Stoke Mandeville Spinal Research: Four key areas of research

Stoke Mandeville Spinal Research (SMSR) was founded in 2006 and is an independent charity dedicated to funding research to improve the quality of life of people living with spinal cord injuries (SCI). SMSR’s vision is to ‘enable people with spinal cord injury to have a life after paralysis without the setbacks of debilitating health conditions.’

“It’s the little things that people don’t see that really affect us. It’s the pain, pressure sores, bladder infections, the things that we don’t want you to know about. It’s those things that make life difficult, not really the fact that we are in chairs.”

Jamie Polk, SMSR Trustee and Ambassador, who lives with an SCI
 

SMSR presented at the Neuro Convention 2023 in Birmingham, where they provided detail as to their four key areas of ongoing research as follows: neuropathic pain, assistive technology for upper limb functions, pressure ulcers and UTIs each of which impacts significantly on the quality of life for people with SCI.

Neuropathic pain

Neuropathic (or nerve) pain affects approximately half of people with SCI and can be severe and debilitating. The pain has been described as hot/burning, tingling, sharp, shooting, squeezing, painful cold, and electric shock-like. There is currently no cure for neuropathic pain once it has developed, and it is often unresponsive to treatment. The impact of this condition can affect ‘sleep, mental health and wellbeing, ability to work, study or maintain a social or family life’. As a result, it can have a hugely detrimental effect on those living with SCI. The effectiveness of a procedure called cingulotomy, a minimally invasive surgical intervention, able to locate and target a specific area of the brain with pinpoint accuracy, to help hinder overactive nerve pathways which regulate the pain, is being explored.

In a separate project, Electroencephalograph (EEG) prediction techniques are being used to measure an individual’s brain activity soon after the injury before the pain develops, with the data being used to analyse and predict the risks and likelihood of the individual developing neuropathic pain, and to facilitate the development of preventative treatment.

Assistive Technology Primarily for Upper Limb Function

Loss of hand function is considered by SCI individuals to be one of the most devastating consequences of their injury as it makes daily tasks difficult, significantly reduces their independence and impacts upon the level of care provided. A two-year study will test a commercially available exoskeleton for the first time on people with incomplete tetraplegia to establish whether the device improves upper limb mobility.

In addition, a project is underway to examine the role of virtual reality (VR) as an assistive technology by developing and testing VR games to improve upper limb function in people with acute/sub-acute tetraplegia following SCI. Users have found VR training more motivating and engaging than traditional therapies.

Pressure Ulcers

People with SCI often have limited mobility and where there is a constant pressure on the skin surface, low blood flow to the skin can develop into a pressure ulcer. If the individual is unable to feel the pain of the ulcer, it can go undetected and lead to serious infections and hospital treatment. SMSR report that this can create ‘an enormous physical, emotional and financial burden’ and aim to fund research which ‘identifies new ways to prevent and treat pressure ulcers’.

Urinary Tract Infections

Urinary tract infections (UTIs) are described as ‘one of the most common and debilitating complications of paralysis’ which are painful and disruptive to the lives of those suffering from them, restricting work, study, family, and social lives. One piece of SMSR-supported research involves individuals self-administering antibiotic treatment at home via bladder catheters to prevent the onset of UTIs and to ‘minimise the risk of antibiotic resistance’. Early results show that the treatment may be able to reduce UTIs by around 80%.

In mid-2023, SMSR announced 2 new projects exploring prevention and treatment of UTIs - one testing a UTI vaccine for the first time in SCI people, and the second exploring whether or not catheter re-use leads to increased rates of infection.

Comment

It is important to recognise the impact that these complications have upon the quality of life of people living with SCI; and the extent to which they lead to increased levels of hospital treatment, care and assistance.

It is hoped the research being done by SMSR will lead to a reduction of complications in this area and to an improved quality of life in the future.

For more information on any aspect of SMSR’s work, please visit www.lifeafterparalysis.com or contact Derek Cutler, SMSR Research Manager derek.cutler@smsr.org.uk