Some people living with spinal muscular atrophy (SMA) have never been able to stand on their own.
SMA is a genetic disorder that causes the nerves that connect the brain and muscles to deteriorate over time, making it challenging or even impossible for those affected to contract their muscles. Over time, their muscles shrink through lack of use.
Depending on the severity, this condition can confine individuals to a wheelchair or leave them bedridden. It can also make eating and even breathing difficult, sometimes fatally so.
But a new tool has shown it can help SMA patients rebuild their strength. After just a few weeks of engaging with a video game, six children in China could stand up from a chair for the first time.
The children, aged six to 10, volunteered for a study that involved strapping a robot to their knees. The robot, weighing less than 1kg (nearly 2lbs), did not help them to move – instead, it resisted them. When they kicked, the robot made it a little harder.
This forced their muscles and nerves to work together, building muscle mass and strength.
The research was jointly conducted by Beihang University and Peking University Third Hospital in Beijing, and the Massachusetts Institute of Technology. Their findings were published in Nature on May 20.
“Their parents also feel immensely happy about their achievements, and their optimistic spirit deeply moves us,” Feng Yanggang, the study’s corresponding author and professor at Beihang University’s school of mechanical engineering and automation, said last week.
“We will subsequently promote this device to a larger SMA population, including international patients.”
He added that since the publication of the Nature article, the research team had received many requests for help from patients overseas.
Existing treatments can slow the progression of the disease but cannot reverse it.
Unlike traditional rehabilitation robots that provide support, Feng’s team has taken the opposite approach – using resistance to help children with SMA rebuild their motor function.
Support could actually hinder muscle development for SMA patients, Feng said in the paper. “For these users, resistive, rather than assistive, wearable robots may be more suitable for fostering progressive neuromuscular growth over time,” he said.
For their study, the research team recruited children with SMA who were previously unable to stand unassisted.
While wearing the robot, the children played a video game that involved kicking a ball on the screen by stretching their legs.
During the exercise, the device applied variable resistance to increase the difficulty of the movement. This resistance was not uniform; rather, it increased in line with the force of the children’s kicks.
After 30 training sessions over six weeks, the children’s ability to move their legs had improved significantly. The size of their quadriceps – four large muscles at the front of the thigh – increased by 19 per cent and the muscles’ strength increased by 130 per cent.
Upon completing the training, all the children were able to stand up from a sitting position without help.
“One parent even stated that this was the most effective rehabilitation therapy their child had ever received,” Feng told US-based website Medscape Medical News last month.
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