Month: April 2022

Every year, 55.9 million people suffer from an acquired brain injury (ABI), which is any injury to the brain that is not hereditary, congenital, degenerative, or induced by birth trauma. 15 million suffer from strokes, or cerebral vascular accident (CVA)—the fifth leading cause of death in the United States and a major cause of long-term disability.  A stroke results when part of their brain is deprived of oxygen caused by a blood clot blocking blood flow or by a rupture in the artery feeding blood to a part of the brain. Up to 500,000 people suffer from spinal cord injury (SCI), classified by decrease or complete loss of sensation and/or movement below the level of injury.

As a result, those with an ABI, CVA, or SCI may be left with limited mobility or some form of paralysis. This can be a devastating diagnosis that is completely life-changing for patients and their families.

Human robotic exoskeletons offer a new, promising approach to restoring mobility after such injuries. Health experiences including regained mobility, as well as improved oxygen intake, bowel and bladder function, joint maintenance, circulation, and easement of pain have been shown in patients using robotic exoskeletons. With the use of human robotic exoskeletons, patients who are working with physical therapists can regain basic movements or even develop the ability to walk again independently.

What are Exoskeletons?

Robotic exoskeletons are wearable devices made of mechanical and sometimes electrical technologies that are used to enhance the physical performance of the wearer or act as orthotic devices for gait rehabilitation or locomotion assistance. Depending on the purpose they serve, human robotic exoskeletons can be made from materials such as carbon fiber and metal, or they can be made entirely out of soft and elastic parts. Some exoskeletons need to be tailored to the individual that is using them and have adjustable hardware to fulfill that need. Overall, the technology behind the exoskeleton depends largely on its type and function.

Exoskeletons can be considered powered, using technology like sensors and actuators, or passive, using purely mechanical parts. The electronics with which powered exoskeletons are equipped register how much force is being applied to any given action, allowing the exoskeleton to share some of that burden with the user. Passive exoskeletons take the weight from the body’s extremities and distribute it to the core or leg muscles, spreading the weight out to relieve pressure from the targeted body part. This prevents fatigue from occurring as quickly and lowers the chances of strain or injury.

Groups That Benefit From Exoskeletons

Human robotic exoskeletons can be used for the purpose of health, industrial labor, and military research and development. For health, exoskeletons can be used to restore someone’s limb functionality and help them to walk again.

Instances of health-related applications for exoskeletons include stroke, spinal cord injury, acquired and traumatic brain injury, muscular dystrophy, cerebral palsy, orthopedic injury, Guillain barre, brachial plexus injuries, multiple sclerosis. These diagnoses can result in a range of impairments including monoplegia, hemiplegia, paraplegia, quadriplegia, ataxia, and other weaknesses. Benefits of exoskeletons used in the healthcare field include: increased user independence, decreased chronic pain, reduction of energy required for movement, increased range of motion and endurance, increased quality of life, and more.

Patients with lower extremity mobility loss can enlist the help of lower body exoskeletons to address gait inefficiencies by supporting the spine, trunk, and legs including hip, knee, and ankle joints. In this instance, the exoskeleton promotes correct movement patterns in all phases of physical rehabilitation and challenges patients as they progress towards walking back into their communities.

Patients with upper extremity mobility loss can wear upper-extremity exoskeletons designed to assist their affected shoulder and arm during rehabilitation, resulting in rehabilitation sessions with a higher dosage, more intense therapy, and a wider active range of motion. An exoskeleton can provide access to the shoulder joint and scapula to help therapists facilitate movement while the device supports the patient’s arm with minimal interference, allowing for a natural motion.

For patients with acquired brain injury and stroke, lower-extremity robotic exoskeletons are utilized by physical therapists to improve patients’ orientation to midline, weight shift, stepping quality, and lower extremity muscle strength. These exoskeletons utilize the principles of neuroplasticity to help physical therapists deliver high quality, intense, repetitive, task-specific practice to patients on their journey of reclaiming independence.

Patients with spinal cord injury exhibit a wide range of potential symptoms including: extreme pain in the neck, back, or head, urinary or bowel urgency, retention, or incontinence, abnormal band-like sensations in the thorax, impaired breathing, weakness or paralysis in upper and/or lower extremities. The use of a robotic exoskeleton can help to significantly alleviate these symptoms or, in some cases, eliminate them. The patient wears a backpack-like support which connects to robotic leg-support structures and attaches comfortably to the waist, hips, legs, and feet. This helps to support the body and protect joints during preGait and gait training.

Those who suffer from loss of mobility after a stroke or ABI can wear a robotic exoskeleton, which provides therapists the opportunity to retrain their muscles and brains to regain lost mobility. This has proven to be successful in helping thousands of patients leave their wheelchairs or walkers behind. The 2022 clinical trial (WISE), performed by The International Spinal Cord Society, focused on a 12-week exoskeleton-based robotic gait training regimen to track clinically meaningful improvement in independent gait speed among participants with chronic incomplete spinal cord injury (iSCI). The results showed that the proportion of change in the clinical ambulation category was highest among participants in the group using exoskeletons developed by Ekso Bionics. 5 of 9 participants in the “Ekso group” exhibited the greatest change in ambulation status. In comparison, only 3 of 10 within the Active Control group showed improvement in the ambulation category, and 0 of 6 in the Passive Control group displayed any meaningful change (between group difference in proportions p < 0.05, Table 5).

For the prevention of injury rather than recovery from it, those working in industrial settings such as construction and manufacturing benefit significantly from exoskeleton technology. For industrial application, exoskeletons are designed to increase productivity and reduce fatigue, with the goal of eliminating work-related injuries to the neck, shoulder, and back.

Types of Mobility Exoskeletons Target

Exoskeletons can target mobility nearly anywhere on your body—your ankles, knees, shoulders, and so on. They are generally divided into two segments: lower body and upper body.

Lower body exoskeletons are engineered for patients suffering from lower extremity paralysis or weakness and offer postural trunk support as well as support at the knee, hip, and ankle. In doing so, they may help the wearer regain their natural walking ability.

Upper body exoskeletons are designed to assist a patient’s affected shoulder or arm and have been a revolution in upper limb rehabilitation. Engineered for patients suffering from upper extremity paralysis or weakness, upper exoskeletons help patients recover strength, endurance, and range of motion.

7 Ways Exoskeletons Help Regain Mobility

1. Posture support

Posture has a significant impact on movement patterns and is directly correlated with a person’s ability to walk. A rigid component on the back of an exoskeleton offers support for patients with decreased trunk control. This helps them bear their own weight with proper postural alignment for maximized treatment time. Your posture is a central part of your body’s functionality, affecting the way both your upper body and lower body move, so this level of support is non-negotiable when it comes to regaining mobility.

2. Adaptive Gait Training

Sensors and software components of the exoskeleton continuously monitor and regulate leg movement. If a patient is leaning, the exoskeleton will automatically detect it and provide feedback that their physical therapist can use to help improve their balance and gait. The device and therapist work in conjunction to keep patients from compensating to avoid discomfort and achieve faster results.

3. Pre-ambulatory tools

It’s commonly known that balance plays a big role in maintaining successful mobility. If you’re struggling to keep your weight centered, walking is going to be a challenge to say the least. The pre-ambulatory tools are a suite of programs dedicated to helping patients balance, weight shift, squat, and step in place before walking. The squat function can also be used as an advanced feature to challenge patients in strengthening lower extremities.

4. Feedback

Resuming natural step length and swing symmetry is one of the most common goals in rehabilitation. Without proper symmetry, walking is possible. However, loss of symmetry would make walking difficult, could delay progress, and require an uncomfortable amount of effort to achieve movement. Real-time feedback helps patients regain proper step length and swing symmetry in hopes of restoring their ability to walk naturally and with ease.

5. Data

Regaining mobility shouldn’t be a guessing game. In order to make the necessary improvements for resuming natural mobility, a patient needs to be able to build on successes and correct any irregularities. Data tracking allows for this by showing session-specific walking time, distance, and speed in addition to symmetry, securely saved to a cloud-based dashboard for easier analytics. With smart data capture and clinician controls, medical professionals can evaluate patients and their training sessions in real-time to best help each individual on their road to recovery.

6. Assisted Motion

By providing the proper support, exoskeletons can boost the range of motion being used to regain mobility. For example, the Ekso Bionics upper-extremity exoskeleton offers assistance to the shoulder and arm on all planes. As a result, the patient can exercise 180 degrees of motion where they otherwise may not be able. It also allows for a more natural movement pattern by supporting the limbs with minimal interference.

7. Robotic Powered Movement

With powered exoskeletons, the robotic power itself can drive significant results in the process of regaining mobility. The bionic components can provide total support and trajectory assistance for patients with complete paralysis. Patient-initiated movements can be used to encourage muscle activity for those with remaining strength and the sensors will register that initiation and assist the patient in carrying out the movement – only as much as the patient requires.

Alternative Methods of Treatment Alongside Exoskeletons

Depending on the diagnosis that led to a loss of mobility, there are a number of different kinds of treatment approaches that your physical therapist may use in conjunction with the use of exoskeleton technology to aid in the rehabilitation process.

Individuals with loss in mobility due to disease or an injury sustained by the nervous system may need a physical therapist who specializes in neurology to evaluate and contribute to a full recovery.

Elderly patients, whose mobility is declining due to age, may benefit from geriatrics in addition to their exoskeleton treatment. Likewise, adolescents with inherited illnesses or injuries should supplement their exoskeleton treatment with physical therapists who specialize in pediatrics. There are also specialized therapists for sports-related injuries and women’s health.

Why Choose Ekso Bionics Exoskeletons?

Since 2005, Ekso Bionics has used exoskeleton technology to enhance natural abilities and improve quality of life. We are the leading exoskeleton company to offer technologies that help those with paralysis stand up and walk, enhance worker capabilities globally, and provide research for the advancement of R&D projects intended to benefit U.S. defense capabilities.

As the first exoskeleton FDA-cleared for acquired brain injury, stroke, and spinal cord injury, EksoNR offers the industry’s most natural gait, re-teaching the brain and muscles how to properly walk again.

Conclusion

If you or a loved one is suffering from imparied mobility after a stroke, brain injury, or spinal cord injury do not hesitate to get the best possible care. Consider the pros and cons of using human robotic  exoskeletons in the rehabilitation process and do your research to find out if they are right for you.

As one of the top trends in the health and tech industries today, human robotic exoskeletons are reshaping our approach to both medical treatment and industrial labor. On one hand, robotic exoskeletons are bringing hope to people across the world who are dealing with the loss of mobility and independence or suffering from paralysis after a stroke, brain injury, or spinal cord injury. On the other hand, they are enhancing worker capabilities beyond what was previously thought possible. Considering the nature of their advantages, it shouldn’t come as a surprise that they are also being used in military research and development.

What are Human Robotic Exoskeletons?

Human robotic exoskeletons are mechanically made, taking a user’s anatomy into consideration, to improve mobility and endurance. They involve the application of robotics and bio-mechatronics — a study of science that merges biology with “mechatronics”, a discipline at the crossroads of electronics, mechanics, and computing. The focus of this groundbreaking technology is to increase bodily independence and effectiveness. It is designed to assist humans by enhancing, reinforcing, or restoring, depending on the circumstances, an individual’s physical performance. Human robotic exoskeletons can also work to reduce the energy it takes to move joints, making repetitive tasks easier, and also work to improve human movement in cases of mobility loss.

The earliest work related to human robotic exoskeletons was much earlier than you might think. A Russian inventor named Nicholas Yagn had the first approved patent for a powered exoskeleton in 1890. It was a spring-operated device designed for the military with the intention of enhancing a user’s ability to run and jump, but it never made it past the drawing board.

It wasn’t until the 20th century that robotic exoskeletons were actually assembled. In 1960, General Electric created the Hardiman, or “Human Augmentation Research and Development Investigation” and “MANipulator”, a 1,500-pound machine produced with military funding. Unfortunately, the machine was too large and too heavy to operate properly and the project was discarded altogether.

Finally, around the year 2000 came BLEEX (Berkeley Lower Extremity Exoskeleton), a pair of robotic legs designed by engineers at UC Berkeley and funded by DARPA (Defense Advanced Research Project Agency) aimed at lessening the effort it takes to carry heavy loads over long stretches.

Today, robotic exoskeletons have become more prevalent and complex, with an array of functions and uses. Companies like Ekso Bionics have designed exoskeletons for the purpose of military research, assisting industrial labor, and aiding neurorehabilitation.

Components of Human Robotic Exoskeletons

Robotic exoskeletons made for humans may look different depending on the functions they serve. Exoskeletons can be made from materials such as carbon fiber, metal, and elastic. Their coverage also varies from the entire body, to lower or upper extremities, or to a specific body part like the shoulder, hip, or ankle. Some exoskeletons have adjustable hardware so they can be tailored to the individual that is using them. Overall, the technology behind the exoskeleton depends largely on its type and function.

There are two types of exoskeletons: powered and passive.

Powered exoskeletons are equipped with electronics that register how much force is being applied to any given action, allowing the exoskeleton to share some of that burden with the user. In order for the exoskeleton to work properly, there must be technologies to support the three modules: sense, decision, and execution. These technologies include sensors, actuators, mechanical structures, algorithms, and control strategies that gather necessary information for carrying out each action. It may sound complicated, but it’s actually fairly straightforward. There are three basic steps that accompany the three modules.

• The sense module is where the information gathering takes place. The exoskeleton records data from the user via the device sensors.
• Next, the decision module interprets that data and sorts it into the intended activities.
• Finally, the execution module provides the mechanical power to complete the task.

Examples of the lower-extremity powered exoskeleton at Ekso Bionics:

• Data capture

This feature allows the user to view session-specific walking time, distance, and speed. It also securely saves this information into a cloud-based dashboard for easier analytics.

• Clinician control:

This feature allows the clinician to set certain parameters they can use to help better assist their patient, ushc as training targets and step parameters.

• Smartassist software:

This feature allows the clinician to customize motor support  independently on each leg for various impairment levels, from full assistance to patient-initiated movement, in both swing and stance phases of walking.

• Adaptive gait training:

This feature consists of sensors and software continuously monitoring and regulating leg movement to minimize compensatory gait patterns.

• Pre-ambulatory tools:

The feature possesses a program suite called preGait that consists of programs that help patients balance, weight shift, squat, and step in place before walking.

To contrast with the lower-extremity exoskeleton, here are the features of the upper-extremity exoskeleton vest for construction at Ekso Bionics:

• Mobility Structure

The exoskeleton vest was built with a patented stacked-link structure that seamlessly follows the user’s arm and elbow through the full range of motion while providing proper joint alignment through repetitive movement.

• Extreme logistics positions

These positions include reaching directly overhead, across the body, or even into a back pocket for a phone — are unrestricted with this wearable exoskeleton.

• Adjustable, high-force actuators

These actuators are proven to be extremely durable with over a million cycles before requiring replacement.

• Customized Assistance Levels

The level of each device can be adjusted for the user and task by easily swapping out the set of compact gas springs. Different levels can even be selected for each arm independently depending on the task.

Passive exoskeletons are purely mechanical, providing support using pulleys, a spring balancer, and weights to counterbalance the workload. Passive systems generally take the weight off the user’s shoulders and arms and transfer it to their center of gravity so that the user obtains increased endurance during overhead tasks and other demanding work.

Exoskeleton technology not only helps the individual perform tasks that directly aid in increasing mobility, but also provides medical professionals with the information needed to offer treatment with a higher chance of success. For patients with a low likelihood of regaining their mobility, these machines can be a saving grace, in many cases enabling full rehabilitation.

Exoskeletons for Rehabilitation

Diseases or injuries that can be treated with physical therapy and a wearable exoskeleton include but are not limited to: stroke, spinal cord injury, traumatic brain injury, aneurysm, hypoxia/anoxia, ischemia, brain tumor, or any other acquired brain injury. For individuals recovering from these injuries, exoskeletons are great for rehabilitation and mobility restoration. Exoskeletons have the potential to bring these patients from lower limb disability and complete loss of movement all the way to the point of getting out of their wheelchairs, and learning to walk again. One study from 2015 found that, “The ability to restore gait for individuals with paraplegia has improved with progress in various powered exoskeletons and neuromuscular stimulation technologies. The powered exoskeletons are able to restore the stand up, sit down, and walking motions.” These human-augmenting devices are truly a rehab tool for physical therapists to challenge their patients, requiring active participation known to drive brain plasticity.

Exoskeletons for Upper Extremity Therapy

Upper-extremity rehabilitation exoskeletons assist physical therapists, occupational therapists, physiatrists, and doctors in clinically rehabilitating patients with upper-body weakness or paralysis. This new technology also greatly benefits industrial applications and other workplace settings or job sites. Wearable exoskeletons help workers complete tasks with full range of motion rather than giving in to fatigue, overuse, or repetitive movements.

An injury resulting in decrease of upper-body strength can come from any number of areas whether that be occupation risks, sport injury, or illness. An upper-body exoskeleton is a wearable vest that helps you perform everyday tasks and use your arms and shoulders without limitations. There are a few different reasons why someone may benefit from upper-extremity therapy and bionics. Some conditions EksoUE is beneficial for include: stroke, spinal cord injury, traumatic brain injury, muscular dystrophy, ataxia, orthopedic injury, Guillain barre, brain tumor, brachial plexus injuries, and other upper-extremity weakness or paralysis. Rehabilitative treatments may begin immediately post-injury or after any chance of reversing the damage through medical means has passed. These treatments are designed to strengthen weakened muscles, reteach parts of the brain to take over for the damaged areas, and help the patient adapt to a new way of doing things.

Exoskeletons for Lower Extremity Therapy

Exoskeletons for lower extremity therapy are appropriate for many people recovering from spinal cord injury, stroke, and brain injury at any stage of in-patient or outpatient rehabilitation, preferably as soon as possible after diagnosis. It can be helpful for patients to stand and take their first steps post-injury and retrain brain and muscle function as they learn to walk again. It can also help fine-tune walking skills and help improve patients’ gait as they learn to regulate their movements.

With this tool, patients have the opportunity to gain as many lost abilities as possible. The exoskeleton provides progressive levels of support so the clinician can reduce the assistance the system offers patients as they improve, and can even add resistance to one or both legs. Patients who use a wheelchair can use the exoskeleton to regain the ability to stand, retraining muscles to support body weight without strain. Therapists toggle between patient-initiated and therapist-initiated movement, tailoring rehabilitation to the patient.

Human Robotics for Industrial Labor

Industrial workers in construction or manufacturing benefit from a significantly lower likelihood of injury and increased quality of work by using exoskeletons to enhance their physical capabilities. Mechanical arms and vests help them lift heavy loads and perform repetitive tasks through an active range of motion so they can avoid giving in to fatigue and/or injury.

Why Choose Ekso Bionics for Human Robotic Exoskeletons?

Ekso Bionics is the leader in exoskeleton technology with the first FDA-cleared exoskeleton for both stroke and SCI in addition to acquired brain injury. With more than 175 conference presentations, chapters, and published articles, Ekso is the most widely-studied exoskeleton for rehabilitation, progressing patients far beyond what they would otherwise be able to accomplish. Our exoskeletons are backed by data from over 40 industry-leading research partners and help those with paralysis to stand up and walk, enhance worker capabilities globally, and provide research for the advancement of R&D projects intended to benefit U.S. defense capabilities.

Industries Ekso Bionics Specializes In

EksoHealth is the arm of Ekso Bionics that specializes in neurorehabilitation. We have helped thousands of patients with lower extremity disabilities take over 180 million Ekso-aided steps and have inspired an entirely new medical device industry. Similarly, we have helped many patients with upper extremity disabilities, allowing them to achieve rehab sessions with a higher dosage, more intense therapy, and a wider active range of motion.

EksoWorks is the arm of Ekso Bionics that specializes in our exoskeleton technology for industrial applications. Our EksoWorks upper-body lifting exoskeletons were designed to increase productivity and reduce fatigue, with the goal of eliminating work-related injuries to the neck, shoulder, and back.

Conclusion

Whether you’re looking to regain mobility, increase your capabilities on the job, or prevent injuries, human robotic exoskeletons are a reliable and technologically safe choice. We hope our exoskeletons provide you support and progress in rehabilitation and lower the number of worker-related injuries for years to come.