Improved lower body exoskeletons are giving new abilities and hope to people with limited mobility. They are helping patients relearn how to walk and reeducating their nervous systems. Exoskeletons can help patients take more steps in physical therapy sessions than other methods. Exos have been improving and are more adjustable and sophisticated than they were just a few years ago. They are allowing people to move faster and in spaces that would have been inaccessible.
Lower body exoskeletons can be used for gait training, mobility, and exercise. They can help users improve their balance, conditioning, and neuromuscular cortical activity; reduce spasticity and pain; and improve their quality of life. Although many people say they have dramatically improved their mobility, exos have not been studied rigorously and are prohibitively expensive for many people.
ReWalk was the first exoskeleton to be approved by the Food and Drug Administration for sale to individuals. It can be used for gait training and personal mobility. ReWalk has sensors that monitor upper body motions and trigger stepping and gait patterns for walking and shifting from sitting to standing positions. Users can use their hands. ReWalk is recommended for T4 and lower injuries and can be used for 3.5 hours of walking on one battery charge.
The makers say people who use ReWalk have reported improvements in balance, core strength, bowel and bladder function, bone density, body composition, fitness, and sleep patterns and less pain, spasticity, hospitalizations, and need for medications. The company can work with purchasers to help them get reimbursement for ReWalk from their insurance companies.
The Ekso Bionics exoskeleton lets a user shift weight and activate footplate sensors to initiate steps. It has a variable assist mode, automatic mode, and manual mode. It can also be programmed to walk at a specific speed and stride length. Ekso adjusts depending on the user’s level of muscle control. It can also be adjusted for a person with different amounts of strength on each side of the body.
The Ekso is currently classified as a “Class II pending” medical device (medium safety risk) for functional-based rehabilitation, over-ground gait training, and upright weight-bearing exercise. It is intended to be used under the supervision of a physical therapist and can fit a wide range of users.
Parker-Hannifin is working on the Indego to help people relearn how to walk and to serve as a mobility assistive device for those who are fully or partially walking-impaired. It is intended to be used in conjunction with a wheelchair, not to replace it. The company intends for it to be used to help patients with spinal cord injuries, MS, strokes, and other neurological problems
A user can stand up and walk with the device compensating for muscle weakness. Mild vibrations and LED lights signal to the user when the Indego is about to initiate a step. It has a five-piece design with a back component, two upper leg pieces, and two lower leg pieces with integrated ankle-foot-orthoses. The pieces can be carried in a bag and are easy to put on and take off. Indego can support a person with level 3 spasticity.
These exciting innovations are giving new abilities and hope to people with limited mobility. We have been privileged to observe these devices being demonstrated at several Abilities Expos. It is heartwarming to see people move and walk who have been unable to for a long time. Their joy is obvious. As technology continues to advance and prices diminish, we hope that more people will be able to improve their mobility with these exoskeletons.