Neurostimulation Helped This Paralympian Walk Again

Jennifer French answers user questions on Reddit. [image via imgur/Reddit]

Prior to sustaining a spinal cord injury in 1998, Jennifer French was, among other sports, an active snowboarder and skier, sailor, fly fisher, and scuba diver. Today, thanks to her neurostimulation implants, she still is. In 1999 French became the first woman to receive the Stand and Transfer implant system created by the Cleveland Functional Electronic Stimulation (FES) Center. The implant uses a series of muscle- and nerve-based electrodes to stimulate muscles in the lower body. By pressing a button on an external control unit, French is able to activate her implants and restore limited movement to her body. In 2010 she underwent surgery that upgraded her 8-channel electrode implant into a 24-channel one. She was even able to walk down the aisle at her wedding.

Since her injury French also won a silver medal for sailing at the 2012 Paralympic Games. She has also founded Neurotech Network, a non-profit group that advocates for education on the potential of neurotechnology.

French took to Reddit over the Memorial Day holiday to participate in an Ask Me Anything (AMA) session – an open-topic Q+A session open to the general public. There she shared her experiences with neurostimulation as well as her thoughts on the future of medical technology.
 
On the impact of her implants:
 
This technology has had a huge impact on my life. Not only does it allow me to stand for functional use, like reaching high objects or going thru narrow doorways, it has also allowed me to stay healthy. What we need to understand is that you may see someone who is paralyzed but that is only one component. Perhaps they can not walk or stand, but we also have daily battled against medical or secondary complications that can be life threatening like infections from pressure ulcers or kidney failure. This technology allows me to easily combat those medical complications. Finally, the technology give a social aspect. I can stand at the 7th inning stretch of a baseball game, at a standing ovation at a concert and even walk down the isle at our wedding. Those are aspects that we don't always think about when developing technology.
 
I tend to still have dreams as an able-bodied person. Many times, I wake up and think I an just get out of bed like a non-paralyzed person, but then reality kicks in. When I was first injured, my first functional goal was to get some arms movement back to propel a manual wheelchair, then I worked on hands to be able to type and do basic ADLs.
 
She also addressed various technical questions such as this one on the nature of her injury and other neurostimulation technologies being developed:
 
Since I am an incomplete spinal cord injury, I only bruised by spinal cord. I do not have voluntary movement below my point of injury but I do have some restored sensation. Yes, my husband can tickle my feet but I can't move them. There are implants today that address bladder/bowel function. For instance there is the implanted sacral nerve stimulation for bladder and fecal incontinence. There is also an implanted bladder stimulation system called Vocare that is commercially available in Europe. An external system called the tibial nerve stimulation is another device commercially available. There are also active clinical trials using stimulation of various mechanisms for bladder and bowel control such as the pudendal nerve or sphincter stimulation. I think you will see more progress in this area very soon.
 

Learn about "Designing Next-Gen Medical Devices" at the MD&M East Conference June 9, 2014.
 
Many of the AMA participants had not heard of French or the technology behind her implants before. There were questions about why this sort of technology isn't better known, cheaper, and more readily available. To one question from a medical student in France, French responded:
 
...As you know in the medical field, nothing is risk free. Let's address 'simple to use' first. When we address the user interface, the current system is pretty simple. The UECU has a few buttons with an LCD screen with the commands. I have 2 coils that I tape to my skin and wear all day and a control box that I can put in a backpack and take with me. But there is definitely room for improvement. I believe the most complicated part of the system is on the 'deployment side'. The surgery is complex and the programming is challenging.
I tend to think the biggest obstacles are societal. Commercialization of the technology is the biggest challenge. Particularly for devices that address problems in orphan populations like spinal cord injury, multiple sclerosis or cerebral palsy.

French's full Reddit AMA can be read here
 
-Chris Wiltz, Associate Editor, MD+DI
Christopher.Wiltz@ubm.com