Walking again after spinal cord injury

How far are we from people with spinal cord injury walking again routinely?

Electrical stimulation of the spinal cord, and in one case a brain-spine interface, has helped people with paralysis stand and walk. The walking results come from very small groups: a 2018 Nature study of targeted spinal stimulation, and a 2023 Nature study of one participant with a brain-spine interface. A 2022 Nature Medicine study tested three people with complete paralysis and reported restored trunk and leg motor function. The non-invasive device ARC-EX is US-cleared for upper-limb function, not walking, and its 2024 Nature Medicine trial measured arm and hand function. No controlled trial of walking has been reported in the sources reviewed.

AI illustration · Illustrative scene, not a photograph of the specific device or experiment.
WHERE WE AREEngineering prototypes

Getting closer. Prototypes exist, but not in real-world use.

Walking has been shown in small groups of people using implanted or epidural stimulation, and a brain-spine interface has been shown in one person. A non-invasive device is cleared in the United States, but only for upper-limb (arm and hand) function. The sources reviewed show no controlled trial of walking and no routine use of these methods for walking outside research settings. The methods work in people, but they are not yet a reliable product for walking, so the stage is engineering prototype.

The tech tree

Everything recorded on Vrulum that this future needs, oldest foundations at the top and the goal at the bottom. Lines show what each step requires.

What it takes: Walking again after spinal cord injury Unlocked Being researched Locked
  1. 2018Spinal cord stimulation for paralysisPilot and early commercial Unlocked.
  2. 2019Brain-computer interfacesPilot and early commercial Unlocked.
  1. 2018Walking with spinal stimulation in a small group with chronic paralysisDone Unlocked.
  2. 2022Trunk and leg movement restored in three people with complete paralysisDone Unlocked.
  3. 2023Walking with a brain-spine interface in one personDone Unlocked.
  4. 2024US clearance for hand and arm functionDone Unlocked.
  5. Date not recordedControlled trial of non-invasive stimulation that measures walkingNot started Locked.
  6. Date not recordedWalking tested in larger groups with implanted systemsNot started Locked.
  1. GoalWalking again after spinal cord injuryGoalRequires: Spinal cord stimulation for paralysis, Brain-computer interfaces, Walking with spinal stimulation in a small group with chronic paralysis, Trunk and leg movement restored in three people with complete paralysis, Walking with a brain-spine interface in one person, Controlled trial of non-invasive stimulation that measures walking, US clearance for hand and arm function, Walking tested in larger groups with implanted systems. Locked.

The road so far

4 of 6 steps done.

  1. Done · 31 Oct 2018Walking with spinal stimulation in a small group with chronic paralysis

    A 2018 Nature study reported that targeted electrical stimulation of the spinal cord restored walking in people with chronic paralysis after spinal cord injury. The EPFL press release states that neurological function persisted after stimulation ended. [1][2]

  2. Done · 7 Feb 2022Trunk and leg movement restored in three people with complete paralysis

    A 2022 Nature Medicine study tested neurotechnology in three people with complete sensorimotor paralysis, within an ongoing clinical trial. The title reports that it rapidly restored trunk and leg motor functions. The sample is very small. [3]

  3. Done · 24 May 2023Walking with a brain-spine interface in one person

    A 2023 Nature study linked a brain signal decoder to a spinal implant in one participant with chronic tetraplegia. The participant reported that the system let him stand, walk and climb stairs. The CEA reports that the system has been tested in one person only. [4][5]

  4. Not startedControlled trial of non-invasive stimulation that measures walking

    The 2024 Nature Medicine trial of non-invasive spinal cord stimulation enrolled people with chronic tetraplegia. Its primary endpoints were safety and efficacy for arm and hand function. The abstract reports that 60 participants completed the protocol. The sources reviewed show no trial that measures walking with this device. [6]

  5. Done · Dec 2024US clearance for hand and arm function

    ARC-EX received FDA authorisation in December 2024 to improve hand strength and sensation in adults with incomplete spinal cord injury. A later FDA clearance, reported in a news article dated 17 November 2025, expanded home use to upper-limb deficits after spinal cord injury. The FDA decision record itself was not read, so these details rest on the news report. [7]

  6. Not startedWalking tested in larger groups with implanted systems

    Spinal stimulation and brain-spine interfaces for walking have so far been reported in very small groups. The sources reviewed show no larger study of walking outcomes with these systems, and no regulatory clearance for walking. [1][4]

Why it matters

Loss of walking after spinal cord injury affects independence, health and daily life. A method that restored walking reliably, outside specialist centres, would extend what rehabilitation and care can offer. The studies so far also show how much function can return through circuits that remain below an injury.

What stands in the way

  • Walking results so far come from very small groups, and the sources reviewed show no controlled trial that measures walking.
  • The implanted systems require surgery and specialist set-up, which limits where they can be used.
  • The one non-invasive device cleared in the United States covers upper-limb function, not walking.
  • Gains that persist with stimulation switched off have been reported in small groups, and have not been tested in larger groups.
  • Long-term safety and reliability of walking systems in everyday use are not yet shown in the sources reviewed.

Signals to watch

  • A controlled trial that measures walking, not only arm or hand function, with stimulation.
  • A brain-spine interface tested in more than one person.
  • A regulatory decision that adds walking or lower-limb use to a cleared indication.
  • Published long-term follow-up of walking outcomes in the same participants.

Sources

  1. peer reviewed paper
    Targeted neurotechnology restores walking in humans with spinal cord injury
    Fabien B. Wagner, Jean-Baptiste Mignardot, Camille G. Le Goff-Mignardot et al.. Nature, 31 Oct 2018.
  2. university press release
    Breakthrough in treating paralysis
    ScienceDaily (EPFL press release), 1 Nov 2018.
  3. peer reviewed paper
    Activity-dependent spinal cord neuromodulation rapidly restores trunk and leg motor functions after complete paralysis
    Andreas Rowald, Salif Komi, Robin Demesmaeker et al.. Nature Medicine, 7 Feb 2022.
  4. peer reviewed paper
    Walking naturally after spinal cord injury using a brain-spine interface
    Hugues Lorach, Alan Galvez, Valeria Spagnolo et al.. Nature, 24 May 2023.
  5. other
    Brain Computer Interface (BCI) enables thought-controlled walking after spinal cord injury
    CEA, 24 May 2023.
  6. peer reviewed paper
    Non-invasive spinal cord electrical stimulation for arm and hand function in chronic tetraplegia: a safety and efficacy trial
    C Moritz, EC Field-Fote, C Tefertiller et al.. Nature Medicine, 20 May 2024.
  7. news
    Onward secures FDA Clearance to expand home use of spinal cord system
    NR Times, 17 Nov 2025.

Last reviewed 21 Oct 2026.