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Life Care Planning for Spinal Cord Injury
Published in Roger O. Weed, Debra E. Berens, Life Care Planning and Case Management Handbook, 2018
David J. Altman, Dan M. Bagwell
On June 26, 2014, the FDA granted approval to Argo Medical Technologies (now marketed as ReWalk Robotics) for the sale of the ReWalk powered exoskeleton device for private use in the United States. With its initial release, the ReWalk was available in two versions, one for medical institutions for research and therapeutic applications under professional supervision, the ReWalk I, and another for personal use at home or in public, the ReWalk P. In early 2013, a newer version was released, the ReWalk Rehabilitation 2.0, featuring enhanced software for improved control and sizing options for taller individuals.
Exoskeleton: The New Horizon of Robotic Assistance for Human Gait
Published in Stefano Federici, Marcia J. Scherer, Assistive Technology Assessment Handbook, 2017
Marco Bracalenti, Fabio Meloni, Stefano Federici
Parker Hannifin CorporationTM: Indego is a powered exoskeleton worn around the waist and legs, which allows individuals with SCI to stand and walk. At just 26 pounds, Indego's design has no exposed cables or upper body apparatus and does not require bulky backpack-mounted components. Indego mirrors natural human movement, leans forward to initiate standing or walking, and leans backward to stop and sit. Moreover, Indego has a slim profile that is compatible with standard mobility aids and can be worn while seated in a wheelchair. Furthermore, a single-hand strapping and retention system allows Indego to be put on, taken off, and adjusted to fit without assistance. Designed from the beginning for personal use, the features of Indego make it well suited for use in a clinical setting, and for an easy transition to use at home. Functioning: With the Indego, patients with SCI or other motor problems strap their lower bodies into a piece of equipment similar in appearance to leg braces. Gyroscopes and accelerators anticipate a patient's steps by subtle upper body motion, similarly to how a Segway works. Then, the Indego moves in concert with the patient's leg to take a step. The wearer uses his or her muscles to do the work; the Indego provides a little extra help. Sensors determine how much power is needed, eventually decreasing as the patient grows stronger.Weight: 12.3 kg.Maximum speed: 3 km/h.Battery life: 4 hours.Movements: standing up, walking, walking on hard surfaces (including ramps and slopes).Crutches: necessary for this exoskeleton.Who can use: Indego comes in interchangeable sizes and can accommodate people from 155 cm to 193 cm in height, and up to 113.5 kg in weight.
Spinal cord injury providers’ perspectives on managing sublesional osteoporosis
Published in The Journal of Spinal Cord Medicine, 2020
Frances M. Weaver, Bella Etingen, Marylou Guihan, Cara Ray, Michael Priebe, Stephen Burns, Laura Carbone
Providers were most likely to order a DXA scan if a patient wanted to use some type of weight-bearing equipment like an exoskeleton, or become active in wheelchair sports. The DXA results also were used to assess safety with respect to fracture risk. Providers used the findings in their decision making as to whether a patient should be participating in these activities. The other time that DXAs were ordered was when a patient had experienced a fracture. This was done to determine if the fracture was related to having osteoporosis. VA has issued guidance for providing powered exoskeleton devices to veterans with SCI.16 In the guidance, a bone mineral density test is required of the hip (and knee, if available), but no criteria are provided as to a cut-off level for BMD that is appropriate for whether a person with SCI can use the exoskeleton. However, an ongoing clinical trial of exoskeleton in VA SCI patients uses a cut-off level of −3.5 or worse for total hip BMD for exclusion in the trial.17
Neuromechanical adaptations during a robotic powered exoskeleton assisted walking session
Published in The Journal of Spinal Cord Medicine, 2018
Arvind Ramanujam, Christopher M. Cirnigliaro, Erica Garbarini, Pierre Asselin, Rakesh Pilkar, Gail F. Forrest
The powered exoskeleton (Ekso™, Ekso Bionics, Richmond, CA, USA) used with all individuals has been described elsewhere.8 All SCI individuals were trained and tested in Ekso™ (version 1.1) for Max Assist condition while the AB individuals were tested in EksoGT™ for Max Assist condition. The Max Assist setting provides the maximum amount of motor assistance to move the legs consistently through a predefined gait pattern and is less susceptible to the participant's interaction (Ekso GT™ Operating Manual Copyright© 2013 Ekso GT Bionics, Inc Part Number 103299 REV B1). The AB individuals received two sessions of training whereby they could walk using the powered exoskeleton with close supervision.
Evaluation of a lower-extremity robotic exoskeleton for people with knee osteoarthritis
Published in Assistive Technology, 2022
Chris McGibbon, Andrew Sexton, Arun Jayaraman, Susan Deems-Dluhy, Eric Fabara, Catherine Adans-Dester, Paolo Bonato, Francois Marquis, Sylvie Turmel, Etienne Belzile
While preliminary, this study represents the first randomized controlled cross-over trial to evaluate the safety and efficacy of a rigid lower-extremity powered exoskeleton in the KOA population. Strengths include examining both the immediate and cumulative impacts of the technology on mobility as well as evaluating the potential to reduce disability in this population, and quantifying device usability and safety.