How quickly might you expect a return from loss of mobility from a stroke or spinal cord injury?
Warning: content may be disturbing
"Normal healing" provides a unifying concept for considering different impaired functions, such as sensory and motor functions.
The return to normal healing may be the hallmark of non-invasive therapies compared with "managing" disorders.
Throughout the development of the Vari-Chrome Pro, the team remained skeptical about the crazy-fast "quick events" found in the studies.
Real-time recordings helped to overcome the bias of motivated reasoning ("It works") that may be present when prompting unexpected events.
Quick events were frequently observed during the development studies leading to the Vari-Chrome Pro. The impaired functions appeared to switch from unrelenting "nothing works" to normal functioning.
Quick events were frequently observed in the development studies leading to the Vari-Chrome Pro. The impaired functions appeared to switch from unrelenting "nothing works" to normal functioning.
Counterintuitive, the quick events appear to be associated with longstanding "nothing works" impairments, including loss of mobility from stroke or spinal cord injury.
PhotoMed's development studies invited patients who had exhausted conventional interventions. These patients arrived with no reasonable expectation that a few photons might do more than to temporarily relieve pain.
Normal healing includes rehabilitation over an extended period of time. Unlike chronic pain, improvements after a loss of motor function may be objectively measured.
When might it be time to quit rehabilitation efforts?
Normal healing in rehabilitation after a stroke or spinal cord injury typically extends over a significant period of time.
Functional improvements after a loss of motor function may be objectively measured. Unfortunately, all rehabilitation efforts may cease upon reaching a plateau or after a predetermined number of sessions.
Could there be hope for people who remain "locked in"??
Strokes affect millions of Americans despite the best available rehabilitation efforts. About 10,000 people remain "locked in" while awake and aware in a body that won't respond to their thoughts. Unfortunately, muscles atrophy when they haven't been asked to move.
People who remain "locked in" syndrome provide a direct test of the switch from a chronic "nothing works" state to normal healing. Of course, the after state may be only subtlety improved.
Josephine's expectations were zero. Her hope was positive.
PhotoMed's team was lucky to meet Josephine. She had a brain stem stroke 14 years before. She had normal feeling everywhere on her body, an inquisitive and caring disposition, and patience.
Communication with her family and caregivers depended upon spelling by raising and lowering her only controllable muscle - her left eye.
Josephine said that she continues to live a life filled with gratitude, to be alive and surrounded by her loving family. She was expected die on the way to the hospital, then the next day, and you get the picture.
Study Day 1 - no video because no one expected what happened next
The day arrived for Josephine's first exposure to PhotoMed's then experimental therapy. Assessment of her motor functions didn't take long. The only unexpected finding was her right fingers were not clawed. Her index and middle finger showed a reverse bend that might suggest a connection with her brain.
The therapy was applied simultaneously to her fingers and elbow. To everyone's surprise, Josephine raised her eye to signal that she saw her finger move when she asked it to move. The technician wondered if her finger moved by command before. An emphatic NO.
The learning moment: record even when you expect nothing to happen.
Study Visit 2 (Day 4) - No longer "locked in"?
It may be difficult to imagine having no controllable finger or wrist movement for 14 years.
Josephine arrived eager to demonstrate her resumed ability to move her right fingers and wrist. Additional therapy during that visit helped to achieve larger movements. Her movements were limited by atrophy of less connected muscles.
Dr. Conard M.D. expresses his surprise at Josephine's improved movement.
Josephine's improved movement did not expand significantly beyond her early improvements.
Study Visit 7 (Day 46) - No longer "locked in"?
Josephine recovered a variety of functioning over the course of several visits. During her 7th visit (Day 46), She was asked to attempt to speak despite that no one had previously asked her to speak.
Watch as Josephine combines breath control with muscle movement.
To everyone's surprise, Josephine reported that she could move her tongue to the location that she intended to move it.
Her ability to move air to make sounds had improved over the visits. Initially her diaphragm had not be active.
Josephine reported that her most valuable improvement was the resumed diaphragm activity. Her ability to breathe between being "suctioned" in her mouth and tracheotomy port lengthened the time. Initially, she needed to be suctioned about at every 10-15 minutes. After the study, the time between suctioning increased to over an hour.
A follow-up call a few years later confirmed that the increased time between suctioning was the most valuable improvement. The extra time allowed her to get more rest.