This child was born unable to move her limbs or even breathe on her own. Over the first three years of life, she had some spontaneous nerve recovery but muscle weakness (atrophy) made her helpless. Improved muscle growth and awareness with Threshold Electrical Stimulation (TES) led to improved function.

Michelle was born in 1982. On admission to the newborn intensive care unit, she could not move and was unable to breathe. She had a C1-2 spinal cord injury. Initially her doctors were hopeful for recovery. She showed slow and steady gains over the first six to 12 months as the spinal shock from her initial injury wore off. But after three years and despite physical and occupational therapy five times a week, she had not acquired any new skills for at least a year. At three years she remained hospitalized, only able to come off a ventilator and breathe independently for short periods. Like all infants she was developmentally immature. Adults can cooperate with therapy but Michelle didn't even know she had legs. Her disability was caused by damage to the brain stem and spinal cord with subsequent disuse muscle atrophy. The first video clip shows that she could move short distances, but was very weak.

Michelle’s Treatment and Recovery Progress

The research team, led by Dr. Pape, knew that high-intensity, short-duration Neuromuscular Electrical Stimulation (NMES) therapy could treat disuse muscle atrophy. With ethics committee approval, in 1985, a research study program was developed for Michelle.

Might her overall function be improved by treating the muscles directly using a high intensity program like athletes?

Unfortunately, when they tried classic NMES, she did not tolerate the contraction level stimulation. Among other things, she responded with breath holding.

In an “nothing to lose” experiment, Dr. Pape wondered whether low intensity stimulation over a longer duration might offer the benefit, without the discomfort. This was the birth of Threshold Electrical Stimulation (TES). Electrodes were placed on Michelle at night, during sleep. Within five weeks she showed significant gains, pushing herself into a sitting position. Over the next three years, she made steady gains in neurologic function and eventually was able to walk independently. She was off the ventilator 16 hours a day. The second video clip shows her at age eight years after five years of Threshold Electrical Stimulation (TES) and continued therapy.

Treating Michelle's muscles unmasked the neurological recovery that had occurred over the first three years of life. In the presence of severe disuse muscle atrophy, the true extent of her neurological recovery could not be adequately assessed.

Update

Today Michelle lives independently and is employed. She still requires some help with breathing during sleep. She drives a car, has a boyfriend and is living her goals, day by day.

For more Information on Threshold Electrical Stimulation (TES) (click here)

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