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The Rediff Special/Shobha Warrier

Peter Hardley was paralysed waist down in a major motor accident when he was just 16.

As he lay helpless in bed, Peter was devastated. All his ambitions and dreams -- of playing basketball, of driving cars, of... -- had not survived that tragedy.

But when his parents heard about the Brucker treatment, reputed to cure paralysis, they took Peter to the hospital where it was available.

After a year, Peter was driving his car and walking without assistance.

Louis, for his part, had never walked. His mother's complicated delivery, wherein some of his brain cells were damaged, ensured that he never got on his feet.

When he was seven, his parents took him to a doctor named Bernard Brucker. Now, Louis not only walks but runs too -- and dreams of ice-skating.

Catherine's brother suffered from cerebral palsy. He could not even hold his head up, leave alone stand. He too was helped by the Brucker method; one-and-a-half years into the therapy, he can walk.

"I have seen with my own eyes the changes that have taken place in my brother's life," Catherine said. "As a volunteer of the Asha Foundation, I thought I should give hope to many others. Asha Foundation, a non-governmental international organisation, is committed to help neurologically challenged people in India."

Catherine was speaking at the launch of the Apollo Asha Biofeedback Centre in Chennai. Sharing the dais with her was Dr Pratap Reddy of the Apollo hospital.

It took 30 years of research for Dr Brucker, associate professor in the departments of orthopaedics and rehabilitation, psychiatry and behavioural sciences, and radiology at the University of Miami School of Medicine, Florida, to develop the Electromyographic -- EMG for short -- Biofeedback method.

(Incidentally, Dr Brucker is also the director of the biofeedback laboratory and functional electrical stimulation programme at the University of Miami/Jackson Memorial Medical Centre.)

EMG Biofeedback is for patients suffering from paralysis resulting from cerebral palsy, spinal cord injury, head trauma and other central nervous system disorders and orthopaedic.

But what precisely is Biofeedback?

In Peter's case, his spinal cord cells that carry signals to his voluntary muscles were damaged. And in Louis's, the brain cells controlling muscle movements died out at the time of his birth.

The damage that occurs to brain cells and spinal cord cells due to stroke, injuries, cerebral palsy, etc result in their death. These cells cannot be repaired, neither are they regenerated.

But luckily, the brain has over 1,000 trillion cells, of which the average person uses only 10 per cent.

Dr Brucker's research had started in that direction -- that is, into the possibility of getting the surplus cells to take up the functions of the dead ones. And that's precisely what he achieved through the Electromyographic Biofeedback method.

The first step is to evaluate the patient's condition. Computer-assisted surface EMG monitoring allows the patient and therapist to see whether there are chances of recovery.

Electrodes are placed on the paralysed muscles to detect electrical signals that come from the brain through the spinal cord to the muscle. These signals are amplified and fed into a customised PC for analysis, recording and display on a large monitor in front of the patient.

The patient is then able to see how brain cells are being used to produce electrical signals to various muscles. They see, for example, signals for contraction of some muscles, and relaxation of the opposing muscles. The patient can immediately see how well he is doing by observing the trace displayed in real time on the monitor.

Thus, the patient learns new ways of controlling his body -- by bypassing the damaged areas of the brain and training alternate cells.

When a patient finds that the nervous system is correctly reconnecting to the muscles, he is asked to repeat the process to cause the movement till he attains full control of the brain.

Dr Brucker says, "With the advances in technology it is possible to accurately measure the electrical activity of muscle and rapidly process these electrical signals for display on the computer monitor. This display shows the patient's slight changes in neuromuscular activity, which would normally go unnoticed by the patient or therapist.

"Operant conditioning techniques can then be utilised to have the patient learn greater control over the EMG signals to the muscle than would otherwise be possible. In this way biofeedback can restore functional control over paretic muscles which might not be achieved by other therapeutic modalities alone."

According to Dr Brucker, learning to use alternative cells is like learning to ride a bicycle, which you will never forget once you master the technique.

The biofeedback method has been applied in over 8,000 cases from 1981, with very good success -- 98 per cent of the patients have showed varying degrees of improvement.

So far, biofeedback was available only in the US, Brazil and Israel. With the Apollo hospital bringing the technology to Madras, India becomes the fourth country in the world to offer it.

"Biofeedback treatment will do to neuro patients what cardiac bypass has done to heart patients," says the doctor.

Dr Bernard Brucker will be at the Apollo Hospital, Chennai, from February 6 to 9. Patients can seek appointment with him at 91-44-829-3333/0200. Fax: 91-44-829-3546.

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