Exoskeletons for Patients unable to walk

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Dr. Hafsa Akbar Ali
I have a MBBS from King Edward Medical University and did my clinical training at Pakistan’s Mayo Hospital, one of the most prestigious medical institutions in South Asia. My passion for medicine led me to pursue postgraduate training in the US as well, where I received an MD. My writing at TechEngage covers the latest advancements in medical technology.
Modern technology has evolved tremendously in alleviating disability.

Prosthetic limbs have been in use for quite a while now that aid patients in walking. Prosthetic technology is getting better with every passing day. The high-tech advancement in the prosthetic limbs allows the amputee to control the movement of the fingers. Exoskeletons are devices which are attached to the limbs and help patient walk as well as control posture and gait. But they use extra power due to which their use is limited.

 Exoskeletons

They can be used in following patients who are unable to walk:

Paraplegic patients

Patients that have their limbs paralyzed i.e. legs unable to move on their own because of several reasons like stroke, spinal cord injury, genetic causes etc.

Children with cerebral palsy

These children have a brain injury due to deficiency of oxygen at birth, which leads to paralysis with an increased tone of muscles, hence leading to couch gait.
This type of gait is tiring and awkward for the patient. So, the support from the exoskeleton can help these patients in the long run.

Amputated limbs

Patients who have lost their limbs because of long-term diabetes, the soldiers or patients who have undergone traumatic injury to the limbs in accidents can also be helped with these exoskeletons.

Mobility impairing illnesses

Parkinsonism, in which gait of the patient becomes short shuffling and there is increased tendency to fall. In such patients, these robots can add the right amount of force to help them move.

Multiple sclerosis

In these patients, there is an increased tone of the muscles due to some abnormality in the protective coverings of the nervous system. This leads to interference in the normal gait. In such circumstances, exoskeletons can prove to be a big help.

Structure of Exoskeleton

These robotic devices have motors. These motors provide force for correcting the walking pattern of the patients. Speed or movement angles can be easily customized. Developed by biomedical engineers, the exoskeleton is made out of aeronautical aluminum.

How it works

The exoskeleton uses sensors to measure the efforts undertaken by the human body,” says Juan José Iceta Yurrita, an industrial engineer at Gogoa.
Exoskeleton supplements the body movements. It also motivates the patients to put as much effort as possible. Hence, the final gait by which patients walk is a combination of the effort of the patient supplemented by these exoskeletons.
All of this helps the patient walk smoothly, faster and with less effort.

Advancements in Exoskeletons

There is a need to improve these exoskeletons in terms of;

  • Providing protection from falls.
  • Reducing the energy required for walking
  • Reducing spasticity in case of cerebral palsy

Engineers in Italy are designing an exoskeleton to reduce falls among the elderly and those with amputated limbs for example, while researchers at Stanford University are trying to reduce the energy it takes people such as those recovering from the stroke to walk. A team in New York City is helping children with cerebral palsy to get out of the “crouch gait” that makes it difficult and awkward for them to get around.
Technological improvements that are undertaken include;

  • Motors are smaller, more powerful and cheaper
  • Electronics easier to operate
  • Gyroscopes and accelerators are smaller, cheaper and more precise – can give directions on cell phones. It can tell where the patient’s leg is in the space

The development of these exoskeletons was started for the support of soldiers to reduce the energy of walking while caring heavy bag packs. But few years after this project, they started realizing that they could be of much help in the case of stroke patients, who have physical disabilities.

Role of Exoskeletons in patients of stroke

Most of the patients with stroke experience a restriction of their mobility. Research suggests that these exoskeletons can be useful to promote mobility in persons with stroke due to mechanisms of brain plasticity and connectivity re-modulation that are specifically catered by the robotic devices using latest technologies.

Future of Exoskeleton Technology

“We want to be able to give voice orders to the exoskeleton, instead of using tablets or phones,” says Gogoa CEO and Hank Project coordinator Carlos Fernández Isoird. “We’ve already tested this voice command function; it works quite well. This would be good for physiotherapists, as they would have their hands free to safely handle patients. And rehabilitation would become even more customized.”
Let’s see where the future takes us!

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