Spinal stimulation and robotics restore movement in paralysis patients

The challenge with conventional rehabilitation robotics

Rehabilitation robotics aim to facilitate movement in paralysed patients and promote the reorganisation of the nervous system through activity-dependent mechanisms. However, individuals with paralysis often struggle to generate adequate neural activity during robot-assisted therapy, which limits the effectiveness of these interventions. This insufficient neural activation hampers the potential for meaningful neurological improvements.

Spinal cord neuromodulation

To address this challenge, researchers have developed an implantable spinal cord neuroprosthesis that operates in a closed-loop system. The device delivers electrical epidural stimulation to the spinal cord, synchronised with robotic-assisted movements. The stimulation mimics natural neural patterns, enhancing muscle activation during therapy. Importantly, the neuroprosthesis is device-agnostic and designed for seamless implementation by non-expert users, making it adaptable across various rehabilitation settings.

Proof-of-concept study

In a preliminary study, five participants with spinal cord injuries underwent therapy combining the neuroprosthesis with robotic-assisted walking and cycling. The results showed:

• Participants exhibited well-organised patterns of muscle activity during therapy sessions, indicating effective neuromodulation
• Some participants experienced improvements in voluntary movements post-treatmet, suggesting that the combined therapy may promote lasting neurological recovery.

Real-world applications

Beyond controlled therapy sessions, the neuroprosthesis demonstrated potential in real-world scenarios. Participants engaged in recreational activities such as walking with a rollator and cycling outdoors, showcasing the device's versatility and impact on daily life.

Implications for future rehabilitation practices

The integration of spinal cord stimulation with rehabilitation robotics showcases a promising advancement in neurorehabilitation. By effectively engaging neural circuits during therapy, it may lead to more substantial and sustained functional improvements compared to traditional methods. The device's compatibility with existing robotic systems and its user-friendly design facilitate its adoption across diverse rehabilitation environments.

Looking ahead

While the initial findings are encouraging, the researchers state that larger-scale clinical trials are necessary to validate the efficacy of this combined therapy. Future research should focus on assessing long-term outcomes, refining stimulation protocols, and exploring the neuroprosthesis's applicability to a broader population with varying degrees of spinal cord injury.