Paraplegics regain feeling and movement, thanks to virtual reality

After a year of training, eight people paralysed from the waist down showed remarkable improvement. BELINDA SMITH reports.

When it comes to a spinal cord injury, the adage “use it or lose it” applies. Not only do unused muscles wither, but the brain areas that would otherwise be controlling those muscles become dormant, too. If they could be reawakened, would that aid recovery?

Yes, according to a study unveiled Scientific Reports in August.

Eight people paralysed from the waist down regained partial sensation and movement in their legs after reawakening their brain using robotics and virtual reality.

Of the eight, five had been paralysed for at least five years and another two for at least a decade. After the treatment, four improved enough to upgrade from a diagnosis of complete to partial paralysis.

The research was carried out by a team led by Miguel Nicolelis at Duke University in the US and members of the Walk Again Project in São Paulo in Brazil.

When we watch others walking, our motor cortex also lights up. So the patients were shown an avatar of their feet walking in a virtual landscape, just the way our feet would look to us as we walk.

While they watched, an electrode cap recorded their brain activity. At first, their motor cortex failed to respond. But after a few months of weekly training sessions, they appeared to reawaken. “Basically, the training reinserted the representation of lower limbs into the patients' brains,” Nicolelis says.

To encourage the reawakening of feeling in the patients' legs, subjects wore sleeves that vibrated differently depending on whether the avatar was walking on gravel, grass or sand.

Eventually, the subjects progressed from being seated in chairs to rigs that gave them the chance to express the slightest gestures of walking, such as harnesses that supported their weight and eventually to a robotic exoskeleton.

After 13 months of virtual reality training, a 32-year-old woman who had been paralysed from the waist down for 13 years was able to take step-like motions.

The work reported in the paper is only part of the story. The subjects are now more than two years into their rehabilitation and the researchers will continue tracking their progress, Nicolelis says.

Could the technique be even more successful if used in newly paralysed patients before their motor cortex shuts down? The team is designing a new trial to find out.

The findings offer patients with spinal cord injuries or stroke-induced paralysis new hope of regaining strength and control.