Learn about exoskeletons
The powered robotic exoskeleton is an established technology which is used in the medical setting as a rehabilitation tool for various movement disorders, including spinal cord injury (SCI). Exoskeletons are devices comprising an external, powered, motorized orthosis that is placed over a person’s paralyzed or weakened limbs for the purpose of facilitating standing, walking, climbing stairs, and performing activities of daily living. Exoskeletons can allow patients with SCI both to rehabilitate in hospital settings, and / or ambulate in home and community settings.
As a rehabilitation equipment, this technology has been registered and adopted in many countries around the world, and has been shown in the medical literature to be safe to use. In the USA, powered exoskeletons are classified as class II medical devices by the US Food and Drug Administration.
Clinical benefit of exoskeleton use
The clinical benefit of exoskeleton use for chronic SCI patients include:
improved upper body muscular fitness
improved cardiovascular function
counteract the health risks associated with prolonged sitting, including joint contracture and pressure sore formation
reduced neuropathic pain
improve bowel movement regularity
Contraindications for use of any exoskeleton include severe spasticity, significant contractures, vasomotor instability, skin integrity issues where contacting the device, osteoporosis, and existing fractures.
Exoskeleton designer from UC Berkeley Dr. Yoon Jeong PhD visits MMRC to share technical advice with Mr. Terrence Kwong (SuitX Phoenix Exoskeleton).
Dr. Paul Koljonen visits the VA Palo Alto SCI center to observe US army veteran and SCI victim exercise using exoskeleton (ReWalk device).
Types of exoskeletons
Practically, medically used powered robotic exoskeletons can be broadly divided into two categories:
Therapeutic exoskeletons are designated for use in hospital / institutional settings, where a targeted training regimen is usually prescribed by the attending physician for rehabilitation of a specific neurological condition. Patients who are indicated to use this category of exoskeleton are generally those with potential for improvement in their neurological condition or gait pattern, and can benefit from the various therapeutic functions of these devices. Examples of this category of exoskeletons include the EksoGT (Eksobionics), Indego Therapy (Parker Hannifin Corp), and Rewalk Rehabilitation (Rewalk Robotics), and REX Rehab (REX Bionics).
Assistive exoskeletons are designed for personal use in home or community settings. Patients who are indicated to use this category of exoskeleton are typically chronic SCI patients who desire to increase their over-ground walking capacity, but are not expected to gain neurological recovery from the exercise. Due to safety reasons, patients and their carers are usually required to undergo a period of training, plus / minus certification, before they can use the device outside of an institution setting. Examples of this category include Indego Personal (Parker Hannifin Corp), Rewalk Personal (Rewalk Robotics), Suitx Phoenix (US Bionics), FreeWalk (FreeBionics Taiwan) and HAL (Cyberdyne).