Reviewed by Lexie CornerMar 13 2025
A group of researchers at NeuroRestore has developed a system that integrates rehabilitation robots with an implanted spinal cord neuroprosthesis. The study was published in Science Robotics.
Common robotic devices to safely automate and augment gait rehabilitation across the continuum of care for people suffering from traumatic spinal cord injury interfaced with spinal cord stimulation. Image Credit: .NeuroRestore / EPFL / CHUV 2025
Spinal cord injuries often lead to significant mobility issues, dramatically affecting a person's life. While rehabilitation robotics—devices that assist with movement during therapy—have improved training for individuals with spinal cord injuries, their effectiveness remains limited. Robotic-assisted movement alone is insufficient for retraining the neural system without active muscle involvement.
The research team, led by Jocelyne Bloch and Grégoire Courtine, developed a system that generates natural and coordinated muscle activity during therapy. The system uses precisely timed electrical pulses to activate muscles in sync with robotic movements.
This neuroprosthetics development, built on the robotic expertise of Professor Auke Ijspeert’s EPFL team, supports long-term rehabilitation while also providing immediate improvements in mobility.
The seamless integration of spinal cord stimulation with rehabilitation or recreational robotics will accelerate the deployment of this therapy into the standard of care and the community of people with spinal cord injury.
Grégoire Courtine, School of Life Sciences, Swiss Federal Institute of Technology (EPFL)
This technology is versatile and can be integrated into existing rehabilitation procedures worldwide. However, combining spinal cord stimulation with robotic systems presents challenges due to the need for precise synchronization. These techniques must be adjusted in both space and time to align with the patient’s movements, requiring a flexible and adaptive framework.
At the core of the technology is a fully implanted spinal cord stimulator that delivers biomimetic electrical epidural stimulation. This method mimics natural nerve signals, engaging motor neurons more effectively than traditional functional electrical stimulation.
The researchers ensured that the electrical epidural stimulation was perfectly synchronized with each movement phase by integrating it with various robotic rehabilitation devices, such as stationary bikes, treadmills, and exoskeletons. Using wireless sensors to detect limb movements, the system instantly adjusts the stimulation, providing a seamless user experience.
In a proof-of-concept study, electrical epidural stimulation combined with robotics enabled immediate and sustained muscle activation in five individuals with spinal cord injuries. Not only did participants regain the ability to contract their muscles during robotic-assisted therapy, but some also showed improvements in voluntary movements even after the stimulation was stopped.
The researchers worked closely with rehabilitation facilities to test the integration of the stimulation system with widely used robotic equipment.
“We visited multiple rehabilitation centers to test our stimulation technology with the robotic systems they routinely use, and it was incredibly rewarding to witness their enthusiasm,” said NeuroRestore researcher Nicolas Hankov and BioRob researcher Miroslav Caban, the study’s first authors.
“Seeing firsthand how seamlessly our approach integrates with existing rehabilitation protocols reinforces its potential to transform care for people with spinal cord injury by providing a technological framework that is easy to adopt and deploy across multiple rehabilitation environments,” added Hankov and Caban.
Participants in the study demonstrated the system's practical impact by using it to cycle outdoors and walk with a rollator, showcasing the approach’s applicability outside of clinical settings.
This technology offers a more effective rehabilitation strategy compared to robots alone, providing new hope for individuals with spinal cord injuries. By making rehabilitation more active and engaging, recovery outcomes could improve significantly. Early findings suggest that combining neuroprosthetics with rehabilitation robotics could redefine mobility restoration after paralysis. However, further clinical trials are needed to assess the long-term benefits.
Journal Reference:
Hankov, N., et al. (2025) Augmenting rehabilitation robotics with spinal cord neuromodulation: A proof of concept. Science Robotics. doi.org/10.5281/zenodo.12533019