Spinal cord injury researchers at the University of Louisville pioneered activity-based interventions that have helped individuals with spinal cord injury (SCI) improve mobility. The addition of epidural stimulation to the lumbosacral spinal cord has allowed individuals with SCI to stand without assistance. Susan Harkema, Ph.D., who leads this research at UofL, Claudia Angeli, Ph.D., Enrico Rejc, Ph.D., and Sunil Agrawal, Ph.D., an engineer at Columbia University, have won a $5 million grant to develop a robotic device that will aid individuals with SCI further by helping them regain balance. The Tethered Pelvic Assist Device (TPAD) will provide stimulation and feedback to aid in the recovery of balance, and will be integrated with activity-based training and epidural stimulation research at UofL.

Harkema, Angeli and Rejc, faculty members in the Department of Neurological Surgery at UofL, are working with Agrawal, professor of mechanical engineering and of rehabilitation and regenerative medicine at Columbia Engineering, to develop TPAD. Agrawal specializes in the development of novel robotic devices and interfaces that help patients retrain their movements.

The project has won a five-year, $5 million grant from the New York State Spinal Cord Injury Board. The project also includes Joel Stein, chair of the Department of Rehabilitation and Regenerative Medicine, and Ferne Pomerantz, M.D., assistant professor in that department at Columbia University Medical Center.

TPAD is a wearable, light-weight cable-driven device that can be programmed to provide motion cues to the pelvis and corrective forces to stabilize it. It consists of a pelvic belt with multiple cables connected to motors, a real-time motion capture system, and a real-time controller to regulate the tensions in the cables. The UofL researchers will incorporate the device into the training of SCI patients during standing.

“Our stand and step training, combined with epidural stimulation, have shown success in enabling individuals with SCI regain the ability to stand. We hope the integration of the TPAD device will help these individuals with balance, further improving their functional ability and quality of life,” said Harkema, who also is Director of Research at Frazier Rehab Institute, part of KentuckyOne Health.

In their work with the Kentucky Spinal Cord Injury Research Center (KSCIRC), the UofL researchers have studied the effects of stand and step training along with epidural stimulation in adults with spinal cord injury. Epidural stimulation involves surgically implanting an electrode array over the lower spinal cord to activate the neural circuits.

October 24, 2016