pedal a bike. That process causes the muscles to contract and stimulates the legs to move and push the pedals. Therapists program the computer to maintain a cycling speed of 45 rotations per minute. An hour of cycling is the equivalent of the effort needed to take about 6,000 steps. The bike can be adapted to be used for adults, teens and toddlers.

FES works on the theory that, even after a SCI, some nerves in the spine remain dormant. With continued stimulation, doctors may be able to encourage the body to reestablish and strengthen the connections between the dormant spinal nerves and the still healthy nerves and muscles in the lower part of the body.

Researchers have found that, when it comes to rehabilitation, "more FES is better." A few years ago, FES was typically given for one to two hours at a time, once or twice a week. At that pace, it would take one to three years to see any significant recovery. Now, therapists offer FES for four to five hours a day, three to five days a week. With the intensive therapy, some patients are seeing significant recovery in one to three months.

There is no guarantee FES will help a SCI patient walk again. However, researchers are hopeful the treatment will bring a greater degree of recovery to patients. The therapy is also good for building up muscles and increasing cardiovascular endurance. In the future, investigators hope to have some kind of system that uses FES to improve function in the upper extremities as well.