The new system integrates neurological diseases and robotics to improve mobility after spinal cord injury

Spinal cord injuries are life-changing and often leave individuals with severe mobility disorders. Rehabilitation robotic devices that guide movement during treatment have improved training for people with spinal cord injuries, but their effectiveness remains limited. Without active muscle involvement, robot-assisted movements alone will not fully retrain the nervous system.

The Neurorestore team, led by Grégoire Courtine and Jocelyne Bloch, has now developed a system that sham-induces rehabilitation robotics and implanted spinal nerve spraying. The researcher’s device provides timed electrical pulses to stimulate muscles in harmony with the robot’s movement, bringing natural and coordinated muscle activity during treatment. Neuroprosthetics innovation leveraged the robotics expertise of Professor Ijspeert of EPFL. This advancement not only improves immediate mobility, but also promotes long-term recovery.

The seamless integration of spinal cord stimulation and rehabilitation or recreational robotics accelerates the standard of care of this treatment and the deployment of the treatment into communities of people with spinal cord injuries. ”

Grégoire Courtine, EPFL

This adaptability allows rehabilitation professionals to incorporate this technology into existing rehabilitation protocols around the world. Combining treatments also creates a critical challenge as each requires accurate synchronization. Spinal cord stimulation strategies need to be modulated in both space and time to match the patient’s movements, and a flexible and adaptive framework is required to integrate them with widely used robotic rehabilitation systems.

This technology relies on fully implanted spinal cord stimulation devices that provide biomimetic electroduralitis (electroepidural stimulation). Unlike traditional functional electrical stimulation, this method activates motor neurons more efficiently by mimicking natural neuronal signals.

The researchers have integrated electrodural hardening stimuli with a variety of robotic rehabilitation devices, including treadmills, exo skeletons, and stationary bicycles, and integrations that involve the stimuli accurately timing at each stage of movement. The system uses wireless sensors to detect limb movements and automatically adjusts stimuli in real time to allow for a seamless user experience.

A proof-of-concept study involving five individuals with spinal cord injuries showed that the combination of robotics and epidural stimulation resulted in immediate and sustained muscle activation. Participants not only regained their ability to engage with the muscles during robot-assisted therapy, but also improved their spontaneous movements even after stimulation was turned off.

The researchers also worked closely with the rehabilitation centre to test how well the stimulation systems are integrated with widely used robotic devices. “We visited multiple rehabilitation centres to test stimulation techniques with the robotic systems they use on a daily basis. It was extremely rewarding to witness their enthusiasm,” said Nicolas Hankov, researchers at Neurorestore and Miroslav Caban, researchers at Biorob, who are the first authors of the study. “A direct look at how seamlessly our approach is integrated with existing rehabilitation protocols will enhance the potential to transform the care of people with spinal cord injuries by providing a technical framework that can be easily adopted and deployed in multiple rehabilitation environments.”

Additionally, this study demonstrated the potential of this approach beyond the clinical setting, as participants walk outdoors with rollers using the system and examined real-world impacts.

This innovative technology offers new hope for individuals with spinal cord injuries and presents a more effective rehabilitation approach than robotics alone. By making rehabilitation more dynamic and attractive, it could significantly enhance recovery results. Future clinical trials are needed to establish long-term benefits, but the initial results suggest that the integration of nervous system blood and rehabilitation robotics can redefine the recovery of mobility after paralysis.

Contributor list

EPFL Neuro X Lausanne University Hospital (CHUV) and Lausanne University of Lausanne (Unil) Defitech Center for Interventional Neurotherapies (.Neurorestore) EPFL Biorobotics Laboratory Ownward Medical Bern University of Applied Management and Service Switzerland AG Eth Zurich Sensory-Motor Systems Lab of Zurich Spinal Spinal Spinal Spinal Spinal Conter (Look at yourself) sa Applied Sciences (Zhaw) Myoswiss AG