Roanoke Times
Copyright (c) 1995, Landmark Communications, Inc.
DATE: TUESDAY, March 7, 1995 TAG: 9503070091
SECTION: NATIONAL/INTERNATIONAL PAGE: A1 EDITION: METRO
SOURCE: MALCOLM RITTER ASSOCIATED PRESS
DATELINE: NEW YORK LENGTH: Medium
Since the day in 1975 when Bob Recine broke his neck, he has struggled to walk - he took his first step 13 years later, and now he can trek as much as 800 feet on crutches in an agonizing 40 minutes.
But one night two years ago, Recine awoke to find that he was walking.
He wasn't going anywhere. He was in bed, on his back, and his legs were stepping, left-right-left-right, with such force that it made him breathe hard and his pulse race.
What makes a handicapped man suddenly move his legs like pistons?
For the answer, scientists have turned to theories that the spinal cord has a nerve circuit that can produce stepping, independent of the brain.
This is more than a medical curiosity. If it is true, and scientists can find out how to turn the circuit on, it may lead to ways to help some people with spinal cord injuries trade in their wheelchairs for crutches or canes.
Recine has spent most of his time in a wheelchair since he broke his neck Nov. 8, 1975, while playing football for Rutgers University.
But in 1993, the resident of New Brunswick, N.J., was undergoing intense physical therapy in Miami to improve his walking with crutches. Progress was good, and he had every reason to be happy when he went to bed one night, rolled over on his side and drifted off to sleep.
Suddenly, he awoke to find his legs moving.
``If I lay on my back, I couldn't stop them,'' recalled Recine, 39. Finally, he found that if he rolled back to his side and brought his legs up, the stepping would stop. He could sleep again. But only for about 10 minutes to a half-hour, when he would roll over onto his back and he would be jarred awake by the pounding steps again.
``I thought it was a little strange,'' Recine said, but wrote it off as spasticity caused by the training.
After many sleep-deprived nights, he described the stepping to Dr. Blair Calancie of the Miami Project to Cure Paralysis at the University of Miami School of Medicine.
Calancie thought immediately of the suspected spinal cord circuitry for walking, and he and Recine began experiments a few hours later.
Calancie hooked up Recine to a machine that converted his leg muscle contractions to sound, and had him lie on his back. Within five seconds, ``we started hearing this whoosh, whoosh, whoosh sound,'' Calancie said. ``It was like waves rolling in the ocean.''
When one of Recine's legs came up to take a step, Calancie tried to keep it from straightening again. ``I couldn't. His legs were every bit as strong in these contractions as my own, [with] much more power than he could produce during a voluntary contraction.''
Calancie and colleagues published their findings recently in the journal Brain.
The idea that such spinal circuitry exists in humans, and that it could be controlled to help people walk, has long been controversial. But findings published in just the last few years have made ``a lot of people excited about this in a hurry,'' said researcher Reggie Edgerton of the University of California, Los Angeles.
Studies in Germany, for example, show that some spinal-injury patients who use wheelchairs can be trained to walk useful distances with the help of a cane or braces, Edgerton said.
``A lot's being learned quickly, and we don't know how this is going to fall out,'' Edgerton said. ``We don't know what kind of patient is going to be able to improve how much. What we can say ... is that a lot of patients are going to improve some.''
It doesn't take much walking ability to make a big difference in a patient's life, says Hugues Barbeau, a professor of neurology at McGill University in Montreal.
``Just to be able to do a few steps in the kitchen, or a few limited steps when you go to the restaurant, and to leave the wheelchair behind when you go to the restaurant, that's a very significant benefit,'' he said.
As for Recine, he thinks the spinal circuit has helped his walking achieve record performances. It may have worked too well last fall when it apparently switched on during his training with crutches.
``My legs would walk faster than what I could keep up with my arms,'' Recine said. ``It's just like my legs were walking right out from under me.''
Recine's nighttime stepping stopped in 1993 when he took a break from training to return to Rutgers and get a degree in sports management.
He suspects it may return this year as he pushes to increase his walking distances. He doesn't look forward to the disruption of his sleep, but he figures it's worth it.
``It came down to a choice of, do I want to walk and not sleep, or sleep and not walk? I figured I'll walk now and not sleep, because things were improving so much.''
by CNB