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Virtual reality and exoskeletons helped paraplegics walk again

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A study showed significant improvements in voluntary muscle function

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A combination of motorized exoskeletons and virtual reality could help paraplegics regain some control of paralyzed limbs, according to a new study.

New research published today in the journal Scientific Reports looked at how this therapy affected eight patients — all but one of whom were diagnosed as completely paralyzed from spinal cord injury. None of the patients had responded to previous types of rehab.

For 12 months, the patients participated in a training regimen that involved immersive virtual reality training, visual-tactile feedback, and walking with a custom-designed lower-limb exoskeleton.

Patients used robotic exoskeletons

Following the program, all the patients showed signs of recovery of voluntary muscle function below their spinal cord injury and went from experiencing nearly no sensations to experiencing sensations like touch and pain. Patients also regained some degree of bladder and bowel control, as well as improved cardiovascular function. Four of the participants originally classified as completely paralyzed were reclassified as having incomplete paraplegia, a less severe form of spinal injury.

The program involved three parts. In the first, patients were fitted with an Oculus Rift, an EEG cap to measure brain wave activity, and a vibrating tactile feedback device attached to their forearms. The patients were tasked with moving a soccer player avatar through a stadium in virtual reality by imagining the movements in their own body. The study says they were able to activate areas of their brains associated with leg movement, which were picked up via the EEG cap.

In the second phase, patients were put on a treadmill while wearing a robotic exoskeleton that automatically moved their legs for them. The third part combined the first two, with patients placed into another exoskeleton which they controlled with their minds in a similar way to how they controlled the soccer player avatar in virtual reality.

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The paper is the culmination of an effort launched two years ago by the Walk Again Project, which helped a paralyzed man kick off the 2014 World Cup using a mechanized exoskeleton and an EEG headset. The authors of today's study say their work shows for the first time that long-term brain machine interface techniques can lead to the recovery of neurological function in patients with severe spinal cord injuries. The researchers also reported significant changes in patients' brain wave patterns and signals that new neural connections were being made throughout the course of the study.

Researchers say their findings could have significant impact on spinal cord injury rehab

The researchers behind the study, which was conducted Neurorehabilitation Laboratory of the Alberto Santos Dumont Association for Research Support in São Paulo, Brazil, say they don't know the limits of their clinical approach. But they believe their findings could have a significant impact on how paraplegic patients are rehabilitated. Spinal cord injury has remained challenging for doctors. Many approaches — included body-weight support systems, robotic assistance, and functional electro-stimulation — are designed to assist a patient's walking. But Nicolelis and his team's approach could shift lower-body paralysis treatment from adapting patients to live their lives in a wheelchair to actually getting their legs to work again.