BBC Focus

WhatistheWalkAgainproject?

About six years ago, I decided to start an

international collaboration with the goal of

accelerating the development of ‘brain-machine

interfaces’ and the potential application of this

technology in rehab medicine. We started with

eight patients who’d suffered anything that caused

dramatic, traumatic injuries to the spinal cord.

Howdoesabrain-machineinterfacework?

We used a cap fitted with electrodes that can record

the motor commands the brain is producing. The

interface translates those commands into digital

signals that artificial VR devices can understand.

Onthesleevesofashirt,westitchedvibrating

elements that could deliver tactile information to

the skin on the arms of patients. As the patients still

had feeling in their arms, the shirt could simulate

the sensation of touching the ground. Once they’d

trained their brains in this way, they moved into a

robotexoskeleton.Everytimethepatientwalked,

they would receive information about ground

contact via the shirt. By combining this with visual

feedback,wefooledthebrainintogeneratingakind

of phantom limb sensation. The patients reported

that they felt their legs moving.

Whendidpatientsregainmovement?

In the first 12 months, 50 per cent of our patients

hadtobereclassifiedfromcompleteparaplegia

[totalparalysisof thelowerlimbs]topartial

paraplegia [some sensation and movement], which

isamajorstep.Onepatientdroppedoutofthis

study because he had to move, but the remaining

seven patients, after 28 months of training, are

now classified as partial paraplegics. They train

foraboutonehouraweek.It’sdifferentfrom

classical techniques, in which the patient is a

passive recipient of physiotherapy – the patient is

actively engaged in every single manoeuvre. We

RIGHT:First,thepatients

usedtheirbrainwavesto

controladigitalavatarof

themselves,viaanOculus

RiftVRheadset

“50percentofourpatientshadtobe

reclassifiedfromcompleteparaplegiato

partialparaplegia,whichisamajorstep”

NEUROSCIENCE

PHOTOS: DUKE CENTER FOR NEUROENGINEERING X

Eight paraplegic patients have regained some movement and feeling

in their legs thanks to rehabilitation with virtual reality and robot

exoskeletons. Research leader Prof Miguel Nicolelis explains

DISCOVERIES