For the millions of people worldwide suffering from some form of paralysis, the only mobility option remains the same as it did centuries ago - a wheelchair.
But in the US, engineers have developed a wearable robot which allows people with paralysis to stand and walk.
The battery-powered 'exoskeleton' uses a combination of motors, sensors and the patient’s own balance and body positioning.
Currently the device is used for research and rehabilitation and can only be worn with medical supervision, but engineers are now designing a model that can be used at home.
Reporter Dr Joff Lacey travels to San Francisco to meet Arash Bayatmakou as he uses the wearable robot to stand and walk for the first time since a fall left him paralysed.
By Arash Bayatmakou
On July 8, 2012 I fell from a third story apartment balcony, landed on my neck and shattered the C5 and C6 vertebrae in my spine causing major trauma to my spinal cord and instantly turning my world upside down. A couple of hours later, I woke up in a hospital bed, unable to feel or move most of my body and knowing full well that intense medications were the only thing numbing the excruciating pain coursing through my body.
After intense spinal surgery, fusing together four of my cervical vertebrae, I was told that I had suffered a severe Spinal Cord Injury (SCI) and would have a long road to recovery. While I could not see my legs or feet from where I lay, I knew they were there but that was little consolation when I quickly realised I had no motor control of my body from the chest down. Within a few days, I was assessed and told that since no one knew the potential or extent of recovery, I should prepare myself for the very real possibility of never being able to walk again.
I have been an athlete for as long as I can remember and always relished physical challenges. I spent most free moments outdoors: playing football, hiking, biking, backpacking in the mountains, floating with friends on a river, and sharing many incredible moments with amazing people around me. Just three days before this debilitating accident, I had completed one of the most memorable and physically satisfying experiences of my life: a 100km backpacking trip in the high altitude Eastern Sierra mountains of California with an incredible group of friends, filled with laughter, joy and an appreciation for life. To go from that experience to then spending seven straight weeks in the hospital was the most dramatic, contrasting experience of my life.
As horrific, awful, and challenging as this accident was, I was always an inherently positive person and I approached this recovery with the same ambition, perseverance and dedication that I had given to every significant experience in my life. No one had any answers about recovery from spinal cord injury, but that left many doors open for what was possible.
My therapy began just days after surgery, when I could barely sit up in bed or use any part of my body. The first few weeks in the hospital were difficult and surreal. I had to learn how to do the most basic movements. My hands were too weak to grasp a cup of water and I barely had the strength to feed myself with a plastic fork. I kept wondering, if I was not able to do these simple tasks, how was I ever going to get back on my feet?
Upon leaving the hospital and getting out of my neck brace, I decided to jump right into intensive therapy. I had been told that the first few months of rehab were the most crucial so I knew I could not waste any time. I also decided that in order to get the most out of my recovery, I would only surround myself with people who were supportive, positive and sincerely believed in my ability to recover. I worked for many hours a day, seven days a week, focusing fully on my rehabilitation.
A few months later, I started hearing about this local company, Ekso Bionics, and the incredible work they were doing for SCI rehab. “You get into this exo-skeleton, you stand up and you walk,” is how I had heard it described. This sounded too good to be true so I was eager to find out how I could get involved.
The first time I used Ekso, I was amazed. After more than an hour of standing and over 20 minutes of walking, I barely felt fatigued. In fact, if they had asked me to stand and walk in it all day, I would have happily accepted. To be able to stand, to look people at eye level, and, most importantly for me, to get out of my wheelchair was an indescribable feeling.
I was also impressed by the energy and excitement of all the people I met at Ekso. They were genuinely passionate and dedicated to their work and the impact it could have on so many people with injuries like mine, which meant that they fit my criteria for the positive people I wanted to work with in my recovery.
After getting to know the product and the people behind it, I can confidently say that I truly believe in what Ekso is doing and where they want to go. This product is a marvel of human engineering, designed precisely and carefully, and paving the way for people to realise their dreams of standing up and walking again.
For me, the ability to get back on my feet without the help of any devices continues to be the main driving force in my recovery. Retraining the brain and the spinal cord to relearn how to stand and walk and repair those damaged neural connections is not an easy task, but I still choose to work extremely hard everyday, doing a variety of different kinds of treatment, and I remain as determined and motivated as ever to conquer this injury and walk again.
Arash Bayatmakou blogs at http://arashrecovery.com
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