A New Era: How Technology Is Improving Life After Spinal Cord Injury
For 30 years following a spinal cord injury in his neck, David* relied on a button hook—a simple adaptive tool—to fasten his own shirt. His fingers had never regained the dexterity to work a button. But after therapy sessions using a device called ARC-EX at Burke Rehabilitation®, David was able to button his shirt with his hands alone, for the first time in three decades.
"We were all amazed," says Dr. Shelly Hsieh, Outpatient Director of the Spinal Cord Injury Program at Burke. “It was something he hadn’t done in 30 years, and he was able to do it after one session. Just imagine what the outcomes could be if patients will be able to do if they’re using it more frequently and for longer duration. ”
As the nation marks Spinal Cord Injury Awareness Month this September, that kind of progress captures why Dr. Hsieh describes this as one of the most hopeful stretches for people living with spinal cord injury. The last several years have brought a wave of new technologies into clinical use—tools that are changing not just how much function people regain, but how far into their recovery that progress can still happen. It used to be unheard of, for example, for someone like David to regain function in their hand three decades after such an injury.
ARC-EX works by placing electrical pads on the skin (no implantation needed) at the level of the injury to stimulate pathways that the injury has disrupted. Dr. Hsieh describes it as working something like a hearing aid for the spinal cord. In the dormant nerve pathways that remain after injury, it amplifies the natural signals the brain is still sending down to the rest of the body, boosting strength, sensation and function. Burke acquired the device last fall, becoming one of the first rehabilitation centers in the region to offer it. Patients at the Outpatient Therapy Program use it twice a week for six weeks, working through functional tasks with a therapist while wearing it, actively training while the device is on.
Dr. Hsieh has seen a patient more than a decade past his injury notice greater hand strength and endurance that lasted a day or two even after the device came off—early evidence, she believes, that the stimulation may be helping nerve fibers grow, not just fire more efficiently in the moment. It's a meaningful shift in a field where recovery has traditionally been expected to plateau following one to two years of injury.
While technology opens up possibility, it is human expertise that truly drives recovery. At Burke, which is CARF accredited for spinal cord injury rehabilitation, the team includes SCI-specialized physicians, physical therapists and occupational therapists who work in close, ongoing communication—meeting weekly to discuss shared patients. Dr. Hsieh sees patients who travel over an hour for that specialized care. That depth of expertise is what allows new tools such as ARC-EX to have the greatest impact for patients.
Beyond the spinal cord stimulation of ARC-EX, the SCI program at Burker offers other technologies that expand what recovery looks like. Patients at Burke have long benefited from functional electrical stimulation (FES) bikes, which send electrical signals to intact nerves in the arms or legs, prompting muscles to contract and pedal even without voluntary control. For patients recovering from spinal cord injury, this helps improve circulation, maintain muscle bulk and support nerve recovery. Paired with harness systems that offload body weight, patients can also practice the mechanics of walking earlier than would otherwise be possible.
And at Burke Rehabilitation Hospital, patients can use a newly installed screen-based control system called AutonoME to turn lights on and off, adjust their bed and manage their room, regaining a measure of independence well before they regain hand function.
Not Just Surviving, But Living
Dr. Hsieh traces her own commitment to the field back to medical school, to her first rotation in spinal cord injury. She remembers recognizing what patients face in those early days after injury—lying in a hospital bed, staring at the same spot on the ceiling, wondering what could possibly be left of their life. What she saw in that rotation was how much could still be offered, and she has built her career around it.
"We're not saving lives the way someone does with a heart attack and a stent," she says. "We're saving lives in a different way—improving quality of life for the rest of their life, focusing on the whole person." That means treating the nerve pain, spasticity, and bowel and bladder issues that come with SCI, and it also means helping patients get back to driving, to adaptive sports, to relationships and intimacy, to work and school. "It's not just about surviving," she says. "It's about living."
*Patient’s name has been changed
![]()
