How Virtual Reality Can Help Paraplegics

How Virtual Reality Can Help Paraplegics
By Trenton Morgan and Robert Fine

There are many things people take for granted. Often, all of the small and extraordinary things human bodies can do are in this category. Current technology is also within this group, but as for all things, it is important to know and appreciate what modern technology has come to accomplish.

Paraplegia is an impairment in motor or sensory function of the lower extremities. In most cases, it is caused by spinal cord injury or congenital condition. Along with the loss of feeling and control, those affected may lose muscle control in the bladder and reproductive organs. Though nerve damage is often permanent, some medical treatments have offered solutions. Virtual Reality offers another solution.

The answer starts with Dr. Miguel Nicolelis, director of the Duke University Center for Neuroengineering. In the 1990s, Nicolelis and his colleagues developed a mind-controlled arm that rats learned to use. The rats learned to use the robotic arm after the team studied the neuron fire patterns in the rats’ brains as they motioned their own limbs. After studying the patterns and implanting electronic chips into the brains of the rats, a developed algorithm could successfully translate the patterns into movements for the robotic arm. Thus, the arm moved according to the rats’ intentions, which was to get some water.

This project was later furthered by Nicolelis in 2003. The new project worked with a prime ape, Aurora, working for Brazilian orange juice rather than rats working for water. The project was similar in that the goal was to control a robotic arm with the brain, but it differed as Aurora learned first by using a joystick to play a video game and then later learning to play the video game with her mind and the robotic arm. Aurora’s brain learned how to use the robotic arm as an extension of her body.

Furthering it again, Nicolelis and his colleagues now explored controlling a digital avatar with the brain. Monkeys learned how to control this avatar in first person to manipulate digital objects. When the avatar touched the digital objects, electrical signals were sent back directly to the brain to simulate texture. Within four weeks, the brain formed new sensory pathways to understand this texture. This experiment culminated with a monkey on a treadmill at Duke University controlling a humanoid robot in Kyoto, Japan. The robot in Japan received brain signals from the monkey 20 milliseconds faster than a brain signal goes to its own muscle.

Here is where XR comes in.

In 2013, eight Brazilians were introduced to the Walk Again Project, an international nonprofit cooperative, formed under the Duke immersive Virtual Environment and led by Nicolelis. The goal of the project was to test the clinical impact on the paralyzed by mixing traditional physical rehabilitation methods and multiple brain-machine interface protocols. These protocols utilized the Oculus Rift.

The released study covers the participants and their 12-month journey in 2014. Each of the participants were considered chronic paraplegics with their spinal cord injuries. They began by training in a virtual stadium using VR. With VR, they were asked to make a virtual avatar walk by imagining walking. During much of the study, the participants received tactile feedback on their forearms through a haptic display. Researchers hoped that the combined visual and tactile feedback would rekindle brain activity and neurotransmitters to assist in rehabilitation.

Participants continued through the study being upright, using treadmills and a robotic exoskeleton made custom for each participant. This was all accomplished using non-invasive strategies, which makes brain signals to control the machines harder to receive. Astonishingly, all participants in the study showed significant improvement. They all regained some physical and sensory function below their spinal cord injury levels. These recoveries included improved pain detection, pressure detection, major muscle movement, bowel function and many others.

From the study, “Overall, all eight patients involved in the study experienced a significant improvement in tactile, proprioceptive, vibration, and nociceptive (but not temperature) perception. Such improvement was already noticeable after 7 months, but reached its peak at the 10th month of training. As far as we can tell, this is the first clinical study to report the occurrence of consistent, reproducible, and significant partial neurological recovery in multiple chronic SCI patients.”

After 2,052 sessions and a collective 1,958 hours, the participants and many others have new hope. Through this study, Julian Pinto was able to perform the ceremonial kickoff of the 2014 FIFA World Cup. The use of VR in this study gives more insight on the connection between visual immersion and how it affects the human body. The dedication of others to accomplish a study like this is a great testament of what is to come, which is something no one should take for granted.