Robotic help; Hope for the paralyzed
MARLBORO — Gene Laureano rolls his wheelchair next to an upholstered office chair holding a device that looks like a combination back and leg brace, and with one thrust of his arms transfers his body out of the wheelchair and into the contraption.
A 51-year-old who served in the Army and has been paralyzed from about the waist down since 2001, Mr. Laureano straps himself into the device with Velcro flaps and lifts his feet into white sneakers attached to the leg braces.
With a battery tucked into a backpack and a wristwatch-like control device strapped around his left wrist, he fits his arms into crutches and, with a whirring sound emanating from the devices, stands up to his full 6-foot-3-inch height.
“You get to see the tallness, the height,” said his wife of 32 years, Maria, looking on in the offices of Argo Medical Technologies Inc., developer of the device. “I’d forgotten all that.”
The robotic exoskeleton, known as ReWalk, and other wearable machines like it are in the works in academic and corporate laboratories around the world, spurred on by technological advances and supported by research that shows the benefits of getting people with temporary or permanent paralysis up and walking.
University of California researchers have created technology for bionic suits that are being developed with defense contractor Lockheed Martin Corp. to help soldiers carry heavy loads. The California researchers’ discoveries have also gone into small company Ekso Bionics Holdings Inc., which has used the breakthroughs to create bionic suits for use in rehabilitation centers.
In Nashville, Tenn., Vanderbilt University engineers have partnered with Parker Hannifin Corp. to produce a robotic suit that snaps apart so a user can tote it around in a bag or even wear it onto an airplane. Japanese companies, including carmakers, are also testing robots.
“We spent a long time in society really helping people survive, which is pretty awesome, but now it’s time, I think, to do something different,” said Dr. Ross D. Zafonte, vice president of medical affairs for Spaulding Rehabilitation Network of Boston. “I think we’re on the verge of that, and that’s really helping people function and getting to a different level of capability.”
An estimated 273,000 people in the United States had spinal cord injuries in 2013, according to the most recent information from the National Spinal Cord Injury Statistical Center at the University of Alabama. Most of those injured are men, and many are between ages 16 and 30. The most common cause of injuries is vehicle accidents.
Other people lose the ability to walk because of stroke and diseases that damage the central nervous system.
The estimated lifetime cost of care for a person with paraplegia, or an inability to voluntarily move the lower half of the body, is more than $2.2 million, according to the spinal cord center. Paralysis, research shows, can lead to thinning bones, damaged skin and obesity from constantly sitting, depression and a host of other costly medical problems.
The market for robotic devices for people with paraplegia could be worth more than $1 billion in 10 years, said Larry J. Jasinski, chief executive of Argo, which was founded in Israel.
It’s “a wonderful medical outcome and a tremendous business potential,” Mr. Jasinski said.
Robotic exoskeletons rely on physical components that brace a patient’s body, batteries to power the robotic components and software to translate what the patient wants to do.
Argo’s ReWalk system moves when patients lean forward.
“Normally when you walk, your trunk leans forward and you step,” said Dr. Alberto Esquenazi, who helped develop ReWalk and is chief medical officer for MossRehab, which is part of the Einstein Healthcare Network in Philadelphia. “By taking precisely that movement and embedding a system that detects it, you can have a person trigger the stepping pattern.”
Some developers have aimed their bionic walkers at the institutional market, at least initially, while others are aiming to create something individuals will buy. Regardless of the market, the devices are not cheap. Ekso Bionics sells its device to rehabilitation facilities for about $110,000. Argo sells ReWalk to individuals in Europe for about €52,500, or about $72,000, and expects to sell ReWalk in the United States for about $65,000 to $68,000, according to Mr. Jasinski.
Parker Hannefin’s Indego, invented at Vanderbilt, is still under development but is aimed squarely at individuals. The battery fits into a piece that fits across the user’s back, said Michael Goldfarb, professor of mechanical engineering at Vanderbilt. Individuals can control movement with one hand, leaving them free to open doors. Mr. Goldfarb is also working on adding electrical stimulation to the device, something that might help patients’ limbs.
Eventually, people with paralysis may have a number of bionic devices to choose from, depending on their medical needs and personal preferences.
“There’s a decent amount of heterogeneity in the population of people with spinal cord injury,” Mr. Goldfarb said. “Some of those systems are going to be better suited to some people, and other systems are going to be better suited to other people.”
It was a fall from a ladder that led to Mr. Laureano’s slide into paralysis. In addition to the injury, doctors found the Bronx resident suffered from syringomyelia, a condition in which a cyst in the spinal cord compresses and damages nerves.
While undergoing treatment at the James J. Peters Veterans Administration Medical Center in the Bronx in late 2012, Mr. Laureano was invited to participate in a clinical study. As he rolled through the center where the studies took place, he said during a recent visit to ReWalk offices in Marlboro, he saw “this robot thing with sneakers. I wasn’t moving. I wanted to know, what’s this about?”
He started participating in a ReWalk trial in 2013. He has since spent about 80 training sessions in the device, some inside and some outside. Before the trial, his son, now 13, had never seen him standing.
“When I first put it on, I was excited. I was emotional, to look at the trainer eye to eye,” Mr. Laureano said. “I can reach things. I can make coffee with it. I’m at a loss for words. I’m really into it.”
Contact Lisa Eckelbecker at firstname.lastname@example.org Follow her on Twitter @LisaEckelbecker.