Earlier this year I attended the 11th World Congress of the International Society of Physical & Rehabilitation Medicine (ISPRM), held in Buenos Aires, Argentina. My primary reason for attending this conference was to contribute to a symposium on the work of Cochrane Rehabilitation and the inaugural meeting of its Advisory Board. I will be reporting back on my work with Cochrane Rehabilitation at our upcoming New Zealand Rehabilitation Conference, in Christchurch next month. However attending international conferences like this one provides an amazing opportunity to find out about some of the cutting-edge research and technological developments in rehabilitation going on around the world.
One of the most fascinating presentations at this ISPRM conference was by Professor Michael Boninger, Medical Director of Human Engineering Research at the University of Pittsburgh. Professor Boninger presented his team’s very latest research into brain-computer interfaces. His research unit has been working extensively over many years to develop brain implants that allow people with complete high-level spinal cord injury to operate robotic arms with their thoughts alone. These implants are neuro-surgically attached to a person’s cerebral cortex and connect to a computer via a large plug on the top of the person’s head. Five years ago, the University of Pittsburgh released a video of a woman with tetraplegia using this technology to feed herself chocolate. Currently, Dr Boninger’s team is able to give a person in excess of 12 degrees of movement with a robot arm using this approach.
Most astounding, they have now added sensory feedback to this brain-computer interface, meaning that not only can a person with tetraplegia control a robotic arm to perform functional tasks – they also can receive the sensation of movement in their brain when the arm is moved in particular ways. In the video below, a man with tetraplegia uses this neuro-prosthetic to detect, while blind folded and with 100% accuracy, which finger of a robotic arm is being moved by the researcher.
Of course, this type of technology is extraordinarily expensive. This is million dollar technology that requires a team of people to re-calibrate it every day - so it is only ever offered to one or two people at a time. In other words, this is research for the sake of knowledge creation – not research that is going to available to all people with tetraplegia any time soon. Indeed, one thing I appreciated about Professor Boninger’s presentation was that fact he went out of his way to address this limitation in his talk, and to highlight other research he is involved in, which is more immediately important to people with spinal cord injury – but which draws smaller crowds at conferences. One example of this other work was research into training strategies to help people with spinal cord injury learn to use wheelchairs for the first time. Professor Boninger promoted an organisation that had focused on this other type of work – the International Society of Wheelchair Professionals. Practical, low cost solutions for everyday challenges are going do a lot more for improving the quality of life of people with spinal cord injury worldwide than the fancy-pants, Star Trek-level technological ones.
Nonetheless – using a million dollar brain implant plus robotic arm to feed yourself chocolate is still pretty cool.
William Levack is an Associate Professor of Rehabilitation at the Rehabilitation Teaching & Research Unit, University of Otago, Wellington, New Zealand. Twitter: @DrLevack