PostureFlex

I recently had the opportunity to hear about Lee Cole and his miraculous recovery from an untreatable disability that had literally caused his left leg to whither until it was no longer functional . One day, he had the feeling that something had changed and he began a long and arduous process of rehabilitating himself. After correcting for his leg length discrepancy, he focused on skating as a way to restore the function in his leg. Over the years, he has become a successful and competitive skater and he continues to gain new function in his leg. While I did not have the opportunity to meet Lee, to see him prior to his rehabilitation program nor examine him carefully at this time, I do believe that his recovery demonstrates the plasticity of the nervous system and the impact functional movement can have on retraining and reeducation neural processing. While some may suggest that correcting the leg length discrepancy was unimportant, it apparently served to equalize the forces into both legs that encouraged him to work harder and harder at using the affected left leg more normally.

As he increased the complexity of his activities, the left leg continued to gain in strength and coordination. While we do not have a picture of his brain during this process, it is quite conceivable that the sensory stimulation and the motor output allowed him to change the somatosensory map of his cortex. Over time, this map apparently has restored itself in such a way that he has regained control over the frail and declining performance he had been experiencing to the point. We are only now gaining the sophistication to study this phenomenon.

Dr Michael Mereznich at UCSF has done some controlled studies to help determine the function of the somatosensory map and how it changes with different sensory demands. He and others have clearly demonstrated there is neural plasticity and that with controlled sensory stimulation one can alter the somatosensory map. We need to combine the studies that he is doing with clinical research studies with handicapped youngsters and adults. If Lee Cole could assume the responsibility to rehabilitate himself through a very repetitive, but highly skilled motor task like skating, the question is whether others could also achieve this level of performance by working on a similar task. I strongly support Lee Cole’s motivation and support for setting up some clinical studies in San Francisco. Collaborating with the Department of Special Education in San Francisco seems like a valid approach because it targets young people. it would be important to request some consultants to work with him and with the school system to carefully define these studies in order to assure that measurable gains in function can be achieved. I would be happy to assist in this endeavor. Financial support would be critical to enable such studies to be carried out. I hope there is a reasonable support community to assist Mr. Cole in this endeavor.

Sincerely,
Nancy Byl, PH.D., PT
Associate Professor, Director
Graduate Program in Physical Therapy