ROCHESTER, Minn. -- Mayo Clinic researchers used electrical stimulation on the spinal cord and intense physical therapy to help a man intentionally move his paralyzed legs, stand and make steplike motions for the first time in three years.

The case, the result of collaboration with UCLA researchers, appears today in Mayo Clinic Proceedings. Researchers say these results offer further evidence that a combination of this technology and rehabilitation may help patients with spinal cord injuries regain control over previously paralyzed movements, such as steplike actions, balance control and standing.

"We're really excited, because our results went beyond our expectations," says neurosurgeon Kendall Lee, M.D., Ph.D., principal investigator and director of Mayo Clinic's Neural Engineering Laboratory. "These are initial findings, but the patient is continuing to make progress."

The 26-year-old patient injured his spinal cord at the sixth thoracic vertebrae in the middle of his back three years earlier. He was diagnosed with a motor complete spinal cord injury, meaning he could not move or feel anything below the middle of his torso.

The study started with the patient going through 22 weeks of physical therapy. He had three training sessions a week to prepare his muscles for attempting tasks during spinal cord stimulation. He was tested for changes regularly. Some results led researchers to characterize his injury further as discomplete, suggesting dormant connections across his injury may remain.

Following physical therapy, he underwent surgery to implant an electrode in the epidural space near the spinal cord below the injured area. The electrode is connected to a computer-controlled device under the skin in the patient's abdomen. This device, for which Mayo Clinic received permission from the U.S. Food and Drug Administration for off-label use, sends electrical current to the spinal cord, enabling the patient to create movement.

After a three-week recovery period from surgery, the patient resumed physical therapy with stimulation settings adjusted to enable movements. In the first two weeks, he intentionally was able to:

Control his muscles while lying on his side, resulting in leg movements
Make steplike motions while lying on his side and standing with partial support
Stand independently using his arms on support bars for balance Intentional, or volitional, movement means the patient's brain is sending a signal to motor neurons in his spinal cord to move his legs purposefully.

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