‘A Step Closer’ – Miami Project Scientists are assessing how Automated Walking Devices like Lokomat may benefit victims of spinal cord injury.

Climbing out of bed, getting the morning paper, standing in the shower—these are things most of us take for granted. For people with spinal cord injury (SCI), these are lifelong goals. Researchers at The Miami Project to Cure Paralysis are investigating various devices that enable people with SCI to perform patterns of movement with the legs, which improves strength, endurance, and coordination for greater ease in everyday tasks. 

Funded by a new five-year grant from the National Institutes of Health, Miami Project researcher Edelle Field-Fote combines body weight support with an electrical pulse that stimulates a reflex to produce a walking motion. The reflex, “the same as if you or I were walking down the street and we stepped on a tack,” she explains, remains intact after incomplete SCI. She compares outcomes using reflex stimulation on a treadmill, reflex stimulation on an overground track, and traditional treadmill training in which a therapist moves the legs. With the same patients, Patrick Jacobs research assistant professor of neurological surgery at The Miami Project, assesses improvements in strength, endurance, and cardiovascular health with each intervention.  

The Miami Project is currently one of a limited number of locations in the nation with Lokomat, a new robotic orthosis that moves the legs on a treadmill without a therapist and without electrical stimulation. Lokomat eliminates risk of injury to a therapist and inconsistency of leg motion. While on sabbatical from University Hospital Balgrist, Swiss Paraplegic Centre, Lokomat developer Volker Dietz is at The Miami Project to collaborate with Field-Fote and Jacobs on research with the device, acquired through a grant from the Schumann Foundation. 

Another device, invented by Benito Ferrati of Milan, Italy, uses a series of pneumatic valves and links in a custom-fitting suit to move the hip, knee, and ankle joints in a step. Though not a cure for SCI, these interventions can improve daily functioning, says Field-Fote. “We also need to know, for the day we have the cure, which interventions will best help people get back on their feet.”