A team of European scientists developed a system that seamlessly integrates an implanted spinal cord prosthetics with rehabilitation robotics, according to a study published in Science Robotics. The device delivers electrical pulses to stimulate muscles in harmony with robotic movements, producing natural and coordinated muscle activity during therapy. This system not only enhances immediate mobility but also helps long-term recovery.
Spinal cord injuries are life-altering and can cause severe mobility restrictions in patients. Rehabilitation robotics—devices that guide movement during therapy—can be used during physiotherapy for these patients, but their effectiveness remains limited. Without active muscle engagement, robotic-assisted movement alone cannot retrain the nervous system.
“The seamless integration of spinal cord stimulation with rehabilitation or recreational robotics will accelerate the deployment of this therapy into the standard of care and the community of people with spinal cord injury,” says Grégoire Courtine from the NeuroX Institute and Brain Mind Institute, Swiss Federal Institute of Technology (EPFL) in Switzerland.
In simple terms, the new system uses a spinal cord stimulator to deliver electrical epidural stimulation and activate motor neurons by mimicking natural nerve signals. The researchers then integrated electrical epidural stimulation with various robotic rehabilitation devices—including treadmills, exoskeletons, and stationary bikes—ensuring that stimulation is accurately timed with each movement. To ensure the patient’s safety, wireless sensors detect limb motion and automatically adjust stimulation in real-time, allowing for a seamless user experience.
A proof-of-concept study involved five patients with spinal cord injuries. The combination of robotics and electrical epidural stimulation resulted in immediate and sustained muscle activation. Participants regained the ability to engage muscles during robotic-assisted therapy and improved their voluntary movements even after the stimulation was turned off.
The researchers also worked closely with rehabilitation centers to assess whether the stimulation system could integrate with widely used robotic devices. “We visited multiple rehabilitation centers to test our stimulation technology with the robotic systems they routinely use, and it was incredibly rewarding to witness their enthusiasm,” said .NeuroRestore researcher Nicolas Hankov and BioRob researcher Miroslav Caban. “Seeing firsthand how seamlessly our approach integrates with existing rehabilitation protocols reinforces its potential to transform care for people with spinal cord injury by providing a technological framework that is easy to adopt and deploy across multiple rehabilitation environments.”
The authors believe this innovative technology offers new hope for patients with spinal cord injuries, offering a more effective rehabilitation approach than robotics alone. Crucially, making rehabilitation more engaging can significantly enhance recovery outcomes. Future clinical trials are still needed to evaluate long-term results, but the initial data suggests that integrating neuroprosthetics with rehabilitation robotics could redefine mobility restoration after paralysis.
Nicolas Hankov et al. , Augmenting rehabilitation robotics with spinal cord neuromodulation: A proof of concept.Sci. Robot.10,eadn5564(2025).DOI:10.1126/scirobotics.adn5564