Cybathlon: the bionic Olympics

Eight years ago Peter Gray, a keen 33-year-old amateur sportsman, was on holiday in the Dominican Republic. Diving into the warm waters off the island, he was knocked to the sea floor by a wave and dislocated his neck. The injuries rendered him tetraplegic. Yet despite being effectively trapped inside his own body as a result, Gray will this October be competing in an international Olympic-style event in Zurich, Switzerland.

The Cybathlon is a one-day championship for ‘racing pilots’ with disabilities who will use advanced assistive devices including robotic technologies in six different events. The brainchild of Professor Robert Riener, head of the department of health sciences and technology at the Federal Institute of Technology (ETH) in Zurich, it will also serve as a platform for developing and benchmarking novel assistive technologies that can be incorporated into the daily life of people with motor disabilities, as well as help to increase the awareness and uptake of bionics.

Professor Riener is an expert in sensory-motor systems, rehabilitation engineering and robotics; he works and researches in rehabilitation robotics and assistive technologies such as powered exoskeletons and brain-computer-interfaces (BCIs).

The Cybathlon sees teams from all over the world taking part. These range from small independent outfits such as Peter Gray’s ‘Team Gray Matter’ – which will compete in the BCI race – led by Dr Rolando Grave de Peralta Menendez, a leading neuroscientist and bio-medical engineer at HUG (Hospitals University of Geneva), to larger teams such as Team Imperial from Imperial College, London, which will take part in four events and is made up of leaders in neurotechnology and human robotics, industrial partners, students and a group of pilots lead by Dr Aldo Faisal, senior lecturer in neurotechnology.

Professor Riener says he was inspired to organise the event after “I read about a guy in January 2013 using a powered knee prosthesis from a research lab in Chicago to walk up the Willis Tower in Chicago. This inspired me to organise a similar event in Zurich, but I wanted our event to be more competitive, allowing several pilots to race against each other in several disciplines.

“In April 2014 I filmed the first trailer for the event, which attracted worldwide media interest, and in July 2015 we organised a rehearsal with about 30 teams in the Kolping Arena, Zurich, where the actual Cybathlon will take place later this year.”

Why is there a need for an event such as the Cybathlon? “Through my rehabilitation research work with patients I have seen how unsatisfactory current assistive technology is,” says Riener. “Wheelchairs are still not manoeuvrable enough or are too bulky to get along outside and inside buildings. Leg prostheses are not powered, so people have problems climbing stairs or walking uphill, and arm prostheses are often not even accepted and used by people with amputations.”

The rules and regulations of the Cybathlon are detailed and precise, with the ‘rulebook’ for the event running to over 60 pages.

A ‘team’ will consist of at least one technology provider and one pilot. The technology provider will usually be the developer of the device, although in exceptional cases, when the pilot develops and brings their own technology, the provider and pilot can be the same person.

Levelling the field

In the inclusion criteria for each discipline the minimum requested level of the pilots’ disability is carefully defined, although pilots who have more severe handicaps can be included after being ‘vetted’ by the organising committee to ensure that they are not at too great a disadvantage.

The technical devices used in the event may be commercially available, with competitors permitted to modify them to optimise functions, or they may be completely new products in the form of prototypes or research devices.

Peter Gray of Team Gray Matter is the pilot on an independent, non-profit team – one of just a few of their kind at the games. The team will be using a bespoke electroencephalography (EEG)-based BCI model and software. A computer program has been written by Dr Peralta de Menendez working in conjunction with experts from Sheffield University and Sheffield Robotics that will allow Gray’s brain signals to be collected and relayed as commands in order to interact with the computer game that the organisers have created for the BCI Race. This will be relayed to big screens for the audience in the arena to watch.

Pilots in the Cybathlon BCI race have complete or severely affected incomplete loss of motor function (that is, paralysis) at the neck level due to spinal cord injury (SCI), stroke, neurological disease or another lesion. Most teams will use electro-encephalography (EEG) to detect brain signals. However, other methods such as near-infrared spectroscopy are allowed.

In the race, pilots will use BCIs to control avatars through a specially developed computer game. Pilots have to send the appropriate signals at the right time in order to jump over obstacles or accelerate.Incorrect signals will lead to slowing or crashing. This simulates the control of assistive devices that are currently being developed for future use.

“My training for the Cybathlon started in 2015 and it has been intense and challenging,” says Gray. “It was all completely new to me at first – I’d never worn a BCI cap before and the whole process of trying to differentiate my thoughts so the equipment could pick up the strongest and most diverse of them as electronic signals was quite abstract.”

Gray Matter team leader Ivan Nixon says: “In the ‘real’ world BCI is being used in the form of both external and implanted technologies to control everything from robotics to prosthetics. There are already off-the-shelf BCI devices which consumers can use to pilot tech such as drones, and with competitions like Cybathlon promoting and exposing BCI as a way to control games, the potential is very exciting.

“There are definitely still some major barriers to overcome, but the increased focus on the area has helped it become a much more viable assistive technology for paralysed and disabled users. A lot of the available EEG-based BCI devices are still very much medical-grade and can be very expensive, but with companies like Emotiv offering simple five-channel devices for less than £250, the tech is becoming far more accessible,” Nixon adds.

The events

The hard work and innovation that have characterised Team Gray Matter’s approach to the Cybathlon are typical of all the teams that have entered, although the events themselves are very different.

Take, for example, the functional electrical stimulation (FES) bike race. FES is a technique that allows paralysed muscles to move again. By placing electrodes on the skin, a current can be applied to the muscles, making them contract. Thus a pilot with spinal cord injury (SCI), with nerves from the brain to the leg muscles that are no longer effective, can use an intelligent control device to initiate a movement such as pedalling the kind of cycling device that will be used in the FES race.

Teams need to develop effective muscle stimulation patterns that do not exhaust the pilot’s muscle fibres too quickly. At the same time, the pilot needs to train muscle power and stamina in the same way as any able-bodied athlete.

In each FES bike race, two pilots start simultaneously on a circular race track in the arena in a pursuit formation. For this event, French team FreeWheels have designed a bike which uses a wireless electrical stimulator in combination with force and position sensors to adapt stimulation patterns for effective and efficient pedalling by the pilot, Jérôme Parent.

The team comprises researchers, engineers and clinicians from Montpellier (INRIA-LIRMM), Grenoble (INRIA) and Dijon (CRF DIVIO) working jointly with Team Empowering Mobility and Autonomy (Team EMA) from Brazil in order to integrate research and clinical experience into new FES-cycling modalities.

For the powered exoskeleton race, Florida Institute for Human and Machine Cognitions (IHMC) has designed an exoskeleton on the back of its established ‘Grasshopper’ exercise machine, a wearable robotic device designed in association with Nasa to address muscle and bone density loss for astronauts spending extended periods of time in zero-gravity.

IHMC’s Cybathlon exoskeleton features a new actuator design and has powered ankles for faster and more stable walking. The foot plates have integrated pressure sensors to measure how and where the pilot’s weight is on each foot. This will allow the pilot and control system to know when balance is about to be lost so that either one can then make the correct adjustment to prevent this.

Possibly of more immediate relevance to disabled people will be devices developed for the powered arm and powered leg prosthesis races. In recent years, the field of prosthetics has seen solutions that are not only mechanical but can produce power, communicate with the user, are less heavy and more comfortable – all prerequisites for use in everyday life.

Roboticists and doctors from the Swiss/Italian Team Le Mano have come together to develop a bionic hand that provides sensory feedback in real time, meaning that an amputee can be given back the ability to feel and modify grip like someone with a ‘real’ hand. Using a combination of surgically implanted electrodes (connected at one end to the nervous system and at the other end to sensors) and an algorithm to convert signals, the team has produced a hand that sends information back to the brain that is so detailed that the wearer can even tell the hardness of objects they are holding.

In each of the Cybathlon powered arm prosthesis races, four pilots will compete on four parallel tracks including a series of six tasks, some of which must be mastered using the prosthetic device only. These include everyday chores such as preparing breakfast and carrying everyday objects such as parcels and balls over courses that mimic an ordinary household environment. The pilot who successfully completes the most tasks in the least time wins.

This link to the everyday world and everyday tasks is an essential element of the Cybathlon. As Professor Riener says: “We want to help remove barriers between people with disabilities, the device developers and the general public. This means that we need developers and researchers to better look at the patient’s needs when developing assistive technologies. We wish to show what technologies are possible, but even more importantly, we want to show that there are limitations in most advanced technologies. I expect that some pilots will fail with some tasks, because the devices are still not functional and satisfactory enough.

“In short, we want to move people and technology forward. In the long run, we are planning to organise various Cybathlon-related events, roadshows, school projects and associated competitions.”

Tickets are still available for the Cybathlon on 8 October, so why not head along to Zurich to see what could literally be a life-changing series of events?