Robotics combined with spinal stimulation enables natural muscle activation in spinal cord injury therapy, boosting mobility and offering long-term recovery potential.
Spinal cord injuries have a profound impact, often resulting in severe mobility impairments. Rehabilitation robotics—devices that assist movement during therapy—have enhanced training for individuals with these injuries. However, their effectiveness is limited, as robotic-assisted movement alone does not adequately retrain the nervous system without active muscle engagement.
A team at .NeuroRestore (EPFL/CHUV/UNIL), led by Grégoire Courtine and Jocelyne Bloch, has developed a groundbreaking system that integrates an implanted spinal cord neuroprosthesis with rehabilitation robotics. Their device delivers precisely timed electrical pulses to stimulate muscles in sync with robotic movements, enabling natural and coordinated muscle activity during therapy. This neuroprosthetic innovation, developed in collaboration with Professor Auke Ijspeert’s robotics lab at EPFL, enhances immediate mobility while promoting long-term recovery.
“The seamless integration of spinal cord stimulation with rehabilitation or recreational robotics will accelerate the deployment of this therapy into the standard of care and the community of people with spinal cord injury,” says Courtine. This adaptability ensures that rehabilitation professionals can incorporate this technology into existing rehabilitation protocols worldwide. Combining therapies also presents significant challenges, as each requires precise synchronization. Spinal cord stimulation strategies must be modulated in both space and time to match the patient’s movement, and integrating them with widely used robotic rehabilitation systems requires a flexible and adaptable framework.
The technology relies on a fully implanted spinal cord stimulator that delivers biomimetic electrical epidural stimulation. Unlike traditional functional electrical stimulation, this approach more effectively activates motor neurons by replicating natural nerve signals.
The researchers integrated electrical epidural stimulation with various robotic rehabilitation devices — including treadmills, exoskeletons, and stationary bikes — ensuring that stimulation is precisely timed with each phase of movement. The system uses wireless sensors to detect limb motion and automatically adjust stimulation in real time, allowing for a seamless user experience.
In a proof-of-concept study involving five individuals with spinal cord injuries, the combination of robotics and electrical epidural stimulation resulted in immediate and sustained muscle activation. Not only did participants regain the ability to engage muscles during robotic-assisted therapy, but some also improved their voluntary movements even after the stimulation was turned off.
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The researchers also worked closely with rehabilitation centers to test how well the stimulation system integrated with widely used robotic devices. “We visited multiple rehabilitation centers to test our stimulation technology with the robotic systems they routinely use, and it was incredibly rewarding to witness their enthusiasm,” say .NeuroRestore researcher Nicolas Hankov and BioRob researcher Miroslav Caban, the study’s first authors. “Seeing firsthand how seamlessly our approach integrates with existing rehabilitation protocols reinforces its potential to transform care for people with spinal cord injury by providing a technological framework that is easy to adopt and deploy across multiple rehabilitation environments.”
The study also showed the potential of this approach beyond clinical settings, as participants used the system to walk with a rollator and cycle outdoors, validating its real-world impact.
This innovative technology offers new hope for individuals with spinal cord injuries, presenting a more effective rehabilitation approach than robotics alone. By making rehabilitation more dynamic and engaging, it has the potential to significantly enhance recovery outcomes. Future clinical trials will be needed to establish long-term benefits, but the initial results suggest that integrating neuroprosthetics with rehabilitation robotics could redefine mobility restoration after paralysis.
Source:
Ecole Polytechnique Fédérale de Lausanne. Original written by Nik Papageorgiou.
