In a world first, Swiss researchers have enabled three paraplegic patients to stand and walk again, using a nerve-stimulating device that’s controlled by touchscreen tablet.
The device, revealed this week, uses electronic implants and artificial intelligence software to help paraplegic patients gain back their autonomy — and researchers have found it works well on those with even complete paralysis.
The findings, published in the journal Nature Medicine, found that this particular electrode system works faster than other previous attempts at electrical stimulation of the spinal cord. Improvement was seen within just one day of treatment and continued in the days and months to follow.
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Researchers working on this breakthrough took a surgically implanted device called a spinal cord stimulator and modified the technology. Instead of targeting pain receptors, which is what current spinal cord stimulators are used for, the modified device uses electrodes that send personalized signals to the spinal nerves that are responsible for controlling leg and trunk movements.
Instead of stimulating nerves through the back of the spine, which works for managing chronic pain, the device has been redesigned so that electrical signals reach the spine through a person’s sides, allowing for very specific targeting and activation of spinal cord regions.
The three trial patients — all men between the ages of 29 and 41 — were injured in motorcycle accidents. All three were able to use the device on themselves with the help of a touchscreen tablet, and within six months regained the ability to not only walk but also participate in more advanced activities like swimming and cycling.
Grégoire Courtine and Jocelyne Bloch of the Swiss Federal Institute of Technology in Lausanne led the study. They helped establish a Netherlands-based technology company called Onward Medical that is working to commercialize the system.
Once the device was implanted, patients could “immediately activate their legs and step,” Bloch said.
But because their muscles were weak from disuse, they needed help with weight-bearing, and they needed to learn how to work with the technology, the researchers said.
The researchers noted that while the patients regained the ability to perform various activities, including controlling their trunk muscles for “extensive periods,” they did not regain natural movements.
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Still, Bloch said, “The more they train, the more they start lifting their muscles, the more fluid it becomes.
“It’s not easy and it takes a lot of work, but it’s a dream for most people in this group,” Bloch told NBC.
Extensive training is necessary for patients to get comfortableusing the device. But once they’re comfortable, they are able to do more than just walk.
Jimmy James Ravier / EPFL
The company expects to launch a trial in about a year involving 70 to 100 patients, primarily in the United States, Courtine told Reuters.
If this study’s early results are confirmed in larger studies, people immobilized by spinal cord injuries may someday be able to open a smartphone or talk to a smartwatch, select an activity such as “walk” or “sit,” then send a message to an implanted device that will stimulate their nerves and muscles to make the appropriate movements happen, the researchers said.
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Dr. Eellan Sivanesan, director of neuromodulation at Johns Hopkins Medicine, said that this new approach is promising, and that she’s especially excited about the speed at which the device works.
“Previous attempts at using spinal cord stimulation to restore mobility have been largely labour-intensive and have required months of working with an intensive rehabilitation team. If it can be done quickly, you don’t need as many resources and it could be applied at a larger scale.”
A patient with a complete spinal cord injury walks with the help of the device after five months of rehab.
Jimmy James Ravier / EPFL
Courtine told AFP that this new method still requires a lot of training on the recipient’s end to become comfortable using the device.
“It’s not that it’s a miracle right away, not by far,” he said.
Even still, one of the study’s participants said he’s now able to do things he hasn’t done in years.
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Michel Roccati, an Italian man who became paralyzed after a motorcycle accident, told journalists that he’s now able to shower standing up, have a drink at a standing table, and look at his clients at eye-level.
“The first few steps were incredible — a dream come true!” he said. “I’ve been through some pretty intense training in the past few months, and I’ve set myself a series of goals. For instance, I can now go up and down stairs, and I hope to be able to walk one kilometre by this spring.”
— With files from Reuters
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