High-tech exoskeleton lending a hand, arms and legs

MAKING THE ASSIST: Vanderbilt Rehabilitation Center patient Andrea Blair, right, of Cumberland, wears the ­EksoNR exoskeleton and moves through a walking session with the guidance of physical therapist Allissondra Dutra. 
COURTESY LIFESPAN CORP./BILL MURPHY
MAKING THE ASSIST: Vanderbilt Rehabilitation Center patient Andrea Blair, right, of Cumberland, wears the ­EksoNR exoskeleton and moves through a walking session with the guidance of physical therapist Allissondra Dutra. 
COURTESY LIFESPAN CORP./BILL MURPHY

Early last December, Chuck Allen was enjoying a lazy afternoon at home in North Kingstown. His wife, Becky, had run out for a few minutes to do errands, and feeling tired, he stretched out to nap in his recliner.

“But when I woke up, I couldn’t talk,” he said. “I couldn’t move.”

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Minutes later, Becky discovered her husband and called 911. Paramedics transported him to Rhode Island Hospital.

Within hours, Allen had a diagnosis: He’d had a major stroke in his sleep, which doctors attributed most likely to arrhythmia, an irregular heartbeat that can send a blood clot to the brain.

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A professional sailor who loves to bike and run, Allen, 55, was now paralyzed on his right side. He’d become a medical statistic, one of more than 795,000 Americans who suffer a stroke each year, according to the Centers for Disease Control and Prevention.

After a couple of days of tests and treatment at the hospital, and with his medical crisis stabilized, Allen was ready for rehab. It was a critical move, and he opted for Lifespan Corp.’s Vanderbilt Rehabilitation Center, a 28-room facility at Newport Hospital.

Vanderbilt has a good reputation, he says. It offers patients such as him intensive rehab that includes sessions with a recently purchased EksoNR exoskeleton, otherwise known as the Ekso. It’s manufactured by California-based Ekso Bionics Holdings Inc. and is the first of its kind to be cleared by the U.S. Food and Drug ­Administration.

The Ekso helps patients with spinal cord injuries, multiple sclerosis, stroke and Parkinson’s disease. It also speeds recovery, which can be a morale booster. Vanderbilt’s medical director, Dr. Mustapha Kemal, says the Ekso was on the center’s wish list, but with a $200,000 price tag, seemed out of reach until a generous donor helped. “Everyone felt it would be a very important piece of equipment for us,” he said.

Exoskeletons may look like something from a sci-fi movie but they have real-world applications, from construction to the automotive industry.

Vanderbilt’s medical version looks like an oversized black backpack with rigid frames attached by straps to the user’s body and legs, powered by rechargeable lithium-ion batteries. The patient dons the Ekso and its motors assist with movements such as standing and walking.

TEAM ORIENTED: Andrea Blair, seated, has multiple sclerosis and uses the EksoNR exoskeleton for therapy to manage the symptoms. Helping her to get the equipment on is Vanderbilt Rehabilitation Center physical therapists Allissondra Dutra, bottom left; Erin Azar, bottom right; and Cara Genest.
COURTESY ­LIFESPAN CORP./BILL MURPHY
TEAM ORIENTED: Andrea Blair, seated, has multiple sclerosis and uses the EksoNR exoskeleton for therapy to manage the symptoms. Helping her to get the equipment on is Vanderbilt Rehabilitation Center physical therapists Allissondra Dutra, bottom left; Erin Azar, bottom right; and Cara Genest.
COURTESY ­LIFESPAN CORP./BILL MURPHY

Erin Azar, a physical therapist at Vanderbilt, works with patients such as Allen. “I see people at the beginning of their journey at different points and work closely with them up to three hours a day. The treatments can last from two or three weeks, up to two months,” she said.

“I tell patients to give us two sessions. The first ensures the Ekso fits, so that can be difficult. By the second session, they typically love it.”

The Ekso adjusts to her patients, Azar says. The therapist gets the patient standing and the smart sensors detect how much the patient can move. The equipment makes up the difference and helps retrain the brain to walk.

“We set how long a step to take and how fast. We have control,” Azar said. “It meets patients where they’re at. If they’re tipping over, we make sure they don’t fall. We cue the patient to do what the Ekso wants, which is walk normally.

“I get to know my patients, “ she said. “It’s exciting to see their ­progress.”

Allen’s in-patient treatment lasted four weeks, a combination of the exoskeleton, as well as occupational therapy to work on upper body strength and physical therapy for lower limb movement. His speech was the first thing to come back, he says.

During his second week at Vanderbilt, he was introduced to the exoskeleton.

Therapists took measurements of his kneecaps, thighs and waist, then fit the Ekso to him.

“The first time you get into it, you’re sitting down,” he said. “It lifts you till you’re standing. It feels like you’re going to fall forward but you don’t.”

He started slowly trudging up and down the center’s cream-colored halls with a walker and his physical therapist guiding him. The Ekso detected that he was favoring his left side and adjusted. Having arrived at his appointment in a wheelchair, Allen was on his feet for the first time in many days. The next session, a week later, lasted more than an hour, with squats, more walking sessions to build up strength and more practice navigating corners.

His third two-hour session included even more squats and more walking. “You don’t feel weighted down because of the hydraulics. It’s really funky,” Allen said.

At the end of four weeks, Allen was discharged in January and is still doing outpatient occupational and physical therapy. He’s made steady progress with his speech, which is 95% back, although he still has a problem with the letter “s.”

He’s also back to work at North Sails Group LLC and racing sailboats. His crewmates keep an eye out for him while he’s on deck, he says. Doctors attribute Allen’s rapid recovery to his physical fitness and that, as a stroke victim, he’s relatively young. These days, he’s giving his new rowing machine a workout and measuring progress one step at a time.

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