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Underwater Discovery

Reprinted from PN/Paraplegia News April 2013

Results and continued research into scuba diving are generating new hope for people with SCI.

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Cody Unser is ecstatic, and why shouldn’t she be? The nonprofit scuba diving program Unser created for people with spinal-cord injuries is the center of amazing scientific research and a new documentary.

Two years ago, a medical pilot study discovered Unser and others with paraplegia had improvement in motor and mental areas after diving. The gains continued after they returned to the surface.

“Cody swore that she had sensations in her legs from diving, and they weren’t just random ones … they lasted for weeks,” says study co-leader Adam Kaplin, MD, from the Johns Hopkins University School of Medicine. “I spoke to other divers, the disabled veterans in particular, and they, too, reported similar sensations after diving.”

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The groundbreaking results came from a dive with the Cody Unser First Step Foundation (CUFSF). Now, a $25,000 grant from Newman’s Own Foundation will help support a one-hour television documentary about their next dive.

Lights, Camera, Dive!

Following the success and research results from the 2011 pilot study, another dive is planned for this year that again will be studied and this time filmed.

Similar to the dive itself, the documentary is still in the planning stages. The group didn’t have enough money to film the dive before, but the large grant from the Newman Foundation is getting the project off the ground, or underwater in this case.

The dive and documentary will take place when the group returns to the Grand Cayman Islands in late spring or summer of this year. The cameras will be able to capture much of what takes place from diving and research perspectives, but they won’t be able to capture the feeling Unser gets when diving.


Daniel Becker, MD, gives scuba diver Craig Cascella a medical check.

“When I’m underwater and out of my chair, it’s like being in another world. I’m transformed into another being, flying and independent,” Unser says. “It’s an ultimate thrill for me and one I love to share with others. That’s what our scuba training program is all about. It’s a means of gaining independence through a challenge, and the best part is sharing it with your buddies.”

Red Sail Sports has helped with the dives in the past. Operations manager Rod McDowall, a native Australian and part of the Red Sail team since 1987, says the pilot study was something special.

“I saw a new concept unfold as divers sought psychological relief from distress disorders,” McDowall says. “It all jumped out at me, sort of like a third dimension. They found peace and quiet underwater, and I was proud to be part of it.”

Pressure Positive

 

Diving in the pristine waters of Grand Cayman in 2011, nine paralyzed veterans joined Unser and a control group of ten instructors.

The research was conducted by Kaplin and Daniel Becker, MD, from Kennedy Krieger Institute. They looked at the paraplegic individuals and instructors before and after ten dives to an average depth of 60 feet. The findings of Becker and Kaplin were fascinating and have led to further research.

The pilot study found scuba may help improve muscle movement, touch sensitivity, and post-traumatic stress disorder symptoms in people with SCI. Results from the initial research were released during Paralyzed Veterans of America’s Summit 2011 in Orlando, Fla.

Pressure on the body at depth is nearly triple that on the surface, causing nitrogen to build up in the blood stream. Accordingly, research indicates that as nitrogen accumulated in the divers’ tissues, it created and increased levels of serotonin (a chemical used in the brain to transmit signals between neurons) in the central nervous systems.

In theory, this might jump-start nerves in the spine without input from the brain. As a result of diving, the nervous system could be prompted to seek new connections between muscles and nerves, in turn improving feeling and functions.

Better Than Prozac?

The pilot study may be over, but its results are leading to further research into the positive effects diving has on SCI.

During the pilot study Becker tested sensations in detail from light touch to pinprick to sharp touch. Motor skills were tested, as were muscles for spasticity, a stiffness that appears and inhibits functioning. Later, while evaluating the results, Becker was surprised when he saw considerable improvements in this area.

“Cody’s  improvement underwater intrigued me,” says Becker. “As a researcher I wanted to know what we were going to study while examining the ten paralyzed divers and the ten able-bodied ones before and after their dives.”

Current studies are looking at how and why the divers got a 350% increase in serotonin when the nitrogen entered their bodies. By comparison, a normal antidepressant such as Prozac will only provide a 15–20% increase in serotonin.

Researchers want to see if certain drugs such as serotonin might actually lead to an improvement in people’s gait. But in order to see a benefit, scientists are using a pump to deliver higher doses of serotonin directly to the spinal cord of lab rats to see if that makes a difference.

Studies are also planned to look further into hyperbaric oxygen chamber treatment. Some minor studies have been unsuccessful, but they weren’t conducted on those with chronic SCI.

“It’s rewarding to be part of something so powerful and healing,” Unser says. “I would love to walk again and feel my feet in the sand.”

For more information, visit cufsf.org.

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