San Francisco Chronicle - (Sunday)
Exoskeleton suits help immobile walk again
For stroke survivor Jess McNair, each step remains slow and laborious. But the first time the 32-year-old former bartender wore a robotic exoskeleton that a Richmond company is developing, she felt a renewed sense of hope.
“It was the first time that I had really felt what it was like to walk again, because I had to relearn all that,” the
Walnut Creek resident said. “It’s hard not to think pessimistically after all of this. But getting into the machine and feeling what it was like to walk again gave me motivation to get better.”
McNair is a paid tester for Ekso Bionics, which makes robotic, computer-controlled systems, called exoskeletons, designed to help people with arm and leg movements.
One segment of Ekso’s business is aimed at industrial use. Ford Motor Co., for example, is testing the EksoVest, which is worn by auto assembly line workers to help boost their arms and shoulders for tasks that require them to perform overhead tasks thousands of
“I was able to stand ... again, which was absolutely amazing.” Matthew Tilford, Ekso product tester
times per day, to help reduce fatigue and injuries.
These exoskeleton suits give factory workers superhuman strength to constantly lift machinery or products in areas or for tasks where nonhuman industrial robots are not practical, said Gerald Van Hoy, an independent consultant who follows the robotics, automation and drone industries.
Moviegoers might be more familiar with the exoskeleton suit depicted in the futuristic sciencefiction movie “Aliens,” but Van Hoy said industrial suits already exist, with Ekso Bionics competing with companies including Hyundai, Samsung, Daewoo and Panasonic.
However, the development of industrial exoskeletons is also leading to medical uses, which could in the long run become more lucrative with the growing wave of older populations around the world, he said.
“A lot of these robotics are coming, because they know they’re all jockeying for position for this next wave,” Van Hoy said.
McNair is helping Ekso test the EksoGT, which includes braces strapped on both legs and a vest on her torso. The system includes two motors for her hips, two for her knees and sensors on her feet.
“For individuals who have no motor function or motor strength in their legs, it can do all the work for them,” said Michael Glover, Ekso clinical training specialist.
“It basically senses their weight shift and their balance position and once they achieve that balance position, it could automatically step for them if they need it.”
But for patients like McNair, “who have some strength in their legs, we can program the device to give as much power as needed,” Glover said.
The exoskeleton is programmed to actively assist McNair to repeat the same motions, then back off as she relearns the motions on her own, Glover said.
At about $200,000 each, including a service plan, the exoskeletons are designed for rehab clinics and not for patients to take home for everyday use, he said. So far, the company has shipped more than 200 to facilities in North America and Europe, and they’ve collectively logged about 90 million steps by patients.
Ekso began developing the EksoGT for patients with spinal cord injuries. Matthew Tilford, 29, of Santa Clara, also serves as a EksoGT “test pilot.” Tilford was 18 when his car drove off a 600-foot cliff, ejecting him and severing his spinal cord.
Tilford, who also works for a medical supply company, first encountered Ekso in October 2011.
Being able to rise above his wheelchair was lifechanging, he said.
“I was able to stand and have conversation with people eye-to-eye again, which was absolutely amazing,” Tilford said.
McNair was a bartender in San Rafael in June 2016 when she sought medical attention for what she thought was “a horrendous” case of the flu and “a knot in my neck.” Instead, she would suffer a series of strokes over a four-day period.
The strokes left her unable to walk without help. “My balance was so bad, I couldn’t stand on my own,” she said. She would fall over all the time, including once in her sister’s apartment. “I’m really stubborn, so I got up and tried to walk and no one was home, so I ended up sitting on the floor for the rest of the day,” she said.
“One thing you learn from all the physical therapy is repetition,” she said. “You just repeat and repeat. You train your brain how to do everything. I had to relearn how to eat, speak and walk.”
In December 2016, as she was completing outpatient rehabilitation, she met Glover and other Ekso representatives who were looking for patients like her to help with the EksoGT, which is supposed to give patients the constant movement repetition that might not be possible with human physical therapists.
The device has helped her regain some of her balance, with those foot sensors helping her detect when her right ankle and foot is pointed the wrong way and dragging.
“Just to be clear, the Ekso doesn’t walk for me,” McNair said. “It is a workout. And I am quite tired after some of the sessions that we have here. It depends on what kind of resistance they put on my legs. Sometimes it feels like walking through mud. It’s quite challenging.”
The National Stroke Foundation of Centennial, Colo., featured McNair and Ekso in a video on its site as part of National Stroke Awareness Month in May. Foundation CEO Robyn Moore said her organization works with other companies with devices that help stroke survivors regain motor skills, such as a glove that combines music and hand therapy. But she said she’s encouraged by the Ekso device.
“We believe in it as an organization,” Moore said. “We’ve heard the stories, we’ve seen what they’re doing. Mobility goes with independence.”
The problem is there are not enough of the devices to go around, she said, noting there was only one EksoGT available for one brain injury hospital in Colorado.
“They’ve got a long way to go to get them in those rehab facilities,” Moore said.
McNair is happy for the times she’s able to use the EksoGT, because it has helped, although she’s only able to take advantage of the device during product demonstrations and tests at Ekso’s plant, a former Ford plant on the Richmond waterfront.
“I didn’t ever think about being able to walk upright again instead of slouching over a walker,” she said. “I appreciate any time being in the machine. I consider myself lucky.
“I’m just determined to get back to some sense of normalcy,” she said.