One of the most successful workshops of hashtag#RehabWeek2023 in Singapore was organized by Prof. Emilia Ambrosini from Politecnico di Milano, who also contributed a presentation from the FESLeg project, which was supported by INAIL, Istituto Nazionale Assicurazione contro gli Infortuni sul Lavoro. The topic was the advancement in the integration between robotics and Functional Electrical Stimulation (FES) in Rehabilitation Medicine. During the seminar, Dr. Franco Molteni*, Director of Villa Beretta Rehabilitation Research Innovation Institute (VBRRII), delivered a highly insightful speech on hybrid systems. Here are the main points.

✔ Recently developed knowledge on the possibility of modulating the interneuronal component within the spinal cord is opening up new therapeutic opportunities. Functional Electrical Stimulation (FES) is already an extremely important tool in rehabilitation, as it aims to generate movement by involving both the individual’s intention and the robot’s support. Nevertheless, we can also incorporate neuromodulation systems into our intervention.

✔ These systems do not directly stimulate muscle activity, but rather have the ability to re-modulate the system’s control. A first option is a non-invasive form of stimulation called Transcutaneous Spinal Cord Stimulation (tSCS). Another potential tool for the complex re-regulation of the entire system is Transcutaneous Auricular Vagus Nerve Stimulation (VNS).

✔ We all know that it is quite hard to find such a perfectly organized clinical activity that combines different technological devices. This is a strong reason for the engineering activity to be fully integrated with the clinical activity in order to translate research into innovation. Otherwise, new ideas will never transform into opportunities for care. Instead, research must always convert into innovation in clinical practice. Eventually, once we are able to utilize these complex systems to treat our patients, we will also obtain new knowledge on the Central Nervous System’s (CNS) ability to reorganize itself.

Dr. Franco Molteni, Clinical Director of VBRRII