RESEARCH JUNE/JULY 2015 BY LINDA CHILDERS Brooke Burns’ Scary Spinal Cord Injury Gave Her a New Purpose

e actress broke her neck in a pool accident and narrowly avoided paralysis. Now she's a passionate advocate for those with spinal cord injuries.

On a warm November night in almost 10 years ago, Brooke Burns dove into her black-bottomed backyard swimming pool just as she had so many times before. "It was my nightly routine. I didn't even think about it," Burns recalls. "But one of the pool lights was out, and I misjudged the depth and hit my head on the bottom." A quick-thinking friend who was visiting the night of the accident jumped into the pool as soon as he saw her in distress. Trained as a firefighter and paramedic, he immediately immobilized and supported her neck, keeping her afloat until the paramedics arrived. "My friend let me remain in the water and didn't put any pressure on my spinal cord, and as a result he saved both my life and my mobility," Burns says. Doctors inserted a titanium rod, two plates, and 10 screws to stabilize Burns' neck. GETTY IMAGES/ANDREW SHAWAF/THE LIFE IMAGES COLLECTION

Indeed, immobilizing someone with a suspected neck or back injury is critical, says Steve R. Williams, MD, a professor of physical medicine and rehabilitation at the Frazier Rehab Institute in Louisville, KY. "Movement may cause further damage to spinal cord nerves, resulting in possible paralysis below the site of injury," he says. "Brooke's friend did the right thing."

Most people aren't as lucky as Burns. In fact, 90 percent of all diving accidents result in spinal cord injuries and paralysis, specifically quadriplegia, or permanent paralysis of all four limbs. Currently, 276,000 Americans have spinal cord injuries, and approximately 12,600 new cases are diagnosed each year, according to the National Spinal Cord Injury Statistical Center at the University of Alabama at Birmingham. Vehicle accidents are the leading cause, followed by falls, acts of violence (primarily gunshot wounds), and sports, including diving accidents.

The 37-year-old former star and host of the Game Show Network program The Chase is keenly aware of her good fortune; it's what motivates her to educate others about water safety and spinal cord injuries.

A Lucky Break On the way to the hospital, the paramedics asked Burns to move her toes. She couldn't. At the hospital, doctors informed her that she had a high neck break in the cervical 3, 4, and 5 vertebrae of the spine, as well as a bruised spinal cord.

"The doctors told me if my injury had been a millimeter in either direction, I would have been a quadriplegic. Everyone else that I've met with a C3, 4, 5 injury is a quadriplegic." Burns underwent surgery so the doctors could insert a titanium rod, two plates, and 10 screws in her neck to stabilize it.

For the next three months, Burns wore a neck brace while the bone grew back over the titanium rod. "I couldn't drive. It was painful to even ride in a car, and I had to sleep in a sitting position," Burns recalls. "I had a love/hate relationship with pain pills. If I didn't take them I was in pain, but when I did take them I was nauseous. I rested a lot, and to relieve my boredom I decorated my neck brace with fake jewels."

Two months after her accident, Burns was given the all-clear to rejoin the cast of Pepper Dennis, a comedy-drama that aired on The WB in 2006. "When I returned to work, the prop department made me a protective hoop that I wore so that no one would run into me on set," Burns says. "I was glad to be back, but I couldn't help but wonder why I was lucky enough to walk away from the accident."

Giving Back Nagged by survivor's guilt, Burns began researching how she could use her experience to help raise awareness about spinal cord injuries. She discovered Life Rolls On, a non-profit organization based in Marina del Rey, CA, that helps improve quality of life for people affected by spinal cord injuries through sports. Burns, an experienced lifelong swimmer, seized the opportunity.

She was impressed by the organization's work and by the accomplishments of its founder, Jesse Billauer. Burns played Jessie Owens on the hit TV show Paralyzed after a surfing accident in 1996 at age 17, Baywatch from 1998 to 2000. GETTY Billauer learned to adapt his surfing equipment and IMAGES/HULTON ARCHIVE technique, and in 2005 he became the first quadriplegic to surf the legendary waves of Cloudbreak in Fiji. He also speaks to college students and other groups about overcoming adversity.

"People who sustain spinal cord injuries often feel isolated and alone," Burns says. "Their accident happens in an instant, and they're left adjusting to their new reality. I appreciated how Life Rolls On helps people regain control over their lives by providing activities in a supportive atmosphere with other people who understand the challenges they are facing."

Since she was one of the lucky few who beat the odds and made a full recovery, Burns asked Billauer if it was appropriate for her to volunteer. "Jesse encouraged me to stand and be a voice for those who couldn't," she says. Since then, Burns has served as co-chair for one of the nonprofit's fundraisers. She also uses her profile in the entertainment industry to raise funds that benefit spinal cord research. "Whether it's doing interviews or helping with fundraisers, I hope to increase public awareness of spinal cord injuries," she says. "I think we're seeing some incredible medical breakthroughs in the field with stem cells and other treatments."

Burns also teamed up with the ThinkFirst National Injury Prevention Foundation and the North American Spine Society to raise awareness of diving injuries. She educates children and families about water safety tips that can prevent life- altering accidents. "I encourage people to 'think first' before diving into a pool or lake," she says. "I remind them never to dive into an above-ground pool or into the shallow end of a regular pool, and to never swim or dive alone. These are simple rules that can help swimmers stay safe."

A New Perspective Burns didn't face the long recovery and rehabilitation that many patients with spinal cord injuries must endure. "I wore a neck brace for three months, and once the cast was off I returned to the pool," she says. "Swimming has always been therapeutic for me, and it played a huge part in my recovery." She also did stretches to regain her range of motion, and as her recovery progressed she added hiking to her exercise regimen.

Spinal cord injuries are divided into the "acute stage" and the "rehabilitation stage," Dr. Williams explains. The acute stage occurs at a hospital or trauma center, where the patient is stabilized and may undergo surgery, as Burns did. The rehabilitation phase begins as soon as possible afterward and consists of physical and occupational therapy to help patients work toward regaining function and independence. "A majority of people do recover to some extent after spinal cord injuries, typically within the first six months," he says.

Some rehabilitation programs offer pool wellness programs as part of their therapy. Patients like Burns who have sustained back and neck injuries often experience greater range of motion and pain-free movement in the pool because of the decreased gravity and warm water.

Stretching exercises like the ones Burns did are also an important part of therapy for those with more severe spinal cord injuries. They are tailored by doctors or physical therapists to meet each individual's needs.

Those with more severe spinal cord injuries can also learn to use assistive devices such as wheelchairs, scooters, voice recognition programs, screen readers, and hearing aids to help them stay productive and live a good life. "Maintaining a positive attitude and undertaking aggressive physical therapy during the rehabilitation stage can also maximize recovery," Dr. Williams says.

Staying active certainly helped Burns maintain a positive attitude, something she could hardly imagine at the time of the accident. "When this happened, my daughter Madison was five, and in the hospital I kept wondering if I'd ever be able to hold her or play with her again."

As the 10th anniversary of her accident approaches, Burns says the experience has changed her. "I no longer sweat the small stuff," she says. The residual pain she still feels in her neck is nothing compared to the gratitude she feels for having been given a second chance. "I believe that everything we go through inspires new intentions. I've tried to use my experience as a positive, to bring attention to spinal cord injuries."

Promising Treatments In e Pipeline Electrical Stimulation. Five years ago, Susan Harkema, PhD, a neuroscientist and director of the Human Locomotion Research Center at the Frazier Rehab Institute in Louisville, KY, and her colleague Steve R. Williams, MD, a professor of physical medicine and rehabilitation at the Frazier Rehab Institute, began studying whether implanted stimulators that send electrical impulses to broken spinal cords via external remote control could revive dead nerves. The stimulators have been implanted into the abdomens of just four patients, but the preliminary results, which were published last year in the journal Brain, are encouraging, says Dr. Williams.

"Our patients have reported that it improves their ability to control their bladder and bowels and has increased sexual function, even when the stimulator is turned off," says Dr. Williams. Their research, funded in part by the Christopher & Dana Reeve Foundation, should be completed within the next three years, he says.

Peptides. Researchers at Case Western Reserve University have developed a chemical compound called intracellular sigma peptide (ISP) that appeared to activate paralyzed muscles in more than 80 percent of lab rats.

In the study, which was partly funded by the National Institutes of Health and was published in the journal Nature last December, researchers administered injections of the peptide to 26 rats with severe spinal cord injuries for seven weeks. During that time, the scientists assessed the animals' ability to walk, balance, and control their urination. At the end Peptides. DEPARTMENT OF of the seven weeks, 21 of the rats regained one or more of NEUROSCIENCES, these functions. CASE WESTERN RESERVE UNIVERSITY SCHOOL OF "The peptide appears to allow nerve fibers to overcome MEDICINE scarring that normally blocks regrowth, restoring the ability to urinate, move, or both," says senior study author Jerry Silver, PhD, a professor of neurosciences at Case Western Reserve University School of Medicine in Cleveland, OH.

The compound will now be tested in pigs, and, if successful, will move on to human clinical trials. It's possible that in the future millions of people could regain movements lost because of spinal cord injuries, Dr. Silver says. Assistive Robotics. Last June, the US Food and Drug Administration approved the first robotic exoskeleton suit for consumer use based on results from a two-year clinical trial at MossRehab in Philadelphia. During the trial, patients wore the suit for four to six hours a week for four months, for a total of 40 to 80 sessions. Manufactured by ReWalk Robotics, the wearable exoskeleton provides powered hip and knee motion to help individuals with spinal cord injuries stand and walk. Several years before the exoskeleton received approval, veterans at the James J. Peters Veterans Affairs Medical Center in the Bronx, NY, tested the suit and were able to stand and walk independently.

Other companies are developing variations of these exoskeletons, but most current models are only available in rehabilitation clinics and are too limited and costly for consumer use. However, manufacturers are working to engineer simpler, more affordable exoskeletons that could be available to consumers within the next decade.

Stem Cells. A first-of-its-kind study in which researchers inject neural stem cells (self- renewing cells that create neurons, astrocytes, and oligodendrocytes, three important cell types in the central nervous system) into people with paraplegia (paralysis of the legs or lower Exoskeleton. REWALK ROBOTICS extremities) is currently underway at the Sanford Stem Cell Clinical Center at the University of California, San Diego (UCSD).

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By signing up, you agree to our Privacy Policy and Terms. Lead researcher Joseph D. Ciacci, MD, a neurosurgeon at UCSD, hypothesizes that these neural stem cells will connect with any remaining nerve cells near the spinal cord injury or even replace those that have been lost or damaged, which could significantly improve motor function. This hypothesis is based on studies in animals that show that transplanted stem cells generate new cells that act as a bridge, protecting cells at the injury site from further damage and suppressing inflammation. Dr. Ciacci and his colleagues hope to determine whether similar effects will take place in humans.