Researchers have developed a noninvasive, computer-mediated spinal stimulation system that allows individuals with chronic spinal cord injury and paraplegia to regain volitional control of stepping movements. These findings highlight a promising approach for gait rehabilitation without surgery. The study was published online in Brain on November 26, 2025.
Spinal cord injury (SCI) rostral to the lumbar locomotor center disrupts communication between the brain and the spinal circuits that control leg movements, leading to paraplegia. A research team led by Dr. Yukio Nishimura of the Tokyo Metropolitan Institute of Medical Science, in collaboration with Dr. Toshiki Tazoe and colleagues, has now demonstrated a novel noninvasive closed-loop spinal stimulation paradigm that restores stepping control in humans with paraplegia.
The system records electrical activity from hand muscles and converts these signals into trigger pulses for magnetic stimulation delivered to the lumbar spinal cord. By performing rhythmic hand grips, participants with SCI were able to initiate and terminate bilateral leg stepping, and also control step length and cadence.
Ten individuals with chronic SCI participated in the study. Repeated application of the closed-loop stimulation led to progressive improvements:
This noninvasive approach bypasses the lesion site and strengthens preserved spinal and descending circuits, thereby enabling recovery of bilateral stepping control. Because the technique does not require surgery, it represents a safe and promising alternative for patients with contraindications to invasive procedures.
This research was conducted as a special study to advance Tokyo Metropolitan Government policies, supported by the Japan Science and Technology Agency (Sakigake), the Ministry of Education, Culture, Sports, Science and Technology's Grant-in-Aid for Scientific Research (JSPS KAKENHI), and the Wings for Life Spinal Cord Research Foundation.
