Headlines have been made recently with the news that Virtual Reality is making a huge breakthrough for paralysed patients. There is hope that, through Virtual Reality, paralysed patients may regain movement, potentially even be able to walk again. The Walk Again Project, an international collaboration led by Miguel Nicolelis, has brought Virtual Reality into the medical field in a big way. This is ground-breaking research that takes virtual reality, until recently simply synonymous with hard-core gamers, and brings it in to the medical field.
The History of Virtual Reality for Patients with Spinal Injuries
Virtual Reality in the medical arena, focusing on movement and sensation is only just taking its first steps out of infancy. Virtual Reality as a tool for utilising brain activity to stimulate movement first became apparent on the global scene back in 2008 when a monkey in North Carolina made a robot in Japan move. She did this using her brain activity alone. This in itself was a remarkable breakthrough, an underlining of a hypothesis of many years that the brain and body are far more co-dependent than we previously thought. It provided the Launchpad for what was to come.
These types of studies, including the Walk Again Project, had the aim of improving prosthetic devices and brain-controlled devices for use by severely disabled patients. Originally they had no expectations for improvements in sensorimotor and visceral functions. This is what makes the breakthrough even more remarkable. The outcome not only fulfilled their own original desires for the study, but took strides beyond it.
The developments in this field were given a glory moment back in 2014 at the football World Cup in Brazil, when a paralysed teenager was able to walk on to the field and make the first kick of the tournament.
The Use of Virtual Reality in Movement Improvement
What the researchers developed was a complex creation of the first Real-Time Brain-Machine Interface (BMI). The aim is that you can ‘think’ what movement you want, and it is replicated by the machine.
In practice this worked by providing the study candidates, all of whom had been paralysed for between 3 and 13 years as a result of falls, accidents, and injuries, virtual reality simulations of walking. This virtual reality interface was combined with specially designed exoskeletons and tactile feedback clothing and devices. The study participants commenced weekly virtual reality training sessions where they utilised the system for a minimum of 2 hours per week over a year long period.
The results were staggering. After a year of training in this way, 50% of the study candidates were reclassified as partial paraplegic – in short, they had regained some use, and importantly, control, over their movements. Equally remarkable, these patients had also regained some level of bladder control. These individuals, who had been dependent on catheterisation and laxatives, making them at greater risk of infection, were now able to exercise control over their waste elimination.
The Neurosience of Virtual Reality and Movement
Neuroscience is a booming field of medical research. Globally we are equipped with the technology and expertise that have enabled us to start to understand the incredible power of the mind and the brain over the body and our health. We have discovered the concept of neuroplasticity – the brain’s ability to change – meaning that things we once thought were set for life, may be within our scope for change.
For paralysis patients this is incredible news. When a spinal cord is severed, it may not be complete. However, the remaining cord nerves that haven’t been broken become dormant through lack of use. By harnessing the brain’s power over these nerves it is proving possible to activate them to some degree once more.
Prior to the Virtual Reality trial, the patients had undergone MRI scans of their brains. During the scan, they had been told to think about and imagine walking. At this point, the MRI showed no activity in the brain areas associated with movement. However, once the patients had undergone weekly training with the virtual reality-exoskeleton, the movement areas of their brains showed activity. The connection between brain and body had been made.
The Walk Again Project - Who Are They?
The Walk Again Project, headed up by Miguel Nicolelis, is a pioneering collaboration of global experts in their field. It is a non-profit international research collaboration that is bringing together a number of different worldwide researchers and experts. The collaboration includes: the Duke University Center for Neuroengineering; the Technical University of Munich; the Swiss Federal Institute of Technology in Lausanne; the Edmond and Lily Safra International Institute of Neuroscience of Natal, Brazil; the University of California; the University of Kentucky; and Regis Kopper of the Duke Immersive Virtual Environment. It is this international collaboration that is allowing such incredible breakthroughs.
The Future of Virtual Reality in Helping People Regain Movement
Despite the remarkable concept that has been proven to work by combining virtual reality and exoskeletons for paraplegics, this work is still simply the groundwork of the future. There is a huge amount of work and study that needs to be done to achieve greater understanding, and to utilise this understanding for the future.
The technology at present cannot help those patients with a completely severed spinal cord – there needs to be some functional nerves left to be ‘reactivated’. However, with continued research, virtual reality has the potential to vastly improve the quality of life for millions of paraplegics around the globe. Injuries and illnesses (such as stroke) that once meant a future with no hope, a future with no movement, are starting to see hope. With hope that movement can be regained, the outcome for people suffering these injuries and illnesses is made much more positive.
Virtual Reality is not just for gaming, it’s not even just for education, but by bringing it in the medical field it’s completely transformative, and opens a future of possibilities and hope.