Brain-computer interfaces, which can allow people with disabilities to control sophisticated artificial limbs, attract enormous attention. Yet a far more common and vitally important mobility technology — the wheelchair — suffers from comparative neglect, even though improvements could help many more people in the near term.
Dr. Boninger — the UPMC endowed vice chair for research in the Department of Physical Medicine & Rehabilitation at the University of Pittsburgh School of the Health and Rehabilitation Sciences — was the latest speaker in the ongoing Research and Innovation Lecture Series, hosted by Vice Provost of Research, Innovation and Entrepreneurship Mo Dehghani.
Dr. Boninger discussed the remarkable results UPMC has achieved in brain-computer interface studies. Patients manipulating robotic arms and hands via brain implants have been able to achieve seven to 10 degrees of freedom control, allowing them to rotate, flex, grasp, extend and perform other other complex movements. And yet, as promising as this work is, it is still not available to patients outside of the lab.
“Do you know how many people I’ve helped with the brain-computer interface work?” he said. “None.”
Dr. Boninger said researchers must make sure they don’t neglect practical advances that can help people today. The wheelchair, for example, is perhaps the most important technology clinicians can offer to a person with mobility impairment. But there has been relatively little work done on the biomechanics of pushing a wheelchair and its effects on conditions such as repetitive-strain injury and shoulder impairments.
In part this is because of lack of interest in an established technology, but it’s also because patients are reluctant to participate in wheelchair studies; many believe they will walk again or they are enthralled by the promise of brain-computer interfaces.
There has to be a “balancing act,” Dr. Boninger said, so that both kinds of assistive technologies continue to advance.
Dr. Boninger holds joint appointments in the departments of bioengineering and rehabilitation science and technology and the McGowan Institute of Regenerative Medicine. He is senior medical director for post-acute care for the health services division of UPMC and vice president for medical affairs for community provider services. He is also a physician researcher for the United States Department of Veterans Affairs.