Kessler Foundation has released preliminary research findings from its clinical study of the wearable robotic exoskeletal device, Ekso, made by Ekso Bionics. Ekso has been undergoing clinical investigation in patients with spinal cord injury at Kessler since October 2011, when the research team received the second commercial unit. Initial research results are promising for the potential application of Ekso-assisted walking in rehabilitation, exercise/wellness programs, the community, and for home use.
The research not only studies the mechanics of how people with paralysis stand and walk in Ekso, but also looks at the impact of these activities on their muscles, hearts, and lungs. Long-term studies are needed to evaluate the effects on common secondary complications such as cardiovascular disease, loss of bone and muscle, pressure ulcers, depression, chronic pain, and loss of bladder/bowel control.
Data was collected in 13 patients (12 with paraplegia and 1 with tetraplegia) with spinal cord injury (complete and incomplete injuries) enrolled in the Ekso study. Thus far, walking and standing with Ekso is feasible for people with a range of spinal cord disorders that cause paraplegia. Individuals with higher levels of spinal cord injury may also benefit, but require more time to learn Ekso-assisted walking.
Gait and balance data indicate positive results for individuals engaging in Ekso-assisted training sessions; walking speed and distance, fluidity, gait, and balance improve with training on the exoskeleton. Metabolic and cardiovascular responses were evidenced by increases in oxygen consumption, ventilation, and heart rate. These increases occurred with changes from resting to standing position, and increased further with changes from standing to walking.
Advances in engineering are enabling advances in Ekso research. Auto-control for greater flexibility and maximal independence is a new feature in the upgraded device being tested at Kessler Foundation. Data collection is now automated, which will aid the expansion of Ekso's capabilities in the future.
The upgrade adds important functions. Until now, walking in Ekso meant being accompanied by two physical therapists, one of whom triggered each step. Now individuals can gradually progress to independent walking in Ekso by advancing through three levels that enable progressively greater user control. Of interest to researchers is another new feature called EksoPulse, which collects usage data for each user and archives it on a secure cloud server, enabling documentation of individuals’ progress.
