Researchers in Brazil who have been helping people with spinal injuries move again have made a startling yet exciting discovery, NPR reports. Patients undergoing brain training while working with robots were able to regain some movement and sensation.
The study suggests that damaged spinal tissue in certain paraplegic patients can be retrained to a point, in much the same way some people ae able to regain brain function after a stroke by practice and repetition. This is not even a new idea in spinal cord injuries, as even those with severe damage can regain movement and sensation through intensive physical therapy if there are nerve fibers intact.
There were eight people in the Brazilian study, and while they were not able to regain enough movement to support their own weight, they showed a “partial recovery” that will significantly improve their quality of life. Dr. Miguel Nicolelis, a doctor and neuroscientist with Duke University and lead author on the study, says the subjects had better bowel and bladder control, and even erections in some of the men. One woman was able to deliver a baby naturally, too, saying that she could feel the contractions and the baby.
Nicolelis is known worldwide for his work in arranging for one of his patients to kick a ceremonial football ball at the 2014 World Cup in Rio de Janeiro, to much fanfare. It highlighted Nicolelis’ ambitious strides in helping paraplegics through robotics via an international collaboration called the Walk Again Project.
There are similar research groups looking into the same strategies, and several products currently being marketed to help spinal cord injury patients move again.
Nicolelis and his team train paralyzed people to visualize moving their muscles, by providing them with virtual reality goggles and giving them tactile feedback on their arms. The concept was for the brain to send signals that could be picked up by electrodes then used to control the robot.
Nicolelis expressed his surprise that as people got better at visualizing their movements, they also began regaining feeling and mobility.
The patients had been suffering from spinal cord conditions for three to 13 years. This, Nicolelis says, is “an important milestone.”
Nicolelis’ treatments include physical therapy and external stimulation as the robots move the patients’ muscles.
Other scientists have been skeptical about Nicolelis’ study, however. Edelle Field-Fote, director of spinal cord injury research at the Shepherd Center at Emory University says the results are not unprecedented, but the “intervention” that is new. “If you gave anybody [with some remaining spinal cord] 12 months of therapy, you’d see improvement,” Field-Fote notes and says that all the participants were capable of some movements from the start, with help from walkers, crutches, braces and human aids.
Monica Perez, a scientist at the Miami Project to Cure Paralysis, says anyone who regularly exercises will show improvements. “The question is whether this is superior to previous approaches and which are the mechanisms,” she says.
Since the Brazil study was completed over a long period of time, the results suggest that more prolonged efforts to help paraplegics regain movement could pay off.
Dr. Lyn Jakeman, a neuroscientist at the National Institute of Neurological Disorders and Stroke, says that while the study is “plausible and interesting,” there were so many interventions involved in the therapies that it was not clear what exactly was responsible for the improvements. There was no control group for comparison, either.
Nicolelis says two women in the study showed the most improvement, as they had been paralyzed for over a decade. They could now move their legs, flex their knees and one can now even sit and drive. He says that people with weak muscles in their legs can potentially control the robot that his team is developing.
There are some 25 million people globally with severe spinal injuries. Nicolelis admits that his treatments have been expensive, but adds that if virtual reality can help treat paraplegia, it could lead to less expensive therapies. He intends to expand the study to a new group/
The study was published in Scientific Reports.