Blog Oct 16, 2024

Learning to Walk Again Using Exoskeleton Technology

A women walks wearing an exoskeleton walks with the help of a walker and her therapists.

Gait Rehabilitation after stroke or brain injury

Walking is something most of us take for granted. It becomes a huge part of your everyday life that is often done without a thought, but your brain is making it happen; communicating with your legs by sending neural electrical signals down the spine to the leg muscles.

However, some injuries or illnesses, such as a stroke or brain injury, can cause a break in that signal from the brain to the legs. When this occurs, learning to walk again means rebuilding that link. This is often done through physical therapy in an inpatient rehabilitation hospital.

Rehabilitation focused on learning to walk again after a stroke or brain injury is called gait training. The goal is to utilize the neuroplasticity of the brain by performing repetitive movements. Those repetitive movements help create new pathways and reorganize the brain to send signals to the leg muscles. The signals cause the muscles to move and, in turn, become stronger allowing that person to relearn how to stand and take steps again. Typically, an individual is able to do this with the help of a mobility device such as a walker and/or, a therapist’s support.

Select Medical’s network of rehabilitation hospitals* has introduced robotics and advanced technology, such as the exoskeleton, to further aid in gait training and repairing the link between the brain and legs. This robotic assistive walking device and other rehabilitation technologies can make a significant difference.

Recently, the exoskeleton made headlines after being featured at the 2024 Olympic Opening Ceremony. French Paralympian Kevin Piette wore the device to walk while carrying the Olympic torch. His feat was impressive as Kevin lost the use of his legs after an accident when he was 11-years-old. 

What is an exoskeleton?

An exoskeleton is a wearable, battery-powered device that fits like a brace around the legs, hips and waist to assist in standing and walking. There are several manufacturers and models and all use robotic technology to move the legs. The device prevents atrophy and allows the patient to walk while also helping the brain rebuild the necessary communication link to the legs.

The technology within the exoskeleton enables the device to sense the support a patient needs and adjust accordingly. The exoskeleton provides full assistance for patients who need it and less for those further along in their recovery journey, according  to one of the exoskeleton makers. The manufacturer added that the devices is often used with a cane or walker for balance1.

Wearable exoskeletons are emerging as revolutionary devices for rehabilitation and are primarily used to facilitate motor recovery in spinal cord injury, stroke and brain injury patients2. The technology provides highly controlled, repetitive and intense training while also reducing the physical burden for therapists and patients. In clinical practice, it has been found that increased use of a robotic exoskeleton resulted in improved motor function and therapeutic outcomes3.

Exoskeleton Walking Device

Play the accessible version of the “Exoskeleton Walking Device” video

Benefits of an exoskeleton

A women walks wearing an exoskeleton walks with the help of a walker and her therapists.An exoskeleton is a wearable, battery-powered device that fits like a brace around the legs, hips and waist to assist in standing and walking. There are several manufacturers and models and all use robotic technology to move the legs. The device prevents atrophy and allows the patient to walk while also helping the brain rebuild the necessary communication link to the legs.

In addition to the exoskeleton’s hardware, its logs real-time analysis of a patient’s walking patterns – their gait. Therapists read that gait and mobility data, identify the patient’s weaknesses and further refine the treatment plan. Data also alerts therapists to potential safety risks, like excessive leaning. By promptly flagging these issues, therapists can address them with the patient providing a safer rehabilitation environment for patients and therapists.

There are a wide range of additional benefits patients gleaned from the use of an exoskeleton such as: 

  • Managing pain
  • Helping with spasticity (loosening tight muscles)
  • Maintaining bone density (keeping bones strong)
  • Aiding bowel and bladder function
  • Maintaining body composition (keeping appropriate posture/weight distribution)
  • Exercising

Rehabilitation technology

Recovery from stroke or brain injury involves significant challenges and important choices. Where you go for treatment makes a difference. In January 2020, the US News and World Report announced a new ranking methodology for Best Hospitals. For inpatient rehabilitation hospitals, this new methodology includes the use of robot-assisted walking therapy and assistive technology centers. These criteria, among others, set best practice standards for inpatient rehabilitation hospitals4.

At Baylor Scott & White Institute for Rehabilitation we strive to provide exceptional care through training, research and innovation. We closely monitor industry standards and technology advancements to provide our therapists and patients with the tools needed for the best possible outcomes. Our therapy gyms come equipped with advanced technology, including an exoskeleton.

Learn more about brain injury rehabilitation, stroke rehabilitation and our advanced technology.  

 

References:

*TriHealth Rehabilitation Hospital is part of Select Medical’s network of inpatient rehabilitation hospitals

1 EksoNR - The Next Step in NeuroRehabilitation. (n.d.). Ekso Bionics. https://eksobionics.com/eksonr/

2 Rodríguez-Fernández, A., Lobo-Prat, J. & Font-Llagunes, J.M. “Systematic Review on Wearable Lower-Limb Exoskeletons for Gait Training in Neuromuscular Impairments.” J NeuroEngineering Rehabil 18, 22 (2021). https://doi.org/10.1186/s12984-021-00815-5

3 Nolan, K.J., Karunakaran, K.K., Chervin, K., Monfett, M.R. Bapineedu, R.K. Jasey, N.N. & Oh-Park, M.. “Robotic Exoskeleton Gait Training during Acute Stroke Inpatient Rehabilitation.” Front. Neurorobot., 30 October 2020 | https://doi.org/10.3389/fnbot.2020.581815 

4 Harder, B. “New Methodology for Ranking Rehabilitation Hospitals.” US News and World Report, 28 Jan. 2020.