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Even after his death, paralyzed actor Christopher Reeve is still contributing to rehabilitation advances. That's according to Dr. John McDonald, who directs the International Center for Spinal Cord Injury at Kennedy Krieger Institute in Baltimore. The latest advance taking advantage of work done with Reeve and others is a breakthrough medical device to help restore motor functions to previously paralyzed muscles.

"Part of that concept really bore through with the work that we did with Christopher Reeve, demonstrating that he could recover major function many years out from his injury. That kind of shattered the old myth that most of the recovery is in the first year, and then after that it's finished. It's just not true," says McDonald, who was Reeve's lead neurologist.

In August, Restorative Therapies Inc., a designer and supplier of medical devices, announced federal Food and Drug Administration clearance for its RT300-S, a stationary cycle that uses electrical currents to activate a paralyzed or partially paralyzed patient's quadriceps, hamstring and gluteal muscles. McDonald worked with Restorative Therapies engineers to develop and launch the system, which is already for sale to hospitals, clinics and private individuals.

"How can someone move who's completely paralyzed? We take advantage of advanced electronics to actually stimulate across the skin the nerve endings on the muscle so that the muscle contracts. As we stimulate the different groups of muscles of the legs, … completely paralyzed individuals can ride a bicycle as if they have it under the control of their mind," McDonald explains. He adds that Reeve used a similar device during his therapy and even in clinical trials when McDonald was with the Spinal Cord Injury Program at Washington University School of Medicine in St. Louis from 1998 to 2004.

The RT300-S is basically bike pedals on a stand equipped with handles and a small electronic screen. Six wires with sticky pads on the end are adhered to the skin in the area of the muscles to be stimulated. McDonald says the cycle is "designed so that someone can really do this independently, so that you don't need an additional person to get the pedals going. It has a smart motor system that gets the person up to speed and then the stimulation comes on. The whole system understands what's going on and can adapt. In fact, the system knows exactly what the person's doing and can transmit information back to the physician."

Another advantage of the system is its compact design. The cycle can easily fit in a home, thus allowing physicians and therapists the opportunity to design long-term treatments much more convenient for patients. "You know, it's difficult enough for you or me to go down to a center three times a week to exercise. Someone with a disability? It takes three three-quarters of a day. So, time is the biggest limitation," McDonald notes.

For many patients, the cycle offers a cardiovascular workout they may have been missing for years, while building bone and muscle mass to help avoid complications. "That was the primary reason we used this approach with Christopher Reeve. When I met him, he was having so many medical complications, and I knew this type of approach would benefit him," he recalls.

The bonus was when McDonald and other physicians realized that the repeated activity actually promoted regeneration of the nervous system. "We spent years working in animal models demonstrating that these types of patterned activities after an injury to the nervous system can actually cause regeneration and can stimulate really substantial regeneration," he says.

Restorative Therapies has also introduced a pediatric model of the device, which is adaptable to children as young as 4 years old. The basic features are identical. "The kids love it," McDonald says with delight. "Actually, everyone loves it. Can you imagine what it feels like to have your legs move again? To feel the effects of a cardiovascular workout for the first time since an injury?"

Andrew Barriskill, chief executive officer of Restorative Therapies, says both the adult and child models sell for a set price of $14,950. He anticipates that, as scientific published studies acknowledge the device's benefits, commercial and government insurers will move toward uniform reimbursement. "We're working to establish the therapy in a range of clinics across the country to make it accessible," he says. "It's going to be a long process, but we're getting out there." A native of Australia, Barriskill says international distribution to Europe, Canada and Australia should begin before the end of the year.

The next step? To develop similar approaches for upper extremities, says McDonald, "using the same principles of trying to maximize the physical integrity of the body while simultaneously optimizing any potential for recovery of function."

And he adds, "I've been waiting for years to have a tool like this to use for our patients, and now we have it."

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