Advances in exoskeleton tech provide the gift of walking to paraplegic patients

© All rights reserved. Used courtesy of suitX.

The human gait cycle is something that most of us typically take for granted, but we couldn’t get around without it. The gait cycle refers to the ambulatory activity of walking or running which is achieved in bipedal creatures with the use of two legs that switch between a weight-bearing stance phase and a non-weight-bearing swing phase. All of this is a complicated way of saying that we humans get around by putting one foot in front of the other.

For the vast majority of us, walking or running is easily (if sometimes begrudgingly) accomplished, but that’s not the case for everyone. There are many out there suffering from a health condition which affects their normal gait, providing a major strain on a person’s independence and quality of life. Physical injuries from falls or neurological disorders such as Parkinson’s disease alike can cause gait disorders which limit a person’s full range of motion.

Here on IPWatchdog, we’ve revisited the world of bionic technologies time and again over the past few years to see how these medical technologies have been impacting lives for the better. We profiled IPOEF’s Inventor of the Year for 2014, Dr. Hugh Herr, whose bionic foot and calf system has helped those with lower limb amputations, including himself, regain mobility. U.S. defense research investments from the federal government have led to advances in upper limb bionics with enough dexterity to pick up a grape without crushing it. Bionic surgical implants have even shown the capability of restoring sight to the blind, although those technologies are still in a very nascent stage.

Now, powered exoskeletons, which can improve a person’s gait, are starting to gain traction as a new area of bionic development, which could potentially improve the lives of many. Recently, the California-based bionics firm suitX was selected as the winner of the $1 million top prize at the event for its pediatric medical exoskeleton at the 2016 UAE AI & Robotics Competition for Good. The company’s Phoenix exoskeleton is a modular unit which has a maximum weight of 27 pounds and is adjustable in size. The pediatric exoskeleton that won the award is based on the company’s Phoenix exoskeleton platform. The pediatric version of the Phoenix exoskeleton has been envisioned for helping children suffering from cerebral palsy or spina bifida to gain ambulatory mobility. See the video below, titled Walking Would Be Unbelievable.

The $1 million top prize from the UAE robotics competition will be used by suitX to continue development on its Phoenix robotic exoskeletons, which cost up to $40,000, a price tag, which suitX says is two to four times less expensive than competitive products.

The exoskeleton products developed by suitX are themselves based on about 20 years of research that has been performed at the University of California, Berkeley. As the winning entry at the UAE AI & Robotics Award for Good competition, suitX managed to top 663 other contestants who submitted technologies from all over the world. Other semi-finalists at the event included a brain-controlled electric wheelchair, a game that identifies dyslexia in children and a fully automated robotic kitchen.

Others are also involved in exoskeleton development, such as Ekso Bionics of Richmond, CA, which was initially spun off to Lockheed Martin (NYSE:LMT) for development as a military technology. Since then, however, the company has discovered applications for its products to help paraplegics and others with movement disabilities. Over the past decade, Ekso Bionics engineers have figured out how to reduce the energy requirements of its exoskeleton by three orders of magnitude, enabling the unit to be built without the cumbersome addition of large batteries or motors.

The Ekso GT exoskeleton is designed for functional-based rehabilitation from walking disorders when used under the supervision of a physical therapist in a clinical setting. The unit relies on the use of a software product known as Step Generator which provides gait patterning and step dosage tools in a way that progressively moves a patient towards proper gait patterns and biomechanical alignments. The exoskeleton unit provides a variety of walk modes, including FirstStep, in which a physical therapists operates buttons for actuating the exoskeleton to move a patient between sitting and standing; ActiveStep, where patients take control of the actuating buttons on their own walker or crutches; ProStep, where the Ekso GT recognizes lateral shifts to ensure that a patient is moving forward properly; and ProStep Plus, which further recognizes the initiation of forward leg movement for stepping forward.

The suitX team that was victorious in the robotics challenge. From left to right: Yara Najdi, Yoon Jeong, Michael McKinley (back), Dr. Homayoon Kazerooni, Brad Perry, Steve Sanchez. © All rights reserved. Used courtesy of suitX.

Tech companies are also developing exoskeleton technologies that have a range of applications for the military, and for disabled veterans. One such application of the Ekso GT has been to restore movement to soldiers who have suffered spinal injuries while in the service. At the Polytrauma Rehabilitation Center at McGuire VA Medical Center in Richmond, VA, one Marine who had fractured his seventh cervical vertebrae, which left him with little use of his arms and no leg mobility whatsoever, was able to take more than 250 steps down a hallway in his first time wearing the Ekso GT exoskeleton.

The use of exoskeletons to augment the activity of healthy soldiers has also been pursued thanks to research investments from the Defense Advanced Research Projects Agency (DARPA). Projects funded by DARPA at the Wyss Institute for Biologically Inspired Engineering at Harvard University have led to the creation of a military soldier exoskeleton product which was undergoing performance testing at the U.S. Army Research Laboratory as late as September 2015. The exoskeleton incorporates the use of a system of powered cables designed to mechanical assistance so that the wearer expends less muscle energy when transporting heavy loads over wide stretches of rugged terrain.

Back in the medical world, a recent decision by a U.S. medical review board has set a precedent which may result in much greater access to exoskeleton bionics as a walking aid. It was recently announced that a health insurance provider in the Pacific Northwest region of America was required to cover the cost of an exoskeleton product developed by the multinational tech firm ReWalk Robotics (NASDAQ:RWLK). The health plan provider in question at first wanted to deny coverage to a wheelchair-bound patient requesting coverage for the ReWalk device, which costs $69,500 and was the only FDA-approved exoskeleton option at that time. The independent medical review organization found that not only was there sufficient peer-reviewed medical literature on the exoskeleton to support the beneficial use of the ReWalk device, the ability for a patient to walk at modest speeds was cited as a medical necessity. This is one small, early step but we could be on the path towards a day when exoskeleton bionics are able to do away with wheelchairs entirely.