Forty-five minutes a day, two days a week, Mike Cummings is half man, half machine.
His long, slender legs are strapped into robotic appendages, and he takes calculated, Terminator-like steps atop a moving treadmill track.
Cummings is doing some of the work, building back muscles that his multiple sclerosis helped to atrophy. But the machine, called a Lokomat, is helping too.
“It supports more or less weight depending on how hard everybody wants me to work,” Cummings said with a chuckle.
Cummings first tested the Lokomat 30 months ago during a 160-patient, $5 million research project conducted by the West Haven VA Medical Center and Yale. When that project ended, Mount Sinai Rehabilitation Hospital, a Saint Francis Care provider, recruited one of the project’s doctors, Dr. Albert Lo, and bought its very own Lokomat (price tag: about $275,000) to start a program of its own. It also secured a donation from Joyce and Andy Mandell to fund its brand new comprehensive care center for MS: the Mandell Center for Multiple Sclerosis.
Although the center is brand new, set for an official opening Feb. 26, the Lokomat technology is not. It’s been used in the past to rehabilitate stroke victims and patients with brain or spinal cord injuries. But its application toward patients with MS is groundbreaking, and Lo, director of neuroscience research at the center, hopes to continue research into the relatively uncharted area.
Cummings, once a marathon runner, is a Lokomat devotee. He drives an hour from Killingworth twice a week to get his 45-minute sessions. Sometimes, the exercise leaves his leg muscles achy, “which is the greatest feeling in the world to have sore legs after a workout,” he said.
He knows neither the doctors nor the machine can regain what’s been lost; but he believes they can delay disease progression.
“The rehab benefit has just been awesome,” Cummings said, citing his improved posture, speech, gait and muscle tone. “I can almost feel my brain saying, ‘Aha! That’s what walking is like.’”
And such Lokomat research could help rehabilitate some of the 6,000 people diagnosed with MS in Connecticut and increase insurance reimbursement rates, which currently only cover Lokomat treatment as if it were traditional physical therapy.
Further down the road, the Lokomat could advance new regeneration technologies that come available — like stem cell research, Lo said.
Stem cells have to be in a normal environment to learn their new role in the body, and the Lokomat could forge that normalcy, he said, adding, “[The Lokomat] is compatible with virtually everything.”
Multiple Uses
The machine can adjust to conform to each patient’s gait, with adjustable speed and step lengths. It lifts the patient to an upright, standing position and supports as much or as little weight as desired (to adjust workout intensity) and forces the patient to walk normally.
Multiple sclerosis affects the ability of nerves to relay electrical impulses to and from the brain. When those impulses can’t fire, the brain can no longer make the body do what it wants.
Although effects have yet to be proven conclusively, the machine could help answer the question: can you reprogram the brain to use alternative pathways to perform lost functions?
While Lo awaits protocol approvals that would allow him to add more patients to the program, Cummings remains the center’s one and only and is using the robot as his preferred type of physical therapy — the basic cost his insurance company is covering.
The traditional methodology for multiple sclerosis was for patients to limit their physical activity so they wouldn’t fall and injure themselves further. Now, that’s all changing, Lo said. Exercise is now considered a good thing, and consistent rehabilitation could equal better quality of life for a longer length of time.
Mount Sinai’s new comprehensive center will be a sort of one-stop shop for patients with MS, Lo said. It will offer neurology, urology, neuropsychology, an infusion center and a wound care center, among other services. The Connecticut Chapter of the National Multiple Sclerosis Society has also relocated its offices to the Mount Sinai campus.
Previously, such services required a trip to Boston or New York, said Saint Francis CEO Chris Dadlez in a National Multiple Sclerosis Society newsletter. Now, they’re available in Hartford.
“This clinic is a dream come true for MS patients,” said Cummings.
