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Young Paralyzed Jessica Takes First Steps - 2002-10-16


Actor Christopher Reeve, best known for his 1978 portrayal of Superman, is back in the headlines. Eight years after a paralyzing accident, the actor can now feel light touch and partially move his hands and feet. If anyone could make that kind of recovery, Superman could. But the doctor working with Mr. Reeve is also helping a little girl from Illinois. Born paralyzed, Jessica Hill is a "supergirl" herself.

Step by step, four-year-old Jessica Hill is walking her way into medical history. A year ago, the delightfully impish girl with strawberry blonde hair and blue eyes couldn't even crawl.

But thanks to two and a half years of daily workouts on the treadmill at home with her mom, she'll soon walk on her own. A device that looks like a parachute harness suspends Jessica over the treadmill and allows her to move her legs without having to worry about weight or balance. Her mother, Leann Hill, explains Jessica was born paralyzed.

"She was born nine weeks premature; she had meningitis and a septic infection; and they say between all of that she had the hydrocephalus and a stroke to her spinal cord," she explained.

From her matter-of-fact tone, it's obvious Mrs. Hill has listed these ailments many times. But doctors still aren't sure how they all combined to leave Jessica paralyzed from the chest down. The news was devastating for Leann Hill and her husband Kevin. She quit her sales job to stay home with Jess.

"It's worth every minute of it. You have those days when you're kind of down and she wakes up and gives you a big smile and says, 'let's go play,' and how can you have a bad day looking at that?"

By the time she was two-and-a-half years old, Jessica enjoyed zooming around in her tiny wheelchair. But Mrs. Hill wanted more for her little girl. She knew she'd found it when she saw a TV program featuring a St. Louis doctor doing groundbreaking research on spinal cord injuries, the same doctor who designed actor Christopher Reeve's therapy. And St. Louis was just a 40 minute drive from the Hill's home in Troy, Illinois.

Although Dr. John McDonald had never worked with children, he agreed to see Jessica, making her the youngest patient ever accepted to the pioneering Spinal Cord Injury Program at Washington University School of Medicine in St. Louis.

"Right off the bat, he wanted her using a bicycle and a treadmill," said Mrs. Hill, so Jessica and her mom started their daily workouts. With Jess suspended above the treadmill, Mrs. Hill would move Jess' feet back and forth. Dr. McDonald explains scientists now understand that the nervous system is constantly regenerating, but activity is critical for development.

"We don't know what type of activity, how to simulate the nervous system and what's best," said Dr. McDonald. "So let's use physiological things that the normal nervous system would be receiving, like the movements of the legs associated with walking or riding a bike. That activates a pattern generator that's in the spinal cord that governs those types of movements, and so with limited movement you can activate a large part of the spinal cord in an appropriate manner."

Dr. McDonald said this works because no matter how a person's spine is injured, the spinal cord dies the same way.

"It dies from the inside out," he explained. "So that almost everyone is left with a donut-like rim of tissue. And the key is, that outer donut-like rim is what carries the connections to and from the brain. In Christopher Reeve's case, he has about 25 percent of the cord left. Jessica has a lot more. ... We just needed to give her the opportunity to learn these things and associate control and build muscles like any other child would."

Hundreds of patients, even those with old injuries, have benefited from this therapeutic approach, recovering at least partial sensation or movement. Dr. McDonald says the benefits of exercise alone, including retaining bone and muscle mass, are reason enough for paralyzed patients to do it.

Though Jess can now move her legs on her own, the workout is still divided between Jess making them move and her mom marching those little feet.

Leann Hill sits behind her daughter, gently holding her knees and placing one of Jessica's feet in front of the other, over and over and over again, and there's been vast improvement. Jessica has gained feeling from her chest to the tips of her toes, she began kicking her feet on her own, and this past new Year's Eve, as if she had her very own New Year's resolution to get around, Jessica crawled for the first time.

"She crawled for the first time up on her knees. She actually crawled right across the floor. It was absolutely amazing," declared Jessica's mom.

The other key to the therapy devised by Dr. McDonald is that the vast majority of it takes place at home. Visits to therapists are reduced, saving money and time. Jessica and her mother now check in with Dr. McDonald and his team only about once a month. At their most recent visit, Jessica showed off her crawl, which just keeps improving. "That's hard for mom to keep up with some days," Mrs. Hill jokingly complains.

But it's a good problem! And it's just one of Jessica's new tricks. "I like to go fast and slow!" says the youngster.

Jessica wears full leg braces that hug her hips and tummy and keep her legs straight so that Jessica is able to walk with a walker. Mrs. Hill has watched Jess advance at these sessions, from crawling to walking with leg braces and a walker. "The first time she walked with the braces and walker, when I left there I was amazed, and it didn't sink in for awhile," recalled Mrs. Hill. "Then I took her to my mom's work and let her walk in and that's when it finally sunk in. When I saw my mom's reaction. That's where it was really, 'Oh my God, she really walked for the first time!'"

But Dr. McDonald says Jess isn't done. He fully expects her to walk on her own, without braces or a walker.

Back at home on the treadmill, Jess keeps making progress as she gears up for the real thing. Jessica's birthday is Oct 30; she'll be five. She may not walk all on her own by then, but maybe she will by the time she's six!

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