Photo credit: www.sciencedaily.com

Advancement in Spinal Cord Injury Rehabilitation

Injuries to the spinal cord can drastically alter a person’s life, often leading to significant limitations in mobility. The evolution of rehabilitation robotics has indeed contributed to improving therapeutic training for individuals with spinal cord injuries. However, the current limitations of these technologies reveal that robotic assistance alone cannot effectively retrain the nervous system without the patient’s active muscle engagement.

A new initiative by a research team at .NeuroRestore, under the guidance of Grégoire Courtine and Jocelyne Bloch, has introduced an innovative solution that merges implanted spinal cord neuroprostheses with rehabilitation robotics. Their groundbreaking system provides timely electrical impulses aimed at stimulating muscles in synchrony with robotic movements, promoting natural and well-coordinated muscle activity during rehabilitation. This advancement stems from the expertise in robotics developed by Professor Auke Ijspeert’s lab at EPFL, offering both immediate mobility improvements and supporting long-term recovery processes.

“By seamlessly merging spinal cord stimulation with rehabilitation or recreational robotics, we can expedite the incorporation of this therapy into standard care practices for individuals with spinal cord injuries,” states Courtine. This adaptable technology ensures that rehabilitation professionals can incorporate it within existing frameworks used in rehabilitation centers globally. However, this combination of therapies also brings considerable challenges, as they must be precisely synchronized. The modulation of spinal cord stimulation strategies is important both spatially and temporally to match the specific movements of the patient, thus necessitating a versatile and responsive approach to integration with prevalent robotic rehabilitation systems.

The architecture of this technology is based on a fully implanted spinal cord stimulator, which employs biomimetic electrical epidural stimulation. This approach distinguishes itself from traditional functional electrical stimulation methods by activating motor neurons with greater efficiency, as it closely mimics natural nerve signaling.

The researchers successfully integrated electrical epidural stimulation with various rehabilitation robotics—such as treadmills, exoskeleton devices, and stationary bicycles—ensuring that muscle stimulation corresponds accurately with different phases of movement. Utilizing wireless sensors, the system detects limb motion and promptly adjusts stimulation in real time, resulting in a cohesive experience for users.

A proof-of-concept study involved five individuals with spinal cord injuries, demonstrating that the combination of robotic technology and electrical epidural stimulation resulted in both immediate and prolonged muscle engagement. Participants not only regained the ability to activate muscles during robotic-assisted movement but also exhibited improvements in voluntary muscle control even after the stimulation ceased.

The research team engaged rigorously with rehabilitation facilities to assess the effectiveness of integrating their stimulation system with commonly used robotic devices. “We visited several rehabilitation centers to test how our stimulation technology worked with their habitual robotic systems, and the enthusiasm we encountered was incredibly gratifying,” shared .NeuroRestore researcher Nicolas Hankov and BioRob researcher Miroslav Caban, the principal authors of the study. “Witnessing how seamlessly our method aligns with established rehabilitation protocols showcases its potential to revolutionize care for individuals with spinal cord injuries by providing a technology that can be readily adopted across multiple therapeutic environments.”

Moreover, the study indicated that the system’s applicability extends beyond clinical settings; participants reported successfully walking with a rollator and cycling outdoors, underscoring its effectiveness in real-world conditions.

This pioneering technology presents renewed optimism for those affected by spinal cord injuries, proposing a more potent rehabilitation strategy compared to the use of robotics alone. By creating a more engaging rehabilitation experience, it holds the possibility of significantly advancing recovery outcomes. Future clinical trials are necessary to confirm long-term benefits, yet initial findings suggest that the integration of neuroprosthetics with rehabilitation robotics could transform mobility restoration efforts following paralysis.

Source
www.sciencedaily.com