Augmenting rehabilitation robotics with spinal cord neuromodulation: A proof of concept.

Journal: Science robotics
PMID: 40073082

Abstract

Rehabilitation robotics aims to promote activity-dependent reorganization of the nervous system. However, people with paralysis cannot generate sufficient activity during robot-assisted rehabilitation and, consequently, do not benefit from these therapies. Here, we developed an implantable spinal cord neuroprosthesis operating in a closed loop to promote robust activity during walking and cycling assisted by robotic devices. This neuroprosthesis is device agnostic and designed for seamless implementation by nonexpert users. Preliminary evaluations in participants with paralysis showed that the neuroprosthesis enabled well-organized patterns of muscle activity during robot-assisted walking and cycling. A proof-of-concept study suggested that robot-assisted rehabilitation augmented by the neuroprosthesis promoted sustained neurological improvements. Moreover, the neuroprosthesis augmented recreational walking and cycling activities outdoors. Future clinical trials will have to confirm these findings in a broader population.

Authors

  • Nicolas Hankov
    NeuroX Institute and Brain Mind Institute, School of Life Sciences, Swiss Federal Institute of Technology (EPFL), Lausanne, Switzerland.
  • Miroslav Caban
    NeuroX Institute and Brain Mind Institute, School of Life Sciences, Swiss Federal Institute of Technology (EPFL), Lausanne, Switzerland.
  • Robin Demesmaeker
    NeuroX Institute and Brain Mind Institute, School of Life Sciences, Swiss Federal Institute of Technology (EPFL), Lausanne, Switzerland.
  • Margaux Roulet
    NeuroX Institute and Brain Mind Institute, School of Life Sciences, Swiss Federal Institute of Technology (EPFL), Lausanne, Switzerland.
  • Salif Komi
    NeuroX Institute and Brain Mind Institute, School of Life Sciences, Swiss Federal Institute of Technology (EPFL), Lausanne, Switzerland.
  • Michele Xiloyannis
    Nanyang Technological University, Robotics Research Center, School of Mechanical & Aerospace Engineering, Singapore, 639798, Singapore. michele001@ntu.edu.sg.
  • Anne Gehrig
    VAMED Management and Service Switzerland AG, Zurich, Switzerland.
  • Camille Varescon
    NeuroX Institute and Brain Mind Institute, School of Life Sciences, Swiss Federal Institute of Technology (EPFL), Lausanne, Switzerland.
  • Martina Rebeka Spiess
    Hocoma AG, Volketswil, Switzerland.
  • Serena Maggioni
    Sensory-Motor Systems (SMS) Lab, Institute of Robotics and Intelligent Systems (IRIS), Department of Health Sciences and Technology (D-HEST), ETH Zürich, Zürich, Switzerland. serenam@ethz.ch.
  • Chiara Basla
  • Gleb Koginov
    Sensory-Motor Systems Lab, Department of Health Sciences and Technology, Institute of Robotics and Intelligent Systems, ETH Zurich, Zurich, Switzerland.
  • Florian Haufe
    Sensory-Motor Systems Lab, Institute of Robotics and Intelligent Systems, ETH Zürich, Zürich, Switzerland.
  • Marina D'Ercole
    ONWARD Medical, Lausanne, Switzerland.
  • Cathal Harte
    NeuroX Institute and Brain Mind Institute, School of Life Sciences, Swiss Federal Institute of Technology (EPFL), Lausanne, Switzerland.
  • Sergio D Hernandez-Charpak
    NeuroX Institute and Brain Mind Institute, School of Life Sciences, Swiss Federal Institute of Technology (EPFL), Lausanne, Switzerland.
  • Aurelie Paley
    Department of Clinical Neuroscience, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland.
  • Manon Tschopp
    Department of Clinical Neuroscience, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland.
  • Natacha Herrmann
    Department of Clinical Neuroscience, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland.
  • Nadine Intering
    NeuroX Institute and Brain Mind Institute, School of Life Sciences, Swiss Federal Institute of Technology (EPFL), Lausanne, Switzerland.
  • Edeny Baaklini
    NeuroX Institute and Brain Mind Institute, School of Life Sciences, Swiss Federal Institute of Technology (EPFL), Lausanne, Switzerland.
  • Francesco Acquati
    NeuroX Institute and Brain Mind Institute, School of Life Sciences, Swiss Federal Institute of Technology (EPFL), Lausanne, Switzerland.
  • Charlotte Jacquet
    ONWARD Medical, Lausanne, Switzerland.
  • Anne Watrin
    ONWARD Medical, Lausanne, Switzerland.
  • Jimmy Ravier
    NeuroX Institute and Brain Mind Institute, School of Life Sciences, Swiss Federal Institute of Technology (EPFL), Lausanne, Switzerland.
  • Frédéric Merlos
    NeuroX Institute and Brain Mind Institute, School of Life Sciences, Swiss Federal Institute of Technology (EPFL), Lausanne, Switzerland.
  • Grégoire Eberlé
    Department of Clinical Neuroscience, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland.
  • Katrien Van den Keybus
    Department of Clinical Neuroscience, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland.
  • Hendrik Lambert
    ONWARD Medical, Lausanne, Switzerland.
  • Henri Lorach
    NeuroX Institute and Brain Mind Institute, School of Life Sciences, Swiss Federal Institute of Technology (EPFL), Lausanne, Switzerland.
  • Rik Buschman
    Medtronic, Minneapolis, MN, USA.
  • Nicholas Buse
    Medtronic, Minneapolis, MN, USA.
  • Timothy Denison
    MRC Brain Network Dynamics Unit, University of Oxford, Oxford, UK.
  • Dino De Bon
    VAMED Management and Service Switzerland AG, Zurich, Switzerland.
  • Jaime E Duarte
    Department of Mechanical and Aerospace Engineering, University of California, Irvine, California; jeduarte@uci.edu.
  • Robert Riener
    Sensory-Motor Systems Lab, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland.
  • Auke Ijspeert
    Biorobotics Laboratory (BioRob), Ecole polytechnique fédérale de Lausanne (EPFL), 1015 Lausanne, Switzerland.
  • Fabien Wagner
    NeuroX Institute and Brain Mind Institute, School of Life Sciences, Swiss Federal Institute of Technology (EPFL), Lausanne, Switzerland.
  • Sebastian Tobler
    Bern University of Applied Science, SCI Mobility Lab, University of Bern, Bienne, Switzerland.
  • Leonie Asboth
  • Joachim von Zitzewitz
    International Paraplegic Foundation Chair in Spinal Cord Repair, Center for Neuroprosthetics and Brain-Mind Institute, Swiss Federal Institute of Technology (EPFL), Lausanne, Switzerland.
  • Jocelyne Bloch
    NeuroX Institute and Brain Mind Institute, School of Life Sciences, Swiss Federal Institute of Technology (EPFL), Lausanne, Switzerland.
  • Grégoire Courtine

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