Millions of people cannot move their limbs as a result of a neurological disorder or having experienced an injury. But a newly developed algorithm, when coupled with robot-assisted rehabilitation, can help patients who had a stroke or a spinal cord injury to walk naturally.
In the United States, there are approximately 17,000 new cases of spinal cord injury (SCI) every year. Of these, 20 percent result in complete paraplegia (paralysis of the legs and lower half of body) and over 13 percent result in tetraplegia (paralysis of all four limbs).
But SCI is not the only reason that people experience this type of disability. Stroke, multiple sclerosis, cerebral palsy, and a range of other neurological disorders can all lead to paralysis. In fact, a recent survey estimated that in the U.S., almost 5.4 million people live with paralysis, with stroke being the leading cause of this disability.
Now, researchers from the National Centre of Competence in Research Robotics at École Polytechnique Fédérale de Lausanne (EPFL), and at the Lausanne University Hospital in Switzerland, have come up with a groundbreaking technology that may help these patients to regain their locomotor skills.
The scientists came up with an algorithm that helps a robotic harness to facilitate the movements of the patients, thus enabling them to move naturally.
The new research has been published in the journal Science Translational Medicine, and the first author of the study is Jean-Baptiste Mignardot.
Helping people to walk again
Current rehabilitation technologies for people with motor disabilities as a result of SCI or stroke involve walking on a treadmill, with the upper torso being supported by an apparatus. But existing technologies are either too rigid or do not allow the patients to move naturally in all directions.
As the authors of the new study explain, the challenge of locomotor rehabilitation resides in helping the nervous system to "relearn" the right movements. This is difficult due to the loss of muscle mass in the patients, as well as to the neurological wiring that has "forgotten" correct posture.
In order to overcome these obstacles and promote natural walking, Mignardot and colleagues designed an algorithm that coordinates with a robotic rehabilitation harness. The team tested the algorithm in more than 30 patients. The "smart walk assist" markedly and immediately improved the patients' locomotor abilities.
This mobile harness, which is attached to the ceiling, enables patients to walk. This video shows how it works:
Additionally, after only 1 hour of training with the harness and algorithm, the "unsupported walking ability" of five of the patients improved considerably. By contrast, 1 hour on a conventional treadmill did not improve gait.
The researchers developed the so-called gravity-assist algorithm after carefully monitoring the movements of the patients and considering parameters such as "leg movement, length of stride, and muscle activity."
As the authors explain, based on these measurements, the algorithm identifies the forces that must be applied to the upper half of the body in order to allow for natural walking.
The smart walk assist is an innovative body-weight support system because it manages to resist the force of gravity and push the patient back and forth, to the left and to the right, or in more of these directions at once, which recreates a natural gait and movement that the patients need in their day to day lives.
Grégoire Courtine, a neuroscientist at EPFL and the Lausanne University Hospital, comments on the significance of the findings, saying, "I expect that this platform will play a critical role in the rehabilitation of walking for people with neurological disorders."
"This is a smart, discreet, and efficient assistance that will aid rehabilitation of many persons with neurological disorders."
Prof. Jocelyne Bloch, Department of Neurosurgery, Lausanne University Hospital