Non-invasive, Brain-controlled Functional Electrical Stimulation for Locomotion Rehabilitation in Individuals with Paraplegia

Scientific Reports, 2019 · DOI: 10.1038/s41598-019-43041-9 · Published: May 1, 2019

Spinal Cord Injury Neurology Neurorehabilitation

Simple Explanation

This study introduces a new neurorehabilitation method for people with paraplegia caused by spinal cord injuries. It combines functional electrical stimulation (sFES) of leg muscles with a brain-machine interface (BMI). The system uses a brain-machine interface to detect when the patients try to move their legs and then triggers the electrical stimulation to help them walk. The researchers tested this approach on two patients with long-term paraplegia and observed improvements in their cardiovascular health, walking ability, and even some regained motor function.

Study Duration

6 Months

Participants

Two patients with chronic paraplegia

Evidence Level

Not specified

Key Findings

1
Patients were able to walk safely with 65–70% body weight support, accumulating a total of 4,580 steps with this setup.
2
Researchers observed cardiovascular improvements and less dependency on walking assistance.
3
Partial neurological recovery was observed in both patients, with substantial rates of motor improvement for one of them.

Research Summary

This paper introduces a novel, non-invasive neurorehabilitation protocol for locomotion training for patients with severe chronic paraplegia resulting from spinal cord injuries, which targets both musculoskeletal training and corticospinal plasticity. Using this novel approach, we successfully tested a stimulation protocol to reproduce a smooth gait pattern; patients were able to use our setup to walk with partial suspension and little or no external help. Given the improvements obtained in this pilot study in terms of muscular volume and performance, better walking functions and neurological recovery, we propose that our BFNR protocol has the potential to become a valuable neurorehabilitation therapy for patients with SCI in the future.

Practical Implications

Rehabilitation Potential

The BFNR protocol shows promise as a potential neurorehabilitation therapy for patients with SCI, offering improvements in muscle volume, walking functions, and neurological recovery.

Assistive Device Improvement

The study validates the use of sFES systems combined with BMI for restoring locomotion in paraplegic individuals, suggesting potential advancements in assistive device technology.

Cortical Plasticity

The findings support the idea that concurrent cortical and spinal plasticity, induced by BMI use and sFES, plays a critical role in neurological motor improvement in SCI patients.

Study Limitations

1
Small sample size (two patients)
2
The BMI protocol was particularly difficult for one patient
3
Further clinical trials are necessary to disambiguate if achieving good BMI-control accuracy is a necessary condition or even a determinant for patients to benefit from this training.

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