New Italian technique allows four paralyzed young people to walk again

After months of intensive rehabilitation, four young people paralyzed by a complete and chronic spinal cord injury are able to walk again. They no longer had any control over their leg muscles, but now, even with the use of a walker, they can get up from the wheelchair and move around. This exceptional result was made possible by a new Italian technique, developed in the implantable modular neuroprosthesis laboratory (Mine), born from the collaboration between the Vita-Salute San Raffaele University of Milan and the Scuola Superiore Sant'Anna of Pisa and active at the Irccs San Raffaele hospital.

This is the first time that this innovative technique, called Trunk-mediated control (Tmc) by the researchers, has been tested. The first to benefit were four young Italians under 35, three men and a woman. Two are from Lombardy, one from the Marche and one from Umbria. One of them, Nicolò, 21 years old in October, was torchbearer at the opening ceremony of the Milan-Cortina Winter Paralympics.

The progress has been significant. The WISCI II score, used to evaluate walking ability in people with spinal cord injury, went from 0 to 9 for all of them. Three of them achieved the ability to stand for long periods with the help of only one hand, while using the other for small daily activities. One of them even walked 132 meters in 42 minutes without intervals and all managed to walk even facing curves, slopes and uneven external surfaces.

The process that gave the four the ability to move their legs again is based on a spinal cord stimulator already available on the market, which is activated by a slight extension of the trunk, on average about nine degrees. This movement modifies the response to stimulation and favors the transition from the extension of the leg, necessary to support the body weight, to the coordinated flexion of the hip, knee and ankle necessary to advance the pace.

Thanks to this strategy, therefore, it is the patient himself, through the movement of the torso, who voluntarily and immediately contributes to the control of locomotion. Therefore, no brain implants, external sensors or decoding algorithms were necessary. The details are illustrated in a study published in the journal Med-Cell Press.