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An on-going program at Duke University, part of the Walk Again Project in Brazil, helps paralyzed patients regain partial feeling and control of their limbs. The program began in 2013. At the 2014 soccer World Cup in Brazil a patient from the project kicked off a game with a robotic exoskeleton he controlled with his brain. A study published in Nature documents the methodology and the results of eight paraplegic patients who experienced partial neurological recovery. Brazilian Miquel Nicolelis, M.D., Ph.D., co-director of the Duke Center for Neuroengineering, heads up the research.

Eight patients paralyzed due to spinal cord injuries were in the study. Each had been paralyzed from three to 13 years. The subjects trained with brain-machine interfaces, including a virtual reality system. The training simulated full control of their legs. After seven months of training, some of the patients began to see changes. Four patients experienced sufficient improvements in sensation and muscle control their physicians changed their diagnoses from complete to partial paralysis. In addition to feeling and movement control with some of the patients, most experienced increased bladder control and bowel function. Reduced reliance on catheters and laxatives diminishes the chances of infection, a leading cause of death for paralyzed patients.

The weekly brain-machine training in the project re-engaged spinal cord nerves believed to be permanently severed, Nicolelis believes. “We couldn’t have predicted this surprising clinical outcome when we began the project,” said Nicolelis. “What we’re showing in this paper is that patients who used a brain-machine interface for a long period of time experienced improvements in motor behavior, tactile sensations and visceral functions below the level of the spinal cord injury,” Nicolelis continued. “Until now, nobody has seen recovery of these functions in a patient so many years after being diagnosed with complete paralysis.”