Wearable robot can help patients walk again

October 2, 2012 by Jay Price

A team of physical therapists strapped the robot onto him, one hit a button and with a faint electronic whir, David Ayscue was suddenly 6 feet tall again.

Then Ayscue took a step, and a different future came just a little bit closer for him and millions of others who can't walk on their own.

"I guess this is how a baby feels taking its first steps," he said. "I can't describe it. It's just overwhelming."

Ayscue, 56, was learning how to use a new called an Ekso. The state Department of Transportation maintenance worker suffered a spinal cord injury on the job while cutting up a dead tree two and a half years ago.

The device that he was wearing is an outgrowth of Pentagon-sponsored research into to help soldiers carry heavy loads. The civilian model was developed to help people who use wheelchairs to stand and walk again.

WakeMed's is the first in the Carolinas and one of just 16 in the country to get the device since it went on the market in February, said Eythor Bender, CEO of Ekso , based near San Francisco.

For now, the Ekso is an aid for physical therapy clinics with the help of therapists trained in its use, but the company is working on a sleeker, cheaper model for home use, which it hopes to begin selling in two years.

WakeMed began using the device this week. Initially the hospital is using it on patients with who can't walk on their own, but it plans to eventually use it on other kinds of cases, such as .

Elsewhere, the device is already used for patients with other health problems, including multiple sclerosis, amyotrophic lateral sclerosis (Lou Gehrig's Disease) and traumatic brain injuries.

For patients who spend significant amounts of time in wheelchairs, being able to spend at least a little time in the device regularly is likely to offer improvements in a host of functions, such as circulation, respiration and digestion, said Cathy Smith, director of outpatient rehabilitation at WakeMed.

It may help those with partial spinal cord injuries regain some function more easily.

Harder to quantify are intangible benefits, such as what it means for someone who has been in a wheelchair for decades to simply to be able to stand, walk around and look people in the eye again.

The Ekso looks like a kind of mechanized, computerized combination of a backpack and leg braces. Patients wear it with straps below the knees, on the thighs, around the stomach and over the shoulders. Plates under each foot are attached to motors and lift up. More than two dozen sensors feed information into the Ekso's computer, which uses it to decide how and when to step.

Patients must have at least some upper body strength to use Ekso because they must use a walker or crutches when wearing the device to ensure their balance. For the current model, they also must be lighter than 220 pounds and between 5 feet 2 inches and 6 feet 2 inches in height.

The device has three modes. In the most advanced, fully automatic mode, the device takes a step when the patient shifts his weight to the side and leans forward.

They have to work up to that, though. In the most basic mode, therapists talk the patient through the proper motions, and one of them uses a hand - held remote control to trigger each step. In an intermediate mode, the patient triggers each step via a button on one crutch.

Ayscue was still in the first mode Thursday, and all the patients using it will be for a while as they and the WakeMed therapists learn how to use it.

Eventually he will transition to trigger his own steps with buttons on one crutch.

The batteries last about three hours, but can be quickly swapped out for fresh ones.

The Ekso is designed to carry its entire weight, about 45 pounds, but the patient's weight goes through the patient's own legs, something the company believes will help fight the loss of bone density, a common problem for those who spend significant time in wheelchairs.

About 350 patients nationwide have used the device so far, said Bender, the company CEO. So far, there have been no falls. But using it in a controlled environment with trained experts just inches away is much different from using it at home.

A home model will be more elaborate in its function, but lighter, slimmer, and have a look that's more low-key, he said.

"We have to design a system that's comfortable enough and appealing enough that's it's something you would be proud to wear," he said. "There could be more than one model, and eventually it could become like when we choose our pants in the morning, the jeans of the future."

That first "personal unit" also will need to have fall-prevention features. Also, cost and who pays are key issues. The current model costs $140,000, with a $10,000 annual service contract, Bender said.

The company is trying to reduce the cost and working with several rehab hospitals on research into the health benefits of getting people back on their feet and walking each day. If the various health benefits can be quantified, he said, the device could become a reasonable thing for insurance companies to cover.

The long-term potential that the Ekso suggests is limited by little more than the speed of improvements and imagination, Bender said.

"Maybe devices could help arthritis suffers with their mobility, or help people like you and me do something outrageous like climb Mount Kilimanjaro," he said.

The potential market is huge, with nearly 70 million people worldwide who need wheelchairs, many in a position to benefit from assisted walking.

The company has a couple of competitors, Bender said, but it expects more. "It's just too obvious," he said. "Just look at all the unbelievable developments we have seen for amputees.

"Now it's time for people with neurological problems - their time is now and this is just the beginning."

As Ayscue was being strapped into the Ekso he quipped that he felt like astronaut John Glenn. And WakeMed's CEO, Bill Atkinson, who had joined a small crowd of other hospital employees marveled at what he was seeing.

"A lifetime of changes in health care and rarely does it walk right in front of you," Atkinson said. "For these patients, this is like the first steps on the moon."

After a few dozen steps, the motors overheated and Ayscue had to pause and sit until they cooled.

Company technicians said the problem was that Ayscue still has limited muscle function and his own muscles were fighting the machine, which has been programmed to take relatively slow, short steps until he's adept enough to go faster.

New software is on the way that will allow them to dial down the assist from the robot so it can more easily accommodate patients with at least limited function. For now, he needs to dial down himself. If he can.

"The motion just feels so natural, I guess in my mind I think I can walk just like I used to," he said. "That's the deal with the machine. I need to get used to it so that we can work together."

Explore further: Preliminary research findings released for Ekso robotic exoskeleton in spinal cord injury

shares

Related Stories

Preliminary research findings released for Ekso robotic exoskeleton in spinal cord injury

September 5, 2012
Kessler Foundation has released preliminary research findings from its clinical study of the wearable robotic exoskeletal device, Ekso (Ekso Bionics). Gail Forrest, PhD, assistant director of Human Performance and Engineering ...

Upgraded Ekso to advance study of mobility in spinal cord injury

August 14, 2012
Kessler Foundation has begun testing the upgraded Ekso in individuals unable to walk due to spinal cord injury. Ekso, a wearable, battery-powered robotic exoskeletal device, has been undergoing clinical investigation at Kessler ...

Robot legs helping stroke patients

September 26, 2011
(Medical Xpress) -- When it comes to recovering from a stroke, one of the major goals or rehabilitation is learning how to walk again. Researchers in the Netherlands are working with a prototype device called the LOwer Extremity ...

Recommended for you

Across Asia, liver cancer is linked to herbal remedies: study

October 18, 2017
Researchers have uncovered widespread evidence of a link between traditional Chinese herbal remedies and liver cancer across Asia, a study said Wednesday.

Eating better throughout adult years improves physical fitness in old age, suggests study

October 18, 2017
People who have a healthier diet throughout their adult lives are more likely to be stronger and fitter in older age than those who don't, according to a new study led by the University of Southampton.

Global calcium consumption appears low, especially in Asia

October 18, 2017
Daily calcium intake among adults appears to vary quite widely around the world in distinct regional patterns, according to a new systematic review of research data ahead of World Osteoporosis Day on Friday, Oct. 20.

New study: Nearly half of US medical care comes from emergency rooms

October 17, 2017
Nearly half of all US medical care is delivered by emergency departments, according to a new study by researchers at the University of Maryland School of Medicine (UMSOM). And in recent years, the percentage of care delivered ...

Experts devise plan to slash unnecessary medical testing

October 17, 2017
Researchers at top hospitals in the U.S. and Canada have developed an ambitious plan to eliminate unnecessary medical testing, with the goal of reducing medical bills while improving patient outcomes, safety and satisfaction.

No evidence that widely marketed technique to treat leaky bladder/prolapse works

October 16, 2017
There is no scientific evidence that a workout widely marketed to manage the symptoms of a leaky bladder and/or womb prolapse actually works, conclude experts in an editorial published online in the British Journal of Sports ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.