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Sometimes things that lead to a major breakthrough are just before our eyes — only overlooked. This appears to be the gist of the story of two Singaporean men, paralyzed from the chest down, who regained motor ability in their legs following a therapy developed by trialled by National Neuroscience Institute, Tan Tock Seng Hospital and the Agency for Science, Technology and Research in Singapore this year.

The novelty of the approach was not in coming up with another technological solution — which might be costly and not scalable — but rather relying on what is already in use, focusing instead on the holistic approach to rehabilitation, following a spinal implant surgery.

As reported by the Straits Times, three participants were chosen for the trial, dubbed Restores, two men and a woman (currently waiting for her surgery scheduled for January 2024).

A former jockey, Mr Sam Subian, thrown off his horse during training in 2017, and financial adviser, Mr Asyraf Ghazali, who suffered spine injury in a car accident 5 years ago, have now been able to move their legs and walk several meters using a support frame — something they both were told was unlikely ever to happen again.

Two years of progress in six months

This progress has been achieved in just a few months of rehabilitation following the spinal implant surgery in early 2023.

The implant acts as a booster of signals directed from the brain to the legs, relying partly on those neurological connections that still exist. The rest is down to a carefully planned rehabilitation process and lots of hard work.

The results have so far surpassed expectations:

“One programme in Texas, in the United States, carried out conventional rehabilitation twice a day for 1.5 years to 2.5 years to achieve what we did in six months.”

Wan Kai Rui, National Neuroscience Institute Singapore

The program consists of both physical and mental exercises, with patients first placed into robotic exoskeletons, supporting them during early attempts to walk on their own, while they visualize the walking motion, sending the right signals to the legs they lost feeling in.

“With mind over matter, the patients could eventually move parts of their legs that they could not before.”

Valerie Ng, consultant for the trial

Hope for thousands

With about 100 new cases of spinal cord injury per year, the results certainly bring hope to thousands of paralyzed Singaporeans (and millions of people abroad, waiting for a breakthrough that could one day restore their walking ability).

“The first day after the surgery I could move my toe. I felt happy and curious. I was asking myself: am I the one moving it?”

Sam Subian, trial patient

The therapy is a first in the region and one of a few in the world, achieving significant progress more quickly than other comparable projects, while using existing implants, what can open up opportunities for similar trials and perhaps even more widespread adoption in other countries as well.

While patients still require great effort and are currently only able to cover just meters using an individual supporting frame, it is already a huge improvement over complete reliance on a wheelchair.

The coming months and years will show us how far they can progress in their return to normal mobility.

“My goal now is to be able to put my wheelchair into the back of my car by myself.”

Asyraf Ghazali, trial patient

“The goal that I want to achieve is to stand on my own, without the frame.”

Sam Subian, trial patient

May their wishes be fulfilled in the coming 2024.

Featured Image: HayDmitriy / depositphotos

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