Using virtual reality and brain training to help paraplegics walk
Virtual reality and non-invasive brain-machine interfaces (BMIs) are able to help those who are paralysed regain touch sensations and also some voluntary control of muscles in their legs.
A new study, published in Scientific Reports has seen eight chronic spinal cord injury (SCI) paraplegics complete a 12-month training programme.
The year-long study is one of the first tests of the effects of long-term training using technology on those with chronic injuries. Although the number of people involved in the research is small, each person had been diagnosed as paraplegic for between three and 13 years.
During the research the eight people – seven of which have been diagnosed with complete paralysis below the spinal cord – used a brain-controlled exoskeleton and also virtual reality environments.
The patients all saw improvements in the ability to feel sensations rising from their skin – such as touch, pressure, cold, warmth, and pain. "All eight patients experienced neurological improvements in somatic sensation (pain localisation, fine/crude touch, and proprioceptive sensing) in multiple dermatomes," the team of academics wrote in its paper.
"Patients also regained voluntary motor control in key muscles below the SCI level, as measured by EMGs, resulting in marked improvement in their walking index."
As a result of the research 50 per cent of the patients were "upgraded" to a diagnosis of partial paralysis, rather than full paralysis.
Miguel Nicolelis, leader of the research and a neuroscientist at Duke University, US, said "most" of the patients involved saw improvements in bladder control and bowel function.
"What we're showing in this paper is that patients who used a brain-machine interface for a long period of time experienced improvements in motor behaviour, tactile sensations and visceral functions below the level of the spinal cord injury," the researcher said in a statement.
Aged between 26 and 38 the patients all saw differing levels of improvement. The researchers highlight one 32-year-old female as seeing the most significant changes during the study.
Patient 1, as she was known in the research, was not able to stand using braces at the beginning of the study.
"After 10 months of training the same patient became capable of walking using a walker, braces and the assistance of one therapist," the researchers report.
The "significant" clinical recovery seen by the researchers was "closely" related to long-term, frequent, use of brain-machine interfaces that attempted to recreate lower limb movements – in either VR or using exoskeletons.
As a result of the work they say that brain-machine interfaces should be "upgraded" to a new type of "neurorehabilitation therapy."
"It would be very interesting to repeat the present study using a population of patients who suffered a SCI just a few months prior to the initiation of BMI training," the academics conclude.