products available, such as the ekso, which allows individuals with up to a c7 complete (or any level of incomplete) spinal injury to stand upright and make technologically assisted steps. the initial purpose for this technology is for functional based rehabilitation, but as the technology develops, so will its uses. functional electrical stimulation (fes) uses coordinated electric shocks to muscles to cause them to contract in a walking pattern. while it can strengthen muscles, a significant downside for the users of fes is that their muscles tire after a short time and distance. one research direction combines fes with exoskeletons to minimize the downsides of both technologies, supporting the person's joints and using the muscles to reduce the power needed from the machine, and thus its weight. a research team at the mckelvey school of engineering at washington university in st. louis, led by assistant professor of biomedical engineering ismael seáñez, is launching a clinical trial of electrical spinal cord stimulation for helping restore movement in movement-impaired or paralyzed patients. brain–computer interface recent research shows that combining brain–computer interface and functional electrical stimulation can restore voluntary control of paralyzed muscles. a study with monkeys showed that it is possible to directly use commands from the brain, bypassing the spinal cord and enable limited hand control and function. spinal cord implants spinal cord implants, such as e-dura implants, designed for implantation on the surface of the spinal cord, are being studied for paralysis following a spinal cord injury. e-dura implants are designed using methods of soft neurotechnology, in which electrodes and a microfluidic delivery system are distributed along the spinal implant. chemical stimulation of the spinal cord is administered through the microfluidic channel of the e-dura. the e-dura implants, unlike previous surface implants, closely mimic the physical properties of living tissue and can deliver electric impulses and pharmacological substances simultaneously. artificial dura mater was constructed through the utilization of pdms and gelatin hydrogel. the hydrogel simulates spinal tissue and a silicone membrane simulates the dura mater. these properties allow the e-dura implants to sustain long-term application to the spinal cord and brain without leading to inflammation, scar tissue buildup, and rejection normally caused by surface implants rubbing against nerve tissue. in 2018 two distinct research teams from minnesota's mayo clinic and kentucky's university of louisville managed to restore some mobility to patients suffering from paraplegia with an electronic spinal cord stimulator. the theory behind the new spinal cord stimulator is that in certain cases of spinal cord injury the spinal nerves between the brain and the legs are still alive, but just dormant. on 1 november 2018 a third distinct research team from the university of lausanne published similar results with a similar stimulation technique in the journal nature. in 2022, researchers demonstrated a spinal cord stimulator that enabled patients with spinal cord injury to walk again via epidural electrical stimulation (ees) with substantial neurorehabilitation-progress during the first day.