Hunter Holmes McGuire VA Medical Center - Richmond, VA

Dr. Ashraf Gorgey, Director of Research for Spinal Cord Injury and Disorders at Central Virginia VA Health Care System, walks with a Veteran using an exoskeleton. Photo credit: Mary Beatty

The Congressionally Directed Medical Research Programs awarded a grant worth $3.7 million to Central Virginia VA Health Care System (CVHCS) and Virginia Commonwealth University (VCU). The grant is the first of its kind at a VA medical center to study spinal epidural stimulation in people with spinal cord injuries.

A spinal cord injury (SCI) is a debilitating medical condition that limits the function of movement and control in the body. Having an SCI can also lead to reduced aerobic fitness, glucose intolerance and insulin resistance due to autonomic dysfunction, muscle wasting, increased regional and total body fat mass and relative inactivity. CVHCS has a unique expertise in treating Veterans with these injuries.

The CVHCS research team, in collaboration with Virginia Commonwealth University, will use spinal epidural stimulation treatment in conjunction with a robotic suit to produce better outcomes for an improved quality of life for those suffering with spinal cord injuries. VA’s robotic exoskeleton suits are currently used in research to improve SCI patients’ mobility and outlook for their prognosis.

“A new scientific breakthrough called lumbosacral epidural stimulation, or ES, can help people stand, step and even walk again,” said Dr. Ashraf Gorgey, director of research for the Spinal Cord Injury and Disorders unit and principal investigator for this clinical trial. “Our research team has already used the ‘ES Robot Suit’ for three months in one person with tetraplegia and showed remarkable improvements in motor control. We are aiming to implant 20 Veterans with spinal cord injury by placing electrodes inside the body in the spine.”

With the support of Dr. Robert Trainer to implant the device, Dr. Gorgey says they are aiming to enhance muscle quality in patients. Other benefits may include improvement in the cardiovascular system and bladder functions, which are common side effects for SCI patients.

The study will measure the effectiveness of resistance training for Veterans using the Exoskeletal-Assisted Walking and ES. Specifically, the research will look for improvements in motor recovery, cardio-metabolic health and bladder control.

“The clinical trial will be conducted and completed entirely at CVHCS in Richmond,” Gorgey said.

Dr. Ashraf Gorgey, Director of Research for Spinal Cord Injury and Disorders at Central Virginia VA Health Care System is the principal and lead investigator for a $3.7 million clinical trial to study spinal epidural stimulation in Veterans with spinal cord injuries. Photo credit: Dr. Ashraf Gorgey

Dr. Ashraf Gorgey, Director of Spinal Cord Injury Disorders Research

Ashraf S. Gorgey has a bachelor’s and master’s degree in physical therapy and earned his PhD in exercise physiology in 2005 with special emphasis on electrical stimulation, muscle activation and fatigue.

Dr. Gorgey has received several awards studying the effects of electrical stimulation and testosterone replacement therapy interventions on parameters of physical activity in people with spinal cord injury, including body composition, metabolic profile and mitochondrial health. He has published approximately 110 peer-reviewed articles and presents his scientific findings both nationally and internationally.