Video Overview of the ReStore Exo-Suit
The ReStore Exo-Suit for stroke rehabilitation is introduced, explained and demonstrated in this highlighted clip from Episode 01 of Topics of NeuroRehabilitation.
This week’s Topics in NeuroRehabilitation highlight is an oldie-but-goodie! In a throwback to our very first episode, Jill Butler and I introduce the ReStore Exo-Suit and highlight a couple of patient videos to demonstrate how clinics around the world are seeing the ways that ReStore can help improve to patients’ walking stability, speed, independence, and intensity during gait training sessions with ReStore.
Watch the full Episode 01 of Topics in NeuroRehabilitation here.
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KOD: And our second product is called the ReStore Soft Exo-Suit, which, as we mentioned earlier, was launched in the summer of 2019. Essentially what it is, is a fabric based exo-suit. So it’s not going to give you the structural kind of mass that a rigid exoskeleton would. It’s fabric based and it’s designed for in-clinic rehabilitation for people with hemiparesis or hemiplegia due to stroke.
So it uses these cables which run down the leg and they actually provide on-demand mechanical assistance to lift the patient’s leg during plantarflexion and dorsiflexion. And it does so in synchronized timing with the patient’s gait cycle. So the way that works, it looks almost like a marionette, so you have cables which run down the patient’s leg and they attach to two points, they attach on a sleeve on the patient’s calf, as well as an insole inside the patient’s shoe. And when those cables start to pull in synchronized timing with the gait cycle, they’re going to help to lift the heel up in plantarflexion during paretic propulsion. But then they’re also going to pull on the forefoot to lift the forefoot up in dorsiflexion during ground clearance and heel strike.
And this ability to deliver targeted assistance, particularly in the propulsion phase of the gait cycle, is one of the things that is really unique and exciting about ReStore, because it gives us a new tool to train coordination and timing of plantarflexion in a way that we really haven’t been able to do before. And just to show you a couple of videos of what this looks like on patients, we’re going to pull up a couple of ideas here. And Jill, if you want to talk through this one-
JB: Sure, so the woman that we’re seeing here, she is at an inpatient facility right now, status post-stroke. It is about her third session with the ReStore. And we see her here with the device on, but it is in what we call Slack Mode, which is just what it sounds like in that it is providing her no assistance whatsoever. So this is essentially her baseline walking right now. You can see a lot of trouble with her foot placement for her initial contact. There’s really no heel strike happening there, A a lot of medial-lateral instability.
What we’re going to see here as we switch on the device. So now we’re in Assist Mode. The device is going to be helping to lift her toes and her heel. OK, what that’s going to do for us there is going to improve the ankle stability and the confidence for that foot placement, confidence for the patient and for the therapist, we’re going to see the level of assist that’s needed is going to minimize by a lot you’ll see in a minute here and just improved overall independence with the gait quality you’ll see the speed definitely increases because of this newfound confidence as well, able to navigate some changes there in terrain, as we can see there, all those little things that we take for granted- through the doorway, all that type of stuff. Able to do with this device on after just a few visits training.
And then this gentleman here. So this first video that we’ll look at is his baseline. So in this video here, we’re looking at him. He is clearly not getting much of a push-off, OK? That’s the main thing we want to focus here. He is letting that leg get into terminal stance a bit. It is getting behind him. But he is essentially just powering that leg up and through, not using any propulsive force on that left side. As a result, the therapists have had a hard time getting his intensity level up to where they want it to be. You can see he’s on cardiac monitoring there. This gentleman is in-patient as well, if I didn’t say that. And so they’re just they’re sort of just cruising along pretty slowly here. He’s having a hard time also with his initial contact angle.
So the next video that we’ll see in the next slide here is going to be the same gentleman, same session. And this is his very first time utilizing the ReStore, actually. So in Assist Mode we see not only the obvious heel strike angle improvement there and just consistency. That’s something that we consistently see is improved consistency with the foot positioning for patients, which just helps them to increase their confidence, their stepping cadence immediately. So his motor control, his timing is improved and something that we also love to see was also he was able to get his intensity levels up because his speed was able to increase. So his heart rate was able to get up into a safe training zone where he was able to hopefully make some neuroplastic changes just right there within that session.
KOD: Thanks for watching. This has been a highlighted clip
from ReWalk’s Topics in NeuroRehabilitation web series.
To watch the full episode, Please visit the ReWalk Robotics YouTube page or follow the link in the comments below. Take care!