Training with noninvasive brain–machine interface, tactile feedback, and locomotion to enhance neurological recovery in individuals with complete paraplegia: a randomized pilot study

Scientific Reports, 2022 · DOI: 10.1038/s41598-022-24864-5 · Published: December 6, 2022

Spinal Cord Injury Neurology Neurorehabilitation

Simple Explanation

This study investigates whether combining locomotion training with a noninvasive brain-machine interface (BMI), virtual reality, and tactile feedback can improve neurological outcomes in individuals with complete spinal cord injury (SCI). The study compared intensive assisted locomotion training alone to a neurorehabilitation protocol integrating assisted locomotion with a noninvasive brain–machine interface, virtual reality, and tactile feedback. The results showed potential for sensory and motor improvement in individuals with chronic complete SCI following a protocol with BMIs and locomotion therapy.

Study Duration

Two blocks of 14 weeks of training and an 8-week follow-up

Participants

8 adults sensorimotor-complete (AIS A) (all male) with chronic (> 6 months) traumatic spinal SCI

Evidence Level

Level 2: Randomized controlled pilot study

Key Findings

1
Locomotion training alone can induce some level of neurological recovery in sensorimotor-complete SCI.
2
The recovery rate is enhanced when such locomotion training is associated with BMI and tactile feedback.
3
The BMI classifier accuracy was significantly above the chance level for all participants in L + B group.

Research Summary

This study investigated the effect of assisted locomotion training plus noninvasive BMI and tactile feedback to induce partial neurological recovery for people with the most severe loss of sensory and motor functions. The study found that sustained assisted locomotion training induces partial sensory and motor recovery even at the chronic phase of the lesion. The BMI protocol amplified this partial neurological recovery effect, and participants were able to learn the BMI task consisting of motor imagery of single leg movement.

Practical Implications

Rehabilitation Strategy

The findings suggest that integrating BMI with locomotion training can be a beneficial rehabilitation strategy for individuals with complete SCI.

Cortical Reactivation

The study highlights the potential of reactivating dormant cortical circuits through combined therapies to improve motor and sensory functions.

Clinical Trials

The positive outcomes warrant further clinical trials with larger cohorts to validate the potential of this protocol for neurological and functional recovery.

Study Limitations

1
Small number of participants
2
Lack of blinding of the participants and caregivers
3
Sensory recovery did not reach statistical significance when compared to the period before the onset of the protocol.

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