Forming Life-Giving Connections
Dr. Cristina Sadowsky’s role as co-founder and director of Kennedy Krieger’s International Center for Spinal Cord Injury (ICSCI) is not to tell patients what they can’t do. It’s to show them what they can do.
One of her favorite stories illustrates the ICSCI approach: During his very first visit to ICSCI about five years after he’d been injured, a patient was told by the ICSCI therapist that with time and therapy, he would be standing and out of his wheelchair. With world-class research, cuttingedge therapies and an insatiable willingness to try any reasonable treatment, ICSCI was true to its word. Five years later and standing next to his chair, near tears, that patient said it was the first time he had stood since his injury.
It’s all about communication. “To restore movement, you must maintain the link between the brain and the effector, which is the muscle,” Dr. Sadowsky explains. With spinal cord injuries and paralysis caused by accidents, strokes, tumors, birth defects and other causes, the brain simply can’t send signals to muscles instructing them to move. At ICSCI, the human connection is also central to helping children and adults re-learn to stand and walk. “To be able to create or restore that neural connection, you have to convince the person that they need to do it,” says Dr. Sadowsky.
The human spirit is the most beautiful thing I’ve ever seen.” – Dr. Cristina Sadowsky
ICSCI’s combination of structured, specialized medical rehabilitative interventions is helping patients with long-term paralysis recover sensation, movement and independence – and find their fortitude and new future. Together, ICSCI’s suite of therapies, interdisciplinary team approach and specialized treatments bring movement, independence and improved quality of life to patients of all ages, who come from across the world to receive care.
Moving Forward Through Novel Treatments
Dr. Sadowsky leads an interdisciplinary team of experts – physicians, nurses, physical therapists, occupational therapists, psychologists and/or educators – and champions the principle that functional restoration is dependent upon and best achieved through structured medical rehabilitative interventions. It’s an approach used with children and adults with paralysis related to traumatic and non-traumatic spinal cord dysfunction (spinal tumors, diseases like multiple sclerosis, spinal cord stroke, infection-induced disorders or neurodegenerative diseases like amyotrophic lateral sclerosis or ALS).
One of the most effective treatment tools ICSCI uses is Activity Based Restorative Therapies (ABRT), targeted activities designed to help patients’ nervous systems “remember” how to move. ABRT uses repetition of specific movements to activate the nervous system above and below the spinal injury, encouraging the nervous system to form new connections.
ICSCI pairs ABRT with other novel therapies to help people relearn how to walk:
- Functional electrical stimulation sends electrical messages to a person’s muscle that cause the muscle to contract in a way that can be used for purposeful movement, like grasping, and helps prevent muscle from atrophying after spinal cord injury.
- Partial weight-supported walking therapy suspends the person in a supportive harness over a treadmill to practice natural walking.
- Aquatic therapy, which takes advantage of water’s buoyancy, allows patients to perform activities, like walking on a treadmill, that wouldn’t be possible for them on land.
Creating Victories and Empowering Possibilities
Kennedy Krieger is the world’s premier healthcare organization dedicated to improving the lives of children and young adults with care and research focused on disorders and injuries of the developing nervous system, from autism spectrum disorder and intellectual disabilities to cerebral palsy to ADHD and more than 200 ultrarare disorders.
That means we are comfortable in uncharted territory. In fact, it’s where we do our best work. Kennedy Krieger has a long history of undertaking and harnessing groundbreaking scientific research, conducting world-class clinical trials and creating new treatments to change lives. When it comes to understanding children and teens with autism, there is no place else in the world like Kennedy Krieger.
With a spinal cord injury, life changes forever. Gaining even the smallest sense of independence after experiencing a catastrophic injury is transformational. Imagine regaining the ability to scratch your nose when it itches. To lift a utensil to eat or use your fingers to text a friend.
Dr. Sadowsky celebrates each victory for the magnificent achievement it is. “I have become enthralled by getting one grade of muscle strength, getting a flicker of a finger that didn’t exist there before,” she says. For every patient receiving treatment and gaining independence at ICSCI, there are many more who cannot, due to space limitations, travel difficulties or lack of resources.
“We need more people to have access to us,” Dr. Sadowsky says. “Physical activity truly elevates the volume of neurologic activities, which contributes to neurologic restoration. This must be done in a structured environment, using state-of-the-art technology and equipment, and, most of all, significant specialists’ expertise.”
She dreams of the day the ICSCI includes expanded access to treatment, room for more connections between patient and clinician, between research and recovery, and to bridge the gap between the impossible and the possible.