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Rehabilitation robotics aims to promote activity-dependent reorganization of the nervous system. However, people with paralysis cannot generate sufficient activity during robot-assisted rehabilitation and, consequently, do not benefit from these therapies. Here, we developed an implantable spinal cord neuroprosthesis operating in a closed loop to promote robust activity during walking and cycling assisted by robotic devices. This neuroprosthesis is device agnostic and designed for seamless implementation by nonexpert users. Preliminary evaluations in participants with paralysis showed that the neuroprosthesis enabled well-organized patterns of muscle activity during robot-assisted walking and cycling. A proof-of-concept study suggested that robot-assisted rehabilitation augmented by the neuroprosthesis promoted sustained neurological improvements. Moreover, the neuroprosthesis augmented recreational walking and cycling activities outdoors. Future clinical trials will have to confirm these findings in a broader population.

Original publication

DOI

10.1126/scirobotics.adn5564

Type

Journal article

Journal

Sci Robot

Publication Date

12/03/2025

Volume

10

Keywords

Humans, Robotics, Walking, Proof of Concept Study, Spinal Cord, Male, Adult, Female, Bicycling, Spinal Cord Injuries, Middle Aged, Paralysis, Muscle, Skeletal, Neural Prostheses