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Kelly Thomas makes an inch through the soft grass, using a walker to fight his way. Each step is exhilarating and exhausting. She pauses in the warmth and smiles of Florida at 90 degrees.
"It only requires a little testing – and a little, I think a lot," she says.
Thomas, 24, is one of three paralyzed patients who can now walk again thanks to a low-back stimulation device associated with intense physical therapy. The news of patients' progress – considered an important medical advance – was published in separate studies in two scientific journals on Monday.
On a sunny day, Thomas returned to the place that took him so long on July 19, 2014. It is there that the truck that she was driving in was stopped after turning four times around a turn on Halls River Road and hitting a tree. . His body was motionless, suspended half-way from the debris mutilated. She was blue and cold.
Since then, she has spent several times in front of the scene of the accident to try to remind him of his memory. To help remember what happened that night. Gather the moment that changed everything. Nothing seems to work.
While visiting this time, she walks towards the tree and talks to her legs to make them keep moving. "One foot in front of the other," she says. "Slowly but surely."
At 5 feet and 1 inch tall, she is a source of inspiration. Her courage shows immediately, not only when she walks, but also when she speaks.
"The paralysis is not in my dictionary."
"Do not call me disabled, because I am not."
"Thank goodness, I've been a tough cowboy."
It takes him several minutes to travel 40 feet from his car to the tree. Every step is worth it: Today, it is about triumph rather than looking for lost memories.
"I tell you what," she said. "It feels good to be standing where I thought my life was over."
She woke up in a hospital a few weeks after the accident, with tubes and wires apparently connected to everything. At 19, she was paralyzed in the chest.
She told her neurosurgeon that she would be walking again, even though the chances were slim. He left the room and told his mother not to "go get something that would never happen".
The trip was not easy.
There were tears and screams. In times of despair she would say to God, "I do not know why it happened, but if you can help me understand that, it might make it a little easier."
She had planned to become a physiotherapist to help others. His mission changed that fateful July day. She is now helping others by taking action and speaking.
The trunk of the red maple still bears scars from the accident, with pieces of bark missing when the truck and the tree met.
Standing next to the tree, Thomas searches the words to describe his emotions. "It's somewhere between" I told you "and the impossible," she says. "Somewhere between possible and impossible.
"Being here gives me a sense of power because I lost a life here. But I have also won a brand new one. And I am proud of the new life that I have. "
Transform the field of spinal cord injury
Thomas is part of an innovative research conducted at the Kentucky Spinal Cord Injury Research Center at the University of Louisville.
In a study published Monday in the New England Journal of Medicine, two of the four patients with "complete motor spinal cord injury" – meaning no voluntary movement below their injury – were able to walk again after suffering thorough physical therapy. They walk with the help of walkers.
"This should change the way we think about people with paralysis," said Susan Harkema, one of the project's lead researchers and a professor in the Department of Neurological Surgery at the University of Louisville. "It's phenomenal. This new knowledge gives us the tools to develop new strategies and new tools for recovery in people with chronic spinal injuries.
Claudia Angeli, the other senior researcher and senior researcher at the Human Locomotion Research Center at the Frazier Rehab Institute in Louisville, said it was a fascinating time for spinal cord research, bringing together decades of investigation leading to modern breakthroughs. .
"It just shows the capacity of the spinal cord and how much we have learned to use epidural stimulation in combination with therapy," said Angeli.
Over the years, their research involved 14 paralyzed people who received what is called an epidural stimulator implanted on a portion of the lower spinal cord, allowing the neurons below their wounds to receive signals from the brain before their accidents.
The 14 patients underwent voluntary movements with the implant, the researchers said. They also showed an improvement in bowel function and bladder.
The last study included four patients, including Thomas, who was treated twice a day for five days a week for several months. A morning therapy session would involve working on the step by step; an afternoon session would be devoted to the standing position. Thomas's therapy lasted 10 months after receiving the implant.
All four were able to stand up and two were able to walk on the ground, the researchers said. One patient has fractured his hip, putting off his therapy for several months, the researchers said.
The other patient who was able to walk on the floor had been paralyzed from his neck until he could no longer move his arms until he received the pacemaker. "With the pacemaker off," Angeli said, "he can not even sit down."
Harkema and Angeli said they thought the positive results were the combination of stimulation and improvement in physical therapy.
Harkema underwent a federal inquiry a few years ago. According to a letter from the Department of Health and Social Services in 2016, some research activities were found to be in violation of federal regulations. The letter indicates that the University of Louisville has taken adequate corrective action to remedy the non-compliance. Harkema says she's standing at her job.
What is it like to see people who are paralyzed?
"I'm inspired by every person with a spinal cord injury who participates in this program," Harkema said. "They each have their own personality and their spirit. They are only pioneers.
Adding to the excitement of these advances, another study published Monday in the journal Nature Medicine unveiled similar results. According to a study conducted with the Mayo Clinic and the University of California at Los Angeles, a man paralyzed since 2013 has regained his ability to stand and walk with assistance through spinal cord stimulation and physical therapy.
"What this tells us is that neural networks below a spinal cord injury can still function after paralysis," said Dr. Kendall Lee, co-principal investigator and director of Neural Engineering. Mayo Clinic Laboratories.
There have been other cases in recent years during which paralyzed people got out of their wheelchairs and walked. One study in 2015 and another in 2016 showed that rehabilitation was associated with an interface called "brain-computer", in which cerebral signals were sent to an electrical stimulator or exoskeleton, resulting in muscle activity allowing some patients to walk.
"The way to activate the central nervous system is different, but the overall result is similar," said Monica Perez, a professor in the Department of Neurological Surgery at the Miami Project to Cure Paralysis at the University of Miami.
Monday's studies, said Perez, provide important additional evidence of ongoing progress in the field of spinal cord injury. She said this proves more that people with severe paralysis often have residual connections "that can engage in functionally relevant ways – and that's amazing."
"What studies show is that these connections in the central nervous system can still be recruited even if you have an injury years ago," said Perez, who was not linked to none of the studies.
From a scientific point of view, she said, one of the important consequences of these studies is the awareness "that we need to work harder to understand how we can better involve these links" , she said. "These people with more severe paralysis find this level of function – and it's beautiful. We also need more accurate assessments of our patients.
"This is not the first time a person with clinically complete and severe paralysis presents assistive technology without the help of a therapist," she said. "But it is extremely important that in many cases the potential of these approaches can be demonstrated."
Harkema and Angeli, whose study was funded in part by the Christopher and Dana Reeve Foundation, said it was imperative for stakeholders to come together to fund more research to help as many as 1 , 2 million people with paralysis. More than 8,000 people have expressed interest in participating in the research in their program.
For Thomas, it's even more personal. She hopes that other wounded as serious as her undergo the transformation she has gone through.
"Nothing will ever stop me in life because I took something that was considered impossible and I made it possible," she says.
"Too much to do"
Since his childhood, Thomas likes to ride horses. She mounted her Shadow horse and took off across the family ranch. At the rodeos, she and Shadow were inseparable.
"All you need, it's love and a horse," says the motto next to his bed.
By the end of her teenage years, she was running 3 to 4 miles a day, training horses and doing endurance training at the gym almost every day. She worked as a waitress at the college to become a physiotherapist.
All that was broken in an instant. The young woman who had been so active was now confined to a chair at the age of 19. It was a fate that she could not accept.
Not only had she lost her ability to walk, but she had also lost control of her bladder and sexual function. If she went out, her body temperature would rise by more than 101 degrees because she could not regulate herself anymore. She felt that every part of her independence had been stripped.
"I was lying there saying," I can not sit in this chair the rest of my life, "she says. "I have way too many things to do."
To walk again, she should "cowboy", as she says. She counted on the harshness her father had forced her to work on the ranch.
It would push her to the limits, sometimes leaving her on the ground crying, wanting to stop. She heard about the program in Louisville. She first went for a screening in January 2017. She returned a month later and stayed until May to do physiotherapy, work standing and walk for one hour each. day.
The pacemaker would require major surgery and a commitment to stay in Louisville for at least a year. She struggled with the decision. She spoke with several men who had the stimulator. They had made gains after the implant, but at the time, no one had walked. She thought, "What's the use of going through so much work?
"Just being able to stand or move your toes," she says, "was not enough for me."
One of his sisters talked to him. She told Thomas that she did not want her to wonder "what if" for the rest of her life. Nobody knew what would be Thomas's decision.
On August 5, 2017, the family vehicle was loaded. "Are we going?" His father asked.
They drove the 13 hours to Louisville. The pacemaker was implanted the following month.
Sensation swept her body as soon as she was turned on. "There was this hasty vibration," she says. "It was like a highlighter of my muscles. All were contracting. It was wild.
The real work is in the months to come. She had undergone physiotherapy sessions three times a week for three years before implantation. This helped her find the path to success, she said, but it was not so difficult to work next year. She attended physical therapy five times a week, a few hours a day.
She clung to her faith during the most agonizing sessions, repeating sentences: "I can do everything through Christ, who strengthens me" and "God is with me. I will not fail. "
"I tell you what: After the implant, I was introduced to a brand new ball game," she says. "The most difficult thing I've ever had to do in my life. I prayed through so many sessions, just to make me understand, because I wanted to stop.
The stimulator does not move her legs for her. It stimulates neurons and nerves, allowing it to consciously control movement.
He started to move his toes, then one leg was able to move, then figured out how to synchronize his legs to be able to walk.
She was wearing a black T-shirt with the phrase "No Days Off" on this magical February day. She took a step or two, then her therapist broke into the dance. The two hugged and cried. "Oh, my God," said Thomas.
She wiped the tears and took more steps.
It was like trying to tapping your belly and rubbing your head at the same time, she explained, explaining how she was trying to coordinate her legs, body and mind.
"Trying to trust my body, trying to find a pace, was very difficult."
Find your call
Thomas can now walk and talk at the same time, but she must always focus on each step.
She presses a device against her abdomen to turn on the stimulator. "I'm always paralyzed as it can be without her," she says.
When she gets up, she wonders, "How to walk again?
In addition to helping him walk, the stimulator has restored sexual function and much of his bladder control. She regained her muscle mass and the nerve pains in her right foot disappeared. "I am totally a stimulator. I love her, she says.
While walking on her lawn in front of the family ranch, she says her short-term # 1 goal is to get rid of her walker. She would like to run again.
She shows the neighboring barn that houses Shadow. She wants to be able to walk alone to the barn, climb it and continue. She would like to find Shadow in his gallop.
"It's the day I'll accept that I'm healed," she says.
For the moment, she takes one step at a time every day. She says that her story does not concern herself; it's about helping others. It is supported by messages of support from friends and strangers. She says it's for them that she works so hard.
In the city, this encouragement is in full swing.
"I just want to say my congratulations, darling. You are fine, "said a woman in front of the public library of Homosassa.
A man in a pick-up sees her struggling against her car. "Need help?" He asks.
"No sir," she replies. "I understood."
She embodies fierce determination like few others. Through her struggle, she found her calling. By being around her, one can not help being inspired. She shakes a series of powerful messages.
"Even though I can not physically help people as I originally planned, I can certainly encourage, help and motivate you."
"I continue my life as nobody's business, even if my legs do not work so well."
"The stimulator makes my movement easier, but my strength comes from within."
This force is what brought it so far. His 19-year-old brother, Sam, sums it up in a cowboy speech: "She can not do anything. It's certain.
He raises his sister on Shadow. Kelly and Shadow trot in the police yard. She does not know when, but she says one day, she will jump without the help of her brother.
"I do not have a deadline," she says, "but I have physical goals to get there."
The moral of her story, she says, is never to underestimate a cowboy.
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