London, United Kingdom – A bionic suit sounds like something out of a 1970s science fiction blockbuster.
But the movies have come to life for users of an innovative wearable robot that is allowing even people who are totally paralysed below the waist to walk again.
The innovative Ekso bionic suit could offer millions of patients with some form of paralysis new freedom from their wheelchairs, which have been linked to numerous physical and psychological side effects. The wearable robot works by using sensors to detect upper and lower body movements to control the machine and walk forward.
It offers exciting new rehab options for a huge number of patients with lower body weakness and paralysis, ranging from devastating lower body injuries to simple old age.
For Arash Bayatmakou, the bionic suit could be the key to learning to walk again, after he was paralysed from the waist down in an accident last summer. A broad smile spreads across the 30-year-old’s face as he stands up to take his first, wobbly steps supported by the device.
“I can get used to this thing – my body just wants to walk,” he said.
Watching proudly alongside, his mother Minoo Moallem commented: “I am really excited to see him in this position because Arash used to be very athletic – running, biking, motorcycling, everything.”
Currently, only a few dozen of the robotic exoskeletons are in use at medically supervised rehab centres. But a home version of the robot could be for sale within two years – at a cost far lower than the $110,000 hospital price tag.
Its creators at Ekso Bionics in the US state of California say it could ultimately replace the wheelchair in many everyday situations.
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“I think you are going to see a lot of people walking in future with an exoskeleton device,” predicted Nathan Harding, the co-founder and CEO of Ekso Bionics in California.
“In the long run, there’s nothing about the machine that should make it cost more than, say, a high-end motorcycle.”
Harding believes that robotic exoskeletons could be about to move into the mainstream, as prices go down and doctors and patients become more aware of the possibilities they offer.
“Hopefully, it is going to come to a point where you don’t really know who is paralysed,” he said.
“They might just be a person who is just trying to get some extra walking time and may just have an injury problem, or they could be a paraplegic, but hopefully you won’t be able to really tell.”
The potential for a breakthrough in working with mobility problems is huge, and developments in medical technology have offered relatively few innovations for patients.
Bayatmakou, who has been wheelchair-bound since his accident, described his spinal cord injuries as “incredibly devastating”.
“It affects everything from physical strength to when you need to go use the restroom – and not being able to look at people at eye level, constantly having to look up,” he said.
Many wheelchair users are unhappy with the stigma and social disconnect of being at a different height from others. Equally, rehab exercises for the lower body have often been painful and discouraging for patients, as they usually require patients to support their full body weight on their upper arms.
The Ekso aims to deal with all of these problems.
State of the art
Originally developed from a project with the US military to help soldiers carry huge amounts of weight, the bionic suit was later adapted at the suggestion of doctors to offer rehab and support to patients with lower body weakness and paralysis.
Some 40 technicians helped to develop the prototype, who grappled with technical challenges including working out how to recreate natural, human-like steps, and ensure the machine did not stumble.
The robotics company also ended up calling in the services of an artist who specialises in leather work to help create the leg straps, which had to be meticulously designed to avoid causing pressure sores.
The finished product looks something like a deconstructed wheelchair that has pulled itself up onto two spindly legs, while a sign on the back warns bystanders: “Stand clear – Ekso may start moving at any time.”
Leg straps replace the support the knee muscles would normally give, allowing users to stand with their full weight on their legs and feet.
Meanwhile, numerous sensors measure the user’s posture and movements to detect when they place their hips over their front foot – a position that humans naturally take when they are about to take a step forward. The Ekso will then take the step for them.
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By learning how to move their weight, users can control the machine even if they are completely paralysed below the waist. And by allowing them to stand on their own two feet and take control of their balance and steps, the Ekso offers an invaluable rehab tool for patients looking to regain or strengthen the use of their legs after an accident.
Bayatmakou, who has used the Ekso once a week for about a month, said it was “pretty effortless” to walk using the robot.
He predicted it be could be a “hugely beneficial” part of recovery, as well as a replacement for the wheelchair in many everyday situations in the future.
“What they have done with the Ekso is pretty brilliantly inventive,” he said. “People don’t think how many things go into walking.”
The bionic suit is already being used to treat numerous mobility problems, from relatively simple lower body weakness to paralysis caused by spinal cord injuries or neurological problems, including multiple sclerosis and Guillain-Barre syndrome.
It can also offer audio training for users, and collect and store data on how patients are walking to monitor their progress.
A newer “variable assist” software upgrade has also been created, which is specially designed to offer rehab for stroke patients, who are often weaker down one side of the body and need more help lifting one leg than the other.
Even for patients who are permanently paralysed, the Ekso could offer psychological benefits in being able to stand and walk.
Researchers at Ekso Bionics are also collecting data to show that the device may be able to help medical problems associated with sitting down in a wheelchair for long periods of time, including pressure sores and urinary infections.
Harding said he believes robotic exoskeletons could become as common as wheelchairs over time.
“The future is going to get really exciting just in the bionic space in general,” he said.
“I think you’re going to see someone come into an airplane in an Ekso skeleton and sit down in an economy seat. And you’re going to see grandma in the mall and she’s going to show off her hip new Ekso pants. And you know she’s going to be able to take a walk with her grandkids.
“It’s not far. That’s what’s really exciting – that it’s not science fiction any more.”
Follow Sonia Elks on Twitter: @SoniaElks