Fresno hospital considers robotic device to help paralyzed walk again (video)

The Fresno BeeJune 18, 2014 

The scene at Community Regional Medical Center on Wednesday could have been taken from a page in an "Iron Man" movie script.

Allen Prahl, a hospital physical therapist, stood motionless, waiting to take his first robot-controlled step.

With an exoskeleton strapped to his ankles, calves and thighs and a 50-pound pack secured to his back, Prahl waited as the robot lifted his right foot and then his left.

"It feels very snug to your body, but it doesn't feel heavy," Prahl said as he took more robotic steps.

Prahl, who is able-bodied, agreed to demonstrate the exoskeleton to his physical therapy colleagues. Community is evaluating whether it should buy the device -- at a minimum cost of $110,000 -- as a rehabilitation tool for stroke patients and people with spinal cord injuries.

Ekso Bionics, a Bay Area company, launched the technology in 2010. It's approved by the federal Food and Drug Administration for use in rehabilitation centers. It's being used in three centers in California, one in the Bay Area and two in Southern California.

The technology has developed over time. Before the exoskeleton, a device was developed that allowed soldiers to carry 200-pound backpacks in extreme conditions without feeling the weight.

But the Ekso Bionics exoskeleton for rehabilitation enables people who are paralyzed to stand and take steps aided by battery-powered motors. The weight shift from foot-to-foot activates sensors that initiate steps.

Measurements taken by sensors allow the exoskeleton to be programmed for the patient's height and weight and length of stride. One side can be dialed in to lift more weight than the other -- which can help stroke patients who may have paralysis on one side of their bodies.

Other companies besides Ekso Bionics are working on technology to help paralyzed patients. A brain-controlled robotic exoskeleton developed by Miguel Nicolelis and the Walk Again Project research team grabbed attention last week when a paralyzed man kicked the first ball at the opening ceremonies for the World Cup.

Ekso Bionics doesn't use brain stimulation or electrical currents. Battery power helps people stand and walk. The company says it has helped people take 1 million steps -- and Prahl added to that number Wednesday, walking back and forth across Community Regional's rehabilitation gym floor.

Colleagues crammed into the room to watch the demonstration and peppered Jenn Macievich, an Ekso Bionics physical therapist, with questions about the exoskeleton's uses and limitations.

The exoskeleton can be used with a walker, as Prahl demonstrated, or with crutches or canes, Macievich said.

But it can't go backward. "It sits, it stands, it walks -- in a straight line," she quipped but added, "the amount of engineering that has gone into this device is pretty amazing."

And while the exoskeleton weighs 50 pounds, it's a full weight-bearing device so the user doesn't carry the extra weight of the backpack.

"It definitely feels like a part of me now," Prahl said by the end of the hour-plus demonstration.

The device allows the user to start and stop steps, which Prahl was able to do with the click of a button attached to the walker. He made it look easy, but Macievich said beginners will need help from physical therapists to control movements.

Prahl, who for two decades has helped patients regain the ability to stand and walk, said the exoskeleton is a game-changer for his profession. "When I first became a PT (physical therapist), this was science fiction. This was something that wasn't even possible."

Community Regional has tools that help people stand and walk, said Lynne Jarman, therapy supervisor. But there are limitations, she said: A standing frame, for example, enables a person to stand -- but it's stationary. A harness system allows people to take steps, but the person is tethered to it.

The exoskeleton "is the most functional, the smallest technology," Jarman said.

And there's no shortage of people who could benefit, she said. "It could apply to almost every single patient we have."

The reporter can be reached at (559) 441-6310, banderson@fresnobee.com or @beehealthwriter on Twitter.

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