Imagine being told you will never walk again. For paraplegics, this is a reality. But it may be changing, virtually.
Patients in Duke University’s Walk Again Project are using brain-machine interfaces that incorporate a virtual reality (VR) system that uses their brain activity to control their legs. The research behind the project was done by neurophysiologist Dr. Miguel Nicolelis, who set out to enable patients with spinal cord injuries, stroke or other conditions to regain mobility, strength and independence.
Walking The Walk
Nicolelis, Duke School of Medicine distinguished professor of neuroscience, and his colleague John Chapin came up with the idea in the late 1990s, when they began experimenting on rhesus monkeys using a brain-machine interface. The animals learned to operate robotic devices just by thinking, a process in which their brains’ electroencephalography (EEG) signals were rerouted to run the robotics.
The two researchers speculated that paraplegics might be able to do the same. Nicolelis and Chapin later described their idea in an article in Scientific American. Readers were more than a bit skeptical.
“They thought we were crazy,” Nicolelis said. “But I was certain.”
After a chance meeting with the president of Brazil, Nicolelis would get a chance to prove his theory in front of more than a billion people. In a successful demonstration to launch the 2014 World Cup, the opening kickoff was delivered by a young Brazilian man paralyzed from his chest down. Using the brain-machine interface, the man was able to control the movements of a lower-limb robotic exoskeleton, while receiving tactile feedback from the exoskeleton’s feet.
Leveling Up With VR
The lab’s first patients — eight Brazilians with spinal cord injuries — were introduced to the system in November 2013. After only six months, the patients became proficient at interpreting the haptic tactile stimulation the system was providing for them.
Nicolelis explained that using virtual reality, a haptic display allows the patients to visualize when their legs touch the ground or are extended. Not only could the patients walk with their robotic legs, some even learned to move their legs by themselves.
According to Nicolelis, tactile feedback was critical to the experiments. The visual component of the VR training was not enough by itself. The Duke researchers figured out why. “If you are confined to a bed or a wheelchair for a long time, your brain starts forgetting what it’s like to have legs and how to control them,” Nicolelis said.
After using VR to refamiliarize the brain with this concept, patients could regain the experience of moving again.
Transforming Even More Lives
As the technology driving VR has progressed, Nicolelis and his team have come to work in more streamlined VR environments. Using VR headsets, the lab at Duke University has drastically reduced its reliance on heavy machinery. Now, because VR systems are more portable, patients can spend more time using them.
The longer they spend controlling avatars of themselves, the better the chance that they will regain control over paralyzed parts of their physical bodies, Nicolelis said. And, as VR costs decline, the Duke lab can afford to involve more patients.
What started with a group of eight in 2013 has increased to 20 patients, with a goal to implement the project on a large scale. Patients may even begin to train virtually over the internet. It may also broaden in scope, he said, noting that the research might be applied “to not only spinal cord injuries, but stroke victims and [those with] other neurological disorders.”
Story originally published in Forbes Magazine on Jan. 16, 2018.