The Technologies That Are Helping Paralyzed People Walk

In the past couple of years, there have been a number of technological breakthroughs that have enabled paralyzed people to walk again with support.

Brian Buntz

It may be early yet, but there have been a number of recent advances to give paralyzed people hope that they may one day regain feeling in their limbs--and even walk. There have already been a handful of patients who have, after years or paralysis, taken a stand and in some cases walked without support.

Consider the case of Darek Fidyka, a Polish man who was paralyzed from the chest down from a severe knife wound in 2010 who, as the BBC reported, is able to walk after transplanting cells from his nasal cavity into the spinal cord. The patient reports regaining some sense of feeling in his extremities after the procedure.

In the United States, there have also been several advances at the University of Louisville, the California Institute of Technology, and UCLA using neurostimulation to help paralyzed patients regain movement. Last year, a spinal stimulator originally designed for pain treatment was used to help four patients regain some control of their legs. And more recently, UCLA has had similar results with a noninvasive approach to stimulate the spine.

Also this year, there have been news reports about the use of robotic exoskeleton technologies melded with electrical stimulation therapy. A great example Mark Pollock, who was able to walk using the technologies after being paralyzed for four years.

To learn more about advances in this area, Qmed reached out to Nick Terrafranca, CEO of NeuroRecovery Technologies (Monarch Beach, CA), who is collaborating with the the three aforementioned universities to develop unique spinal cord neuromodulator technologies.

Qmed: What are the main kinds of technologies currently available that are promising for people who are paralyzed?

Nick Terrafranca: Current technologies to help paralyzed individuals walk can be broken down into three categories: powered devices, non-powered devices, and cell-based therapies. In the category of powered devices you have robotic exoskeleton systems such as those by Ekso and ReWalk. These motorized robotic support systems for the most part allow the paralyzed patient to gain the ability to ambulate under the power of the robotic apparatus, with little to no movement being generated by the user themselves. While these devices provide the patient the ability to ambulate and stand upright, our scientific team at UCLA, in a limited study and scientific review, has observed that they do not provide much long term or sustained benefit toward reversing muscle atrophy or regaining function.

In the category of non-powered robotic or prosthetic systems several are under development by scientific and commercial groups around the world. These non-motorized bracing systems demand more patient interaction, therefore in theory will result in some gains such as in trunk stability, muscle strength, and lessening bone loss or improving bone density (hardening).

Qmed: What about in the future?

Terrafranca: What the future holds is probably a hybrid between the two, a system which in the beginning provides or performs most of the work for the patient and later on as recovery is realized provides little to no movement and simply support.

Patient injuries vary as well as their ability to recover, so there will be a need for each one of these different devices to one degree or another.

Qmed: What is the most important goal for these technologies?

Terrafranca: Ultimately the goal would be to provide a device and/or treatment that will lead to the rehabilitation of an individual to the point where they can ambulate on their own with the use of little to no adjunctive walking aid. However, this will take some time to achieve and will more than likely involve use of a combination of therapies in series or together, such as robotics, neuromodulation, pharmaceuticals, and even stem cells.

Qmed: What can you share about NeuroRecovery's work in this area?

Terrafranca: To contribute to this effort we at NeuroRecovery have on our drawing board a system to help paralyzed individuals regain the ability to walk, but unfortunately it is in the rough prototype stage of development and years away from an attempt to making it a commercial product.

Brian Buntz is the editor-in-chief of MPMN and Qmed. Follow him on Twitter at @brian_buntz.