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Médiathena - AA (*) - 13/06/2019

Christine Azevedo, a researcher committed to the service of human beings, on the path to autonomy

At the head of the CAMIN project-team a joint-team between Inria and LIRMM, Christine Azevedo is developing electrostimulation solutions to enable patients with paralysis of one or more members to regain some of their mobility. Helping people walk, change their posture, and now grasp with the Agilis project, this training automation specialist explores all areas of disability where her contribution could lead to concrete gains in life comfort. Portrait of a researcher committed to the service of human beings.

At first, there was a hesitation. What to choose between life sciences, or medicine, and a career as an engineer? Christine Azevedo decided for the IUSPIM (now Polytech), in Marseille, a general engineering school, with a coloration in Automatics, the science of dynamic systems. In 1997, she did her final internship in an SME in charge of logistics for oil fields. She was recruited as quality manager. But after a short year, the conclusion was clear: the job didn’t suit her. "I wasn't done wanting to learn and I was too curious to be locked into something I found repetitive ."

Back to studies, therefore, for a master's degree in Automatics and Robotics at the Institut national polytechnique (INP) in Grenoble, obtained in 1999. For her research internship, she joined the BIP team, led by Bernard Espiau, which worked on the beginnings of bipedal robots. At the time, the estate had just taken a turn for the better: Honda has released the very first robot capable of walking and climbing stairs. Christine Azevedo stayed with Bernard Espiau for a thesis on the control of posture and walking in humanoid robotics.

From robot to man

From the beginning, what interested her in automation was the control and command of movements. How can we artificially reproduce, in the two-legged robot, the balanced human posture and allow robots to walk around? Christine Azevedo made the state of the art of what neuroscience knew about human motor control.

In the final year of her thesis, she met David Guiraud, who was involved in the European Stand Up And Walk project: the restoration of walking in patients with paraplegia by implanting an electrical stimulator in the pelvis connected to electrodes distributed over the leg muscles. This ass her first encounter with functional electrical stimulation. And a revelation. "I thought, but yes of course, that's what I want to do! Everything I do in robotics, everything that interests me, everything that I like, I want to apply to a disability issue .”

At that time, David Guiraud started to create the DEMAR (Walking and artificial movement) team at Inria in Montpellier and Christine Azevedo wanted to be part of it. To strengthen her knowledge of human physiology, she went for a post-doc on the management of human posture and locomotion to Marseilles. She stayed there for a year, after which she tried the entrance contest to Inria. If her application was well received, she lacked international experience. Time to go to Denmark, at the sensory-motor interaction centre of the University of Aalborg where she trained in functional electrical stimulation with leading names in the field of neuroprostheses, interfaces with the nervous system that activate the contraction of paralyzed muscles.

Develop practical solutions

In 2004, Christine Azevedo was recruited in the DEMAR team. She launched projects on assistance with sit-to-stand transfer, walking assistance for people with hemiplegia or Parkinson's disease and fitted into existing work with her contribution as an automation technician. Because in this field, everything is about teamwork. In addition to the multidisciplinary nature of the research skills mobilized (computer science, microelectronics, neurosciences, etc.), interactions with medical doctors and industrialists are fundamental. "We are trying to develop solutions that can one day become a reality for patients, so the clinical and industrial transfer stage is very important. Up to the patient, who becomes a full member of the team, who must adapt to his physiology, his rhythm, and is  nourished by his feedback. In this field, the human factor is the first, everything else must adapt ."

In 2016, the question arised as to the future of DEMAR. The team had made major technological development effort (stimulators, software...), for which a research team is not designed to support and enhance itself directly. It was decided to create a start-up, Neurinnov, to ensure technology transfer and heavy development related to the team's research work. David Guiraud and his colleague David Andreu dedicated themselves to it. Christine Azevedo took in charge the academic and scientific research part, and created a new research team following DEMAR, the CAMIN team (Artificial Control of Intuitive Movements and Neuroprotheses), joint team between Inria and the Montpellier Laboratory of Computer Science, Robotics and Microelectronics (LIRMM). The first official collaboration between the two structures is the Agilis project (see box below), a European project that ultimately aims to restore hand and wrist movements.

By getting involved in this field, Christine Azevedo wanted to participate in this effort to bring science and technology to people who could benefit directly from it. Passionate about her work, she does not yet consider herself having reached her goal, as her projects are still at the research stage. Her Grail? That results from her work become a practical solutions that can be used on a daily basis to improve the quality of life of people with disabilities.


The Agilis project in a few words

The Agilis project will test, on volunteer patients with tetraplegia, the stimulation of different nerve bundles involved in bending and extending the hand and wrist, using two implanted multi-contact electrodes. A previous project validated the selectivity of stimulation and the initiation of different types of movements in anesthetized patients during a tendon transfer operation. The Agilis project aims to demonstrate the functionality of the proposed system, including the recovery of a functional extension and flexion for grasping, and the thumb/hand clamp.

  • an 18-month European project supported by EIT Health ;
  • already five patients implanted;
  • thirty days of training and experience;
  • approximately 12% of people with spinal cord injury are eligible for the future AGILIS implant, i.e. around 550 people per year at European level;
  • partners: Inria, AP-HP, Hôpital la Châtaigneraie, Neurinnov and the University of Heidelberg.