2.7. Exoskeleton Systems
1. ReWalk Robotics recently (June, 2014) announced that the U.S. Food and Drug Administration has cleared the company's ReWalk Personal System for use at home and in the community. ReWalk is a wearable robotic exoskeleton that provides powered hip and knee motion. ReWalk is now available throughout the United States. For more information, please visit the following links:
SEE ReWalk video in our VIDEO RESOURCE ROOM on the related page below
2. e-LEGS exoskeleton, originally developed by Berkeley Bionics, is now known, formally, as Ekso Bionics. The device is now being offered at 12 rehabilitation centers within the US. The system is adjustable and can fit most people who weigh less than 220 pounds and stand between 5'2" and 6'4". The device provides "unprecedented knee flexion," and it's also fairly quiet in operation; under ideal circumstances, speeds of up to 2MPH can be attained. The system is being studied for use with patients with different levels of spinal cord injury, however it is being offered to persons with paraplegia.
3. REX exoskeleton-produced in New Zeland, $150,000 approximate cost but not yet approved for individual sale in the US as yet.
With state-of-the-art, highly engineered systems some 29 on-board computer processors control movement and balance through joystick control allowing the Rex user to direct the device to sit, stand, walk and turn with consummate ease. These robotic legs can even walk up steps, up or down slopes. Rex has been designed with maximum comfort and stability.Rex does not require any additional supportive aids such as crutches. The device is self supporting allowing you to keep your arms and hands free to use.
Also see the Engadget article with video in our VIDEO RESOURCE ROOM
Innovation for Parker.
Parker has formalized an agreement with Shepherd Center to support the commercialization of Parker's exoskeleton device Indego®, which is planned for release in 2015.
Indego® allows users to stand and walk, and holds great promise for affording people with paraplegia a new level of independence.
Indego® weighs just 27 pounds and snaps apart into three pieces for maximum convenience. The device is small enough to accommodate low profile wheelchairs.
Indego® provides a modular design that can be assembled and dis-assembled for ease of use and transportation. This device is small and light, with a slim profile and no bulky backpack components or footplates.
A proprietary control interface allows for smooth operation that works in harmony with natural human movement and body position
"One of the most obvious benefits of a robotic exoskeleton is that it allows paraplegics to walk again since they have lost the brain function to do so. As a result, being able to walk again can be a huge stress relief for both the individual and their families. According to the Christopher and Dana Reeve Foundation, individuals who are paralyzed are two to three times as likely to develop depression as the non-disabled. The highest risk of suicide occurs between the first five years of a paralysis diagnosis. Caregiver depression is also a common illness that can arise from the stress of taking care of a paraplegic (2012).
The emotional benefits that paraplegics feel by using this device are one of the biggest advantages. In the TED video called "Eythor bender demos human exoskeletons", it shows Amanda Boxtel who has been a paraplegic for almost twenty years from the result of a skiing accident and is now a national speaker and founder of an organization for disabled athletes. Ekso Bionics asked her to be the first person to try out their device in 2010. She could not believe how easy the device was to use and how it created the feeling of freedom she had not felt in such a long time (2011). She also quoted, "Using Ekso was the most powerful psychological and emotional experience for me” (Ramachandran, 2011). This sense of freedom could help many individuals living with paralysis who rely on the help of family and friends to do tasks they once could do alone. Another paraplegic emotionally benefiting from exoskeletons is Brian Shaffer, who was paralyzed in 2010. He has been testing the exoskeleton for Vanderbilt University. He hopes the exoskeleton will allow him to be closer to his family. He believes, "there are some situations, like walking your daughter down the aisle at her wedding or sitting in the bleachers watching your son play football, where it will be priceless” (Kurzweil, 2012). Though these are only two specific examples of lucky individuals who were allowed to test the new exoskeletons, just imagine the other six million people living with paralysis who could experience those same benefits of this technology. Picking up his or her kids for a hug, walking the dog, walking upstairs, and many other every day activities could be done with family and friends if paraplegics had their own personal exoskeleton. Argo Medical Technology states that personal benefits of their exoskeleton include, "addressing people at eye level, engage in conversations more directly and even the ability to hug standing up" (ReWalk, 2012). These are all emotional connections that many people take for granted. Paraplegics are missing these crucial human emotional connections by being confined to their wheel chairs.
Individuals living with paralysis have major obstacles to overcome. Because being bipedal is a human instinct, the human body is not equipped to be stationary for long periods of time. These individuals are at risk of developing "serious problems with their urinary, respiratory, cardiovascular and digestive systems, as well as getting osteoporosis, pressure sores, blood clots, and other afflictions associated with lack of mobility" (Salisbury, 2012). One of the main advantages of the exoskeleton apart from emotional health is the physical benefits it provides. Some of these physical benefits include increased bone density, decrease in body fat percentage, improved cardiovascular, bowel, and bladder function, and improved sitting posture (ReWalk, 2012). In a U.S. Medicine article called, "Robotic exoskeletons allow paralyzed veterans to exercise, reduce sedentary effects", doctors found that users of the Ekso exoskeleton had improved metabolic and cardiovascular function after a session with the exoskeleton. In addition, lower leg muscle function seemed to improve in the patients. Doctors seem to agree that even a small amount of exercise for paraplegics can offset the dangers of constant immobility that the wheelchair causes (U.S. Medicine, 2012). Amanda Boxtel not only felt the emotional impacts of using the exoskeleton, but the physical benefits as well. She said that her bladder function increased and she saw her ankles becoming stronger as a result. Boxtel believes that the exoskeleton will take a while for people to become comfortable, but after a few uses it will begin to feel like a natural part of the body (Svoboda, 2012).
In these two major advantages, the winners of this technology are the paraplegics who will benefit from the exoskeleton, along with the family and friends who will enjoy that their loved one is making a solid recovery. Since the exoskeleton is very expensive, those that have adequate insurance coverage or have the money to purchase one will be able to benefit. Both companies are working towards a solution to get their technologies in the market so that those who need an exoskeleton will be able to purchase one with the help of insurance companies (Ramachandran, 2012). Individuals who fit the height requirement of 5'2'' - 6'4'', weigh less than 220 lbs., and have upper body mobility will also be able to use the device (Emmer, 2012). Since the evidence from the two advantages shows that the exoskeleton promotes both emotional and physical benefits, this will help many paraplegics and their families cope with the obstacles and struggles of living with this condition.
Both Ekso Bionics and Argo Medical Technology have been working towards perfecting their exoskeletons so that they can create a market for private purchase. The main advantage of this is that these companies will benefit from the sales of their devices. Furthermore, creating a market will cause competition which will drive prices down. In addition, a profitable market will create jobs. Ekso Bionics CEO Eythor Bender believes that the medical use for the exoskeleton is just the beginning. He envisions exoskeletons being worn by construction workers, minors, and many other industrial workers for difficult tasks. He calls this the "REI Ekso" which will be a superhuman suit for strength and endurance (Greenwald, 2012). The biggest obstacle the company faces is getting the technology approved by the medical industry. Right now, both Ekso and ReWalk face competition which is a good thing for the economy. Other companies have created their own version of the exoskeleton such as Rex Bionics in New Zealand and Vanderbilt University’s exoskeleton (Greenwald, 2012).
Right now, the exoskeletons are being sold to hospitals and rehabilitation centers. Tests are still being conducted on a variety of patients to observe the benefits of this technology. The companies are currently making $100,000 off of one exoskeleton. ReWalk is being sold individually in the European market. If one exoskeleton could sell for $10,000 dollars in the open market, one could imagine how much money can be generated by selling millions of these devices. Bender hopes for a "Model T" effect for the production of exoskeletons. In the 1920's, Henry Ford mass produced the first vehicle which broke open the entire car industry. Bender believes that this effect could happen for the exoskeleton technology (Greenwald, 2012). As a result, the main advantage would be a profitable market in the U.S. economy. Since the world is constantly globalizing, it is important for American companies to be the leaders of innovation by taking advantage of these new technologies before other countries have a chance. Aside from the users of the exoskeletons that will benefit from this technology, the companies that have invested time and money into its development will reap the rewards and be a different set of winners. In addition, the physical therapists, engineers, scientists, and other categories of employees will profit from the employment with these companies.
Christopher and Dana Reeve Foundation. (2012).
Retrieved from http://www.christopherreeve.org/site/c.mtKZKgMWKwG/b.5184189/k.5587/Paralysis_F acts__Figures.htm
Emmer, G. (2011). Exoskeleton .
Retrieved from http://www.exoskeleton-suit.com/index.html
Greenwald, T. (2012, March). Ekso's exoskeletons let paraplegics walk, will anyone actually wear one?.
Retrieved from http://www.fastcompany.com/1822791/eksos-exoskeletons- let-paraplegics-walk-will-anyone-actually-wear-one
Kurzweil. (2012, November). Advanced exoskeleton promises more independence for people with paraplegia.
Retrieved from http://www.kurzweilai.net/advanced-exoskeleton- promises-more-independence-for-people-with-paraplegia
Ramachandran, P. (2011). From science fiction to reality: Exoskeletons.
Retrieved from http://rewalk.com/
Salisbury, D. (2012, October). Advanced exoskeleton promises more independence for people with paraplegia.
Retrieved from http://news.vanderbilt.edu/2012/10/exoskeleton/
Svoboda, E. (2012). Watch Me Walk. Saturday Evening Post, 284(2), 20-25.
TED. (2011). Eythor bender demos human exoskeletons. [Web Video].
U.S. Medicine. (2012, October). Robotic exoskeletons allow paralyzed veterans to exercise, reduce sedentary effects.
Retrieved from http://www.usmedicine.com/articles/robotic- exoskeletons-allow-paralyzed-veterans-to-exercise-reduce-sedentary-effects-.html