Initial kick-off: Walk Again Project starts testing stage with Brazilian patients

15/01/2014 - 12:52
This month, they will learn how to interact with a virtual environment, an essential stage before using the exoskeleton, which should arrive in Brazil in February. The project, which will enable a paraplegic person to take the first kick-off at the World Cup, is on schedule

By using an exoskeleton, a paraplegic person is going to get up from their wheelchair, walk around 25 metres on the pitch at the Corinthians Arena in São Paulo, on 12 June, and take the first kick-off of the 2014 FIFA World Cup. There will be almost 70 thousand people at the stadium. In fact, billions of TV viewers will be able to follow what could become one of the biggest achievements in Brazilian and world science.

The dream of dozens of scientists from the Walk Again Project is closer to becoming a reality. Five months away from the World Cup opening match, the project is on schedule and tests, essential to ensure that everything works out at the first game, have started this month.

Eight paraplegic patients were selected from the Association for Assistance to Disabled Children (AACC) in São Paulo, where a new neurorobotics laboratory was set up. “They are conducting the basic tests and in the next few days, they'll start interacting with a virtual environment and a static robot vest, which allows them to walk without moving. The vest is completely controlled. We can measure the patient’s reaction, how he/she is going, fine tuning each patient's data before the exoskeleton arrives in Brazil, which should happen in February”, explained the project coordinator, Brazilian neuroscientist Miguel Nicolelis.

Our goal is to develop new technologies that may significantly re-establish the motor control of patients who have suffered from spinal cord injuries or other neurological disorders that lead to a severe grade of paralysis”, explains Nicolelis.

Photo: Facebook/Miguel Nicolelis#Concocted by Mikguel Nicolelis, the Walk Again Project has the essential participation of the Edmond and Lily Safra International Neuroscience Institute, based in Natal, as well as AACD’s partnership. In fact, it is an international non-profit consortium. There are scientists from Duke University in North Carolina (United States), where Nicolelis lectures, in addition to universities from the American states of Colorado, Kentucky and California, as well as European institutions in Munich (Germany), Lausanne (Switzerland) and Paris (France).  The project is supported by the Brazilian Innovation Agency (FINEP), which has provided resources in the order of R$ 33 million.

“We don’t have to innovate like other countries innovate. We can use our own strategy for developing a biomedical industry, or a science that has an impact on society. If everything works out as we've planned, it will be a milestone for Brazilian science. It's a completely new way of showing people who would never have contact with scientific news, that science is everywhere, that science is part of our life. It’s going to be like putting man on the moon. I like to use this metaphor because we're going to achieve a level of boldness and innovation, that those abroad are not used to associating with Brazil" stated the Brazilian scientist.


In order for patients to walk again, they will have the aid of a robot vest - the so-called exoskeleton. The device has already been developed and is undergoing final safety, control and stability tests in France.

According to Nicolelis, the exoskeleton uses the most modern robotics related technology in the world, which allows for real time interaction between the brain and robotic circuits. The patient will be able to control the exoskeleton with his/her brain activity only. The messages sent by the brain, such as the wish to walk, move or stop, will be captured by the robot so that the movements may be generated. The exoskeleton will also provide patients with sensations from the outside world.

The basis for this is the Brain-Machine-Brain Interface concept. First, the sensors are able to read the electrical signals generated by the brain and extract messages from them that produce movement, making the robot or virtual device move also. In the second stage, tactile sensors connected to the device will send signals to the patient.

“When the person touches the ground, when the robot vest’s knee moves, the tactile sensors will allow the signals generated by the robot to be returned to the subject through a t-shirt that transmits these signals back to the skin on their arms or back, where the person can still feel", said Nicolelis.

The t-shirt was developed at the Federal Polytechnic School in Lausanne Switzerland. Afghan scientist Solaiman Shokur, one of the researchers working on the project, is currently part of the team at the Neuroscience Institute in Natal. According to him, tactile feedback will allow the patient to walk without having to constantly look down.

 “We don't want someone wearing the exoskeleton and looking down all the time. The t-shirt has small sensors that vibrate and give feedback to the patient, transmitting them tactile sensations. They won’t have to look down to see where they are treading on. They will believe not only in what they see, but they'll feel the tactile feedback", explained Shokur.

Photo: Danilo Borges/World Cup Portal#


While the final tests are being done on the exoskeleton in France, before putting the device on, AACD patients will start training the robot vest's brain control. They will use a virtual environment developed in Natal for this, which was reproduced in the laboratory set up in São Paulo.

“Think of a flight simulator. If you’ve got a pilot and you want to teach him how to fly, you can’t put it on a plane and say ‘fly’. You need to teach him first – and the best way to do this is using a simulator, using a real enough simulation so that they learn all flight related aspects. Then you put them on a plane. We think the same way in relation to the exoskeleton”, stated Shokur.

In the virtual environment tests, patients wear a static robot vest and see an avatar of themselves moving in front of them. “They’ll get tactile feedback on the avatar’s steps wearing this vest, allowing them to feel what happens with the avatar when they're in contact with the ground in areas of their body where there is still feeling. And these feet are synchronised with the robot vest's feet. In this virtual environment, they can also use their brain signals to control the avatar’s movement. All of this prepares them for the next step, which is putting the exoskeleton on”, added Nicolelis.


The first kick-off at the World Cup will be an important demonstration and a milestone for the Walking Again Project, but the team is unanimous when they emphasise that it is not the end.

“Our intention is to keep the whole team, continue working with the Brazilian government and our partners, to reach the final goal, which is to develop a vest strong enough to be used by patients with spinal cord injuries. Not just paraplegic patients, but also quadriplegic patients, with more severe injuries, with most of their bodies paralysed. What we want is to use the opening of the World Cup to show the world that we're getting close to it", said Nicolelis.

The neuroscientist explained that the demonstration on 12 June will be restricted to some of the technology’s limitations.  “It is a very peculiar demonstration, with a number of risk factors: it will be outdoors, with 70 thousand people in the stadium, television signals from the whole world and mobile phones. Therefore, we have opted for a more conservative technique, using superficial sensors on the scalp, which are non-invasive. They capture global brain waves and the signals are transmitted to the exoskeleton to control the different movements generated by it", he added.

According to Nicolelis, microchips have been developed, which in the future, may be placed superficially on the patient’s brain, through a quick surgery, similar to the procedure carried out to put in a pacemaker.

Next steps

Between the months of February - when the exoskeleton is in Brazil - and May, the challenge for the patients will be to learn how to use the exoskeleton, controlling it naturally and safely.

“Our theory is that it takes some time for these complex tools to be incorporated by our brain, as if they were an extension of our body, before it feels natural. And we have some months to make the patients feel that the exoskeleton is literally their body. We need to give them time to interact with the exoskeleton. And then, one day, a patient will come into the lab and say: ‘it feels like my body’. It will suddenly click because the brain will have made this transition", said Nicolelis.

The number of AACD patients involved in the project should grow from eight to ten. Three will be chosen for the demonstration: one in the starting line-up and two 'substitutes'. They will carry with them the expectations of several scientists and of 25 million people who want to walk again, in addition to the opportunity of showing the world Brazil's science innovation capability.

» Researchers of the Walk Again Project share their expectations in relation to the World Cup’s first kick-off

Carol Delmazo – World Cup Portal


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