Category: Exoskeletons

Using a personal exoskeleton like Ekso Indego Personal can be a game-changer for individuals with spinal cord injury (SCI), offering enhanced independence and improved quality of life. However, maximizing the benefits of your exoskeleton requires commitment, practice, and a solid understanding of how it operates. This blog post will guide you through essential steps to ensure you are as successful as you can be with your personal exoskeleton.

The Importance of Using the Device Often

Consistency is Key:

Build Strength and Endurance:

Regular use of your exoskeleton helps build the necessary muscle strength and endurance required for optimal performance. Like any new skill, the more you practice, the more proficient you become.

Adaptation to the Device:

Your body needs time to adapt to the exoskeleton. Frequent use helps you become more comfortable and confident, reducing the learning curve and making the device feel like a natural extension of your body.

Maximize Therapeutic Benefits:

Consistent use may enhance the therapeutic benefits of the exoskeleton. Repetitive movements facilitated by the device can promote neural reorganization and muscle reconditioning, potentially leading to long-term improvements in mobility. Regular use could also result in improvements in bowel and bladder program, bone strength, cardiovascular health, and more.

Maintain Mobility:

Regular use of the exoskeleton helps maintain and even improve your current level of mobility. It prevents muscle atrophy and joint stiffness, which can occur if you remain sedentary.

Learning How to Balance

Balance is Fundamental:

Start with Supervised Training:

Begin your journey with your exoskeleton under the supervision of a certified Indego specialist. They will provide valuable education and guidance on how to maintain balance and ensure you are using the device correctly.

Practice Standing and Walking:

Spend time practicing standing still and walking in a controlled environment. Focus on distributing your weight evenly and maintaining a steady posture. Think about moving your torso just slightly over your stance leg to allow the other leg to step.

Engage Your Core:

Strengthening your core muscles is crucial for maintaining balance. Engage your core while using the exoskeleton to provide additional stability and support.

Learn to Sequence your Assistive Device:

Start slowly and focus on when and where you are moving your walker or crutches. These assistive devices are crucial to keeping your balance and your chest upright.

Make Sure you Understand your Settings

Understanding Your Device:

Read the Manual:

Thoroughly read the user manual provided with your exoskeleton. Familiarize yourself with the different settings, functions, and safety features of the device.

Attend Training Sessions:

Participate fully in training sessions. Ask questions and offer to return demonstrations of the skills your trainer is teaching. Take videos or pictures to help you remember.

Experiment with Settings:

Spend time learning what the different settings are and which ones are safe for you to adjust on your own. Learn how they affect your mobility.

Keep a Log:

Maintain a log of the settings you use and how they impact your walking experience. This can help you track what works best and make informed adjustments as needed.

Practice any skill under supervision:

Trial walking on different surfaces, standing in front of the sink to simulate brushing your teeth, and walking down ramps if you think these are activities you will do.

Is Ekso Indego Personal the right exoskeleton for you? Learn more here. 

Advancements in mobility aids have significantly transformed the lives of individuals with spinal cord injuries (SCI). Among these innovations, personal exoskeletons and knee-ankle-foot orthoses (KAFOs) stand out for their unique contributions to enhancing mobility. While both serve the purpose of aiding walking, the experience of using each is distinct. This blog post explores the differences between walking in a personal exoskeleton and walking in bilateral KAFOs. 

Understanding KAFOs 

KAFOs are orthopedic devices that provide support and stability to the knee, ankle, and foot. These devices can be traced historically back to around 1200 BC and have been used for a variety of ailments, notably Polio in more recent times. Typically made from a combination of metal, plastic, leather, and velcro, they are custom-fitted to each user. KAFOs are commonly prescribed for individuals with conditions such as multiple sclerosis, cerebral palsy, or spinal cord injuries. They can be worn on both legs (bilateral) or just one (unilateral). Most people with spinal cord injuries use KAFOs on both legs. 

Walking in KAFOs: 

Stability and Support: 

KAFOs provide structural support, maintaining the alignment of the knee, ankle, and foot. This stability helps prevent the collapse of the leg during stance phase of walking. Often, those with SCIs use KAFOs that have a locked knee, meaning the knee remains straight, or extended, throughout any standing or walking.  

Energy Expenditure: 

Walking in KAFOs can be physically demanding. Users often need to exert considerable effort to move their legs, particularly if muscle strength is limited. A 1985 article found that the energy cost of walking in KAFOs in patients with T4 or lower SCI was about 8 times higher than normal walking. [1] The rigid structure of the KAFOs can lead to a gait that is less fluid and more laborious. The wearer also has to manipulate the weight of the KAFO, which is approximately 2-4 extra pounds per leg.  

Donning and Standing: 

Putting KAFOs on without assistance is possible but requires some flexibility. When KAFOs are worn bilaterally, standing requires significant upper body strength, as both legs will be straight in front of you with your heels on the floor when you are sitting. The user will have to rely entirely on their arms on crutches or a walker to get them into a standing position.  

Gait Pattern: 

The gait pattern with KAFOs tends to be less natural because of the knees staying extended. Users will likely exhibit compensatory movements, such as hip hiking or circumduction (swinging the leg outward), to facilitate steps. Users also tend to rely heavily on their arms to help generate forward momentum.  

Customization: 

KAFOs are tailored to fit each individual’s anatomy and needs. Proper fitting is crucial for comfort and effectiveness, often requiring adjustments over time. These adjustments and fitting are completed by an orthotist. 

Understanding Personal Exoskeletons 

Personal exoskeletons are wearable robotic devices designed to augment human movement. They are equipped with motors, sensors, and sophisticated control systems that can assist or enhance the user’s mobility. Exoskeletons are used in rehabilitation settings but also can be used by a person in their home or community. Personal exoskeletons are partially or fully paid for by Medicare, Veterans’ benefits, or workers compensation for eligible individuals. Having a personal exoskeleton allows a person with SCI, with the supervision of their support person, to complete activities of daily living (ADLs), exercise, and leisure activities from a standing position. Personal exoskeletons can go most places that your wheelchair can go.

Walking in a Personal Exoskeleton: 

Stability and Support: 

Personal exoskeletons utilize motors to help keep extension on the standing limb(s) to keep you upright. These are powered by a rechargeable battery. Personal exoskeleton devices, like Ekso Indego Personal, also include fall mitigation strategies to assure the user falls in the safest possible way if they were to lose their balance.  

Energy Expenditure: 

Personal exoskeletons provide powered assistance, reducing the physical effort required for walking. This assistance can be particularly beneficial for individuals with significant muscle weakness or paralysis. The weight of the personal exoskeleton is carried by its motors. With the powered assistance of a personal exoskeleton, users typically expend less energy compared to walking in KAFOs. This can enhance endurance and enable longer periods of walking. 

Donning and Standing: 

Ekso Indego Personal is the only modular exoskeleton on the market, allowing for easy donning piece by piece. The exoskeleton can be put on by most users independently. There is a programmed standing sequence that relies on the power of the motors to help you get into standing in a natural way, starting with your knees bent and feet flat on the floor. 

Gait Pattern: 

Advanced personal exoskeletons are designed to mimic natural human gait. Sensors and algorithms continuously adjust the movement to ensure a smoother and more natural walking pattern. This can improve overall mobility and reduce the risk of compensatory injuries. It also means that there is less reliance on the upper extremities. 

Customization: 

Personal exoskeletons offer different hardware sizes as well as programmable settings that can be adjusted to suit the user’s needs. Parameters such as walking speed, step length, and level of assistance can be fine-tuned to optimize performance and allow completion of different activities in the home and community. 

Comparing the Experiences

1. Level of Assistance:

KAFOs primarily provide structural support without actively assisting movement. Personal exoskeletons, on the other hand, offer powered assistance, significantly reducing the effort required to walk.

2. Gait Quality: 

The gait pattern with KAFOs can be less natural due to the rigidity of the device and the user’s compensatory movements. Personal exoskeletons are designed to replicate natural gait, offering a smoother and more comfortable walking experience. This natural gait pattern also helps to reduce overuse injuries to other joints and muscles.

3. Energy Expenditure:

Walking in KAFOs can be physically taxing, leading to quicker fatigue. Personal exoskeletons reduce the energy required for walking, allowing users to walk longer distances with less effort. This is especially helpful for those with the goal of community integration – whether that is going for walks in a park or running errands.

4. Adaptability:

KAFOs require customization for proper fit and function but lack dynamic adjustability. Personal exoskeletons offer adjustable settings that can be personalized in real-time to meet the user’s evolving needs and goals.

5. Acquisition and Learning:

Both KAFOs and personal exoskeletons are categorized as braces. KAFOs, being less advanced technology, are cheaper and easier to learn. However, they may take longer to master independent use because of the significant upper body strength they require, especially to accomplish a sit to stand. Personal exoskeletons have a higher price point and require more time up front from the user and their support person to master. 

Conclusion 

Both KAFOs and personal exoskeletons play crucial roles in enhancing mobility for individuals with spinal cord injuries. The choice between the two depends on various factors, including the user’s specific condition, mobility goals, and lifestyle. KAFOs provide necessary structural support, while personal exoskeletons offer advanced, powered assistance that can transform the walking experience. As technology continues to evolve, the integration of these devices promises to further improve the quality of life for many individuals, offering newfound freedom and independence. 

Is Ekso Indego Personal the right exoskeleton for you? Learn more here. 

In a groundbreaking move, Medicare has finalized reimbursement guidelines for Ekso Indego Personal, marking a significant milestone in healthcare accessibility for individuals with spinal cord injury. This decision represents a long-awaited breakthrough for many beneficiaries who could benefit from innovative assistive technologies that may enhance their quality of life, reduce health complications, and increase independence with mobility and activities of daily living. 

A Triumph for Accessibility 

For individuals living with spinal cord injury, personal exoskeletons offer newfound freedom and independence. The Ekso Indego Personal is modular, lightweight, and portable, making it the ideal solution for use in the home and the community. While many individuals with spinal cord injury typically navigate their environment using a wheelchair, Ekso Indego Personal allows for opportunities to stand at eye-level with their peers, all while walking at the fastest speed currently possible with an exoskeleton. This can profoundly impact a person’s physical and emotional well-being, as well as their ability to complete daily activities. For example, washing dishes while sitting in a wheelchair can result in water running down one’s arms, whereas completing this task in standing is less messy. 

Until now, access to Ekso Indego Personal has been limited to select adults who are Veterans or covered under Workers Compensation insurance. For Medicare beneficiaries, this placed a considerable financial burden on those who could benefit from an exoskeleton for home use. However, with the recent finalization of reimbursement guidelines, Medicare has officially recognized the medical necessity of these devices, opening the door to expanded access for eligible beneficiaries. Physicians and Physical Therapists will play a vital role in identifying, evaluating, and screening eligible individuals to ensure the Ekso Indego Personal will be safe and effective for them. 

Navigating Medicare Reimbursement 

While the finalization of reimbursement guidelines is undoubtedly a step in the right direction, navigating the Medicare reimbursement process can still be daunting for many. To ensure smooth access to personal exoskeletons, individuals and healthcare providers should take the following steps: 

1. Consult with your Healthcare Providers: Discuss the potential benefits of Ekso Indego with your healthcare provider to determine medical necessity and eligibility criteria. 

1. Evaluation and Trial: A trained clinician will work with you to trial the Ekso Indego to make sure it fits and works for you. 

1. Documentation and Authorization: Work closely with your healthcare team and Ekso Bionics to gather necessary medical documentation and obtain authorization for coverage from Medicare. 

The finalization of Medicare reimbursement for personal exoskeletons represents a monumental victory for individuals with spinal cord injury and underscores the importance of inclusive healthcare policies. By recognizing the medical necessity of these transformative devices, Medicare has taken a significant step towards improving accessibility and enhancing the quality of life for thousands of Americans. Ekso Bionics is proud to have played a part in advocating for this coverage and we applaud the Centers for Medicare and Medicaid Services for this decision.  

Want to learn more? If you are interested in pursuing an Ekso Indego Personal for yourself or someone you know, please visit our Ekso Indego Personal page or contact us here. 

Henry Hasson was injured in a car accident in 1994 that left him paralyzed at injury level T7. Although recovery from his injury was strenuous, Henry didn’t let it slow him down, as he went on to graduate medical school in 2001, followed by a neurology residency and fellowship in 2006. Dr. Hasson has now been practicing neurology for 15 years, with special qualifications in child neurology.

Dr. Hasson read an article in the Wall Street Journal about a clinical research study at NYU for the Ekso Indego Personal exoskeleton, which would give people with paraplegia the ability to walk again. After learning more, he decided to see if he would be a candidate for the device. His T7 injury level fell within the FDA approval range, making him eligible for training. He began his rehabilitation with the device in October 2016. Physical Therapist Clare Hartigan of  Shepherd Center conducted the training with Dr. Hasson at his home in Brooklyn, where he said learning how to walk again was “easy and fun.” After his first walk with Ekso Indego Personal, Henry said he felt excited that the device would help with his core muscle strength and balance. He was also excited that the weight bearing would be beneficial for his bones.

Henry had tried other exoskeletons, but he chose Esko Indego Personal based on a variety of key features. The modular design of the device that allows it to be broken down into small parts for easy transport was one such differentiator. Other key attributes included how smoothly the device walks, the variable assist feature (which allows the user to customize the level of support given by the device), how easy it is to put the device on, and the fact that there is no backpack or exposed wires.

Although the exoskeleton has not replaced Dr. Hasson’s wheelchair, it acts as a complementary tool that has enabled him to do things he hasn’t done in years, such as exercising in an upright position. Henry uses Ekso Indego Personal for his daily exercise and regular walks and hopes to one day use it on stairs (currently, Ekso Indego Personal is not meant for staircase use). He says that being upright has improved his quality of life and assisted with his breathing, circulation, and weight bearing.

Dr. Henry Hasson is one of the first users to own Ekso Indego Personal. He finds the device to have a positive influence on his day-to-day life and hopes it continues to improve his overall quality of life.

In November 2017, Dr. Hasson completed the 1 Mile Spinal Cord Damage Research Center Fundraiser Race using Ekso Indego Personal, and he couldn’t be more proud.

Now offered under Ekso Bionics, Ekso Indego Personal is a flagship at-home exoskeleton that is designed to help patients with spinal cord injuries walk again in their homes and community. Equipped with a modular, quick-connect design, you can put it on and take it off anytime without assistance. It’s also extra light, weighing only 29 lb (13kg), and is designed to help you take it with you anywhere you want to go. Try Ekso Indego Personal today and regain your independence. For any inquiries, reach out to us today.

On June 1, 2013, 16-year-old Will Hutchins was involved in a car accident that left him paralyzed with a T8 spinal cord injury (SCI). Today, Will is able to walk again with the help of Ekso Indego Personal and the PTs at Shepherd Center in Atlanta, Georgia.

Will was a participant in the clinical trial that enabled the Indego Personal to be made commercially available in the United States and Europe. Will continues to support the team as a subject for potential Indego functionalities such as Functional Electrical Stimulation (FES) and is prominently featured in marketing materials. The following is a transcript from an interview with Will about his experience with Ekso Indego Personal thus far.

How and when did you hear about Ekso Indego Personal?

WH: Someone at Shepherd told me about Ekso Indego Personal, but I was too young at the time to try it. Very shortly after I turned 18, I was offered the opportunity to participate in an Indego study.

Describe some of your feelings/emotions when you first walked using Ekso Indego Personal.

WH: I was blown away. To have the opportunity to walk again was amazing. My girlfriend Kaci liked it as well. She was with me in the car during the horrible car accident, and she supported me during my rehabilitation at Shepherd Center.

What was it like being able to walk with your classmates at your high school graduation?

WH: It was always my goal to walk again and be on the stage with my peers. Thanks to Indego, this dream came true. I was very nervous as it was the first time that I walked with Indego in front of so many people. When I walked up the ramp, it was super quiet, but when I got up to the stage, people started to stand up and cheer. I am not the guy who is looking for this kind of attention, but I am very thankful that I was given the chance to walk during my graduation.

Does Ekso Indego Personal replace your wheelchair?

WH: No, but it is better than sitting down constantly. It gives me another option.

How was the training/learning to walk with Ekso Indego Personal?

WH: It was pretty easy. I started with a walker, and within 30 minutes, I graduated to the crutches. I had to learn to trust the device. The device looked so slim and light that I was afraid that it wasn’t going to hold me, but it did. Now I am in the process of further improving my walking in Ekso Indego Personal.

How do you use Ekso Indego Personal today/now?

WH: I don’t have my own exoskeleton yet, but I hope to have one eventually. I would walk in the yard and would take it anywhere I could.

Does Ekso Indego Personal improve your quality of life? If yes, how so?

WH: It stretches me out, and my spasms reduce significantly after use.

What are you able to do now with Ekso Indego Personal that you weren’t able to do before?

WH: Ekso Indego Personal offers me opportunities I couldn’t imagine after my accident, such as going to a concert. This wasn’t possible with my wheelchair.

Now offered under Ekso Bionics, Ekso Indego Personal is a flagship at-home exoskeleton that is designed to help patients with spinal cord injuries walk again in their homes and community. Equipped with a modular, quick-connect design, you can put it on and take it off anytime without assistance. It’s also extra light, weighing only 29 lb (13kg), and is designed to help you take it with you anywhere you want to go. Try Ekso Indego Personal today and regain your independence. For any inquiries, reach out to us today.

I have always dreamt about having the opportunity to walk again. While it would be different than before my spinal cord injury, I’d love to be able to look someone in the eyes while speaking. For my wedding day, I wanted to stand face to face with my future wife, stare into her eyes, hear the words “you may kiss the bride,” and walk her back down the aisle.

Why I Decided to Use Ekso Indego Personal in My Wedding

In 2018, I saw other people with Spinal Cord Injuries use exoskeletons to celebrate milestones in their lives, including graduating from college and getting married, and I wanted to do the same. Of course, my beautiful fiancė (now) wife, Lindsay, was more than willing to help me incorporate Ekso Indego Personal into our big day. To be honest, I was the one who was most skeptical about using an exoskeleton at my wedding. I had many worries and unanswered questions. Would the exoskeleton take away from the shining moment that Lindsay had envisioned for her entire life? Would our family and friends focus too much on me walking for the first time in seven years? Would I like the way that I looked standing at the altar? After all, my wheelchair had become an essential part of my life and our relationship.

I brought my concerns to the Ekso Indego team, who were very understanding. Lindsay and I had picked out a beautiful outdoor venue in a nearby national park months before and were committed to having an outdoor ceremony. My biggest priority was practicing enough to feel confident while walking through grass and on uneven terrain. I had used the device quite a bit, but never in the grass or across stone walkways outdoors. After working with the team to train my best man as my “Indego support person,” everyone at Indego rallied together to provide a device for me to take home and practice with the week before the wedding.

Days Before the Wedding

Lindsay and I both wanted to use the Ekso Indego Personal for our first dance, as the reception was indoors, and I was confident that it would be possible. We were still unsure if we would be able to use the exoskeleton during our ceremony, as Ohio weather in October is anything but predictable. Naturally, the entire week leading up to our wedding day, October 6, 2018, had been nothing but rain.

Due to the weather, I did not have the opportunity to practice much outside, so with the first ray of sunshine, I got in the Ekso Indego Personal and walked all the way around our two-acre yard. This was the first time in seven years that I was able to walk in my own home. I picked apples and pears from the trees in our backyard, chased the dogs around for a bit, and cracked a few jokes while walking. Needless to say, I couldn’t wipe the smile off my face.

The next day was our rehearsal dinner, and Ohio weather delivered again— rain all day. The weather cleared up just before the rehearsal, so I took advantage and used the Ekso Indego Personal to practice. I knew that Lindsay and I had a backup plan in case the slippery grass and mud created a less-than-ideal situation. I was thrilled that I had no issues walking in these conditions and was confident that I could make this happen. It was finally starting to set in that I was going to be marrying my best friend and the love of my life the following day.

The Ceremony

Everything went perfectly on the day of our wedding. All my closest family members and friends were there, everyone looked so sharp, and the weather was absolutely gorgeous! It was 80 degrees and sunny. Very rare for Ohio in October.

The time had finally come. I walked my mother and father down the aisle, gave them a big hug and kiss before seeing them to their seats, and stood beside my handsome groomsmen. While looking out over my dear family and friends, I watched the beautiful bridesmaids lead the way for my soon-to-be wife, escorted by my in-laws, to meet me at the altar. This was the greatest moment of my life.

It was truly a once-in-a-lifetime feeling to be able to stand and overlook our guests while Lindsay and her father walked down the aisle. It took everything I had in me not to completely lose it. This was the first time I had seen her in over 24 hours. I was speechless at how beautiful she looked as we stood hand-in-hand, reciting our vows. I will never forget hearing the officiant say the words, “I now pronounce you husband and wife. You may now kiss the bride.” We then, for the first time as husband and wife, walked side-by-side, being cheered by all our loved ones as we exited the ceremony.

The Reception

After the ceremony, Lindsay and I had a photoshoot before everyone moved into the barn for the reception. Once we all finished eating dinner, we moved straight into our first dance. For obvious reasons, I had never thought that Lindsay and I would be able to share this intimate moment, looking each other in the eyes while I held her in my arms. This was a special surprise for our guests as well, and there was not a dry eye in the room. We then moved on to the father-daughter dance, followed by the mother-son dance. I wanted to surprise my mother with this dance, and it definitely worked. This was the first time that I ever danced with my mom – something that she probably thought would never be possible after my injury.

For so many reasons, I am grateful to have such a great group of people who love and support Lindsay and me. The fact that I was able to stand and walk on the day of our wedding is something that I will never forget and is a priceless memory that I will cherish forever.

The National Veterans Wheelchair Games held in Louisville, KY, in July 2019 were the 39th annual games and pulled in over 800 athletes. Starting in 1981, the wheelchair games have drawn individuals from all 50 states, including the Dominican Republic and Great Britain. Over the past years, the wheelchair games have expanded from the original 7 events to over 20 events bringing veterans together to compete on one stage.

In 2019, veteran Jim Kempner joined as an athlete in his 4th wheelchair games and participated in 9 different events, including slalom, trap shooting, bowling, and archery. His outstanding dedication and ability to battle to the top led him to receive three gold medals and four silver medals. When receiving his medals, Jim used his Ekso Indego Personal to walk across the stage. When explaining his feelings, Jim expressed, “to show veterans that now we have the opportunity to not only stand but walk again is a feeling that is hard to explain.”

Injured in March of 2014 when he fell off the second story of a building, Jim was determined to continue pursuing his passions and hobbies. By participating in the veteran wheelchair games, he was able to compete on a high level and dedicate himself to the challenge each sport provided. His interest in participating in sports at a high level and continuing to be active led him to seek out other interests, including exploring technology available for veterans— exoskeletons. Jim started his training with the Ekso Indego Personal exoskeleton in April of 2018 through VA Palo Alto. Walking across the stage to accept his medals at the National Veterans Wheelchair Games was only the beginning for Jim.

When he is not competing in his sports, Jim uses Ekso Indego Personal on a daily basis to walk with his family and friends. He truly takes it to the limits, demonstrating how Ekso Indego Personal is not only helping veterans walk at home but around the community. Jim enjoys walking around Walmart and Home Depot, something that was not an option for him following his injury in 2014. Not only has he been able to see personal changes when using Ekso Indego Personal, but his family has also been a big part of his journey as well. So much so that a letter written by his granddaughter outlining three wishes included a wish for her grandpa Jim, “My last wish would be for my grandpa to walk again.”

“To be able to stand and walk again really can’t be put into words. To be able to show others that there are options other than to just be in a chair the rest of their life is great.”

 Jim Kempner, United States Veteran, Wheelchair Olympics Athlete, and Indego user

Ekso Indego Personal has helped Jim to continue reaching for his goals and passions. Not only in his love for sports but also in making his granddaughter’s wish come true.

Now offered under Ekso Bionics, Ekso Indego Personal is a flagship at-home exoskeleton that is designed to help patients with spinal cord injuries walk again in their homes and community. Equipped with a modular, quick-connect design, you can put it on and take it off anytime without assistance. It’s also extra light, weighing only 29 lb (13kg), and is designed to help you take it with you anywhere you want to go. Try Ekso Indego Personal today and regain your independence. For any inquiries, reach out to us today.

My name is Jim Dahlin. I’m an army veteran who served as a combat medic with the 4th infantry division in Vietnam from 1969-70. I was discharged in June of 1971 and used the GI bill to become a nurse anesthetist. When I was 48, I could ride a bicycle across the US from Seattle to Williamsburg, Virginia, in 24 days averaging 140 miles a day. Two short years later, at the age of 50, I was unable to even get on a bicycle. I had been diagnosed with a spinal cord injury, which eventually put me in a wheelchair.

The Minneapolis VA and My Introduction to Exoskeletons

I didn’t get involved with the VA until 2014 when I had an MRI done at the Minneapolis VA. I needed to have my baclofen pump checked before I could be discharged and had to go to the SCID (spinal cord injury or disease) center. When I met with the physician there, she told me that my disease qualified me to be seen and treated at the SCID center. As part of my two-day physical, I was seen by a physical therapist who asked me if I would be willing to try a new therapy device. This new therapy device was an exoskeleton called the Ekso NR. I attended physical therapy three days a week for five weeks. It was so nice to stand and move. Unfortunately, the Ekso was only for therapy and not for home use.

After a few weeks, I got a call from another therapist in the SCID who was looking for people to try the ReWalk exoskeleton, which was approved for home use. I went through training for three weeks to learn how to use the device. Since you need to have someone with you using the exoskeleton, my wife went through some of the training with me. After completing my training, I was approved to take it home for a three-month trial. After my trial period ended, I returned the device and was asked if I wanted to have it purchased on my behalf by the VA. Later, I found out that another device was launching for trial in the next few months, so I decided to try the new exoskeleton as well before I made a decision.

Why I Chose Ekso Indego Personal

When the Ekso Indego Personal exoskeleton launched, my wife and I attended and completed the training for it at the Minneapolis VA. I was then given the opportunity to take the Ekso Indego Personal home for a three-month trial. During my trial period, Indego made some changes to the exoskeleton. They sent me the new components with each change, so my trial period was extended to give me the opportunity to test all the new components. 

I made the decision to go with Ekso Indego Personal for a few reasons. I can make adjustments to such things as step height and step length while walking in the device. Its five-piece design makes it easy to assemble and put on, and if I spend some time away from my home, it has a travel case to store it in.

The thing I love most about exoskeletons is the ability to stand, walk, and look someone straight in the face while talking. Those of us in chairs know how tiring it can be on our necks to look up at someone who is standing and carry on a long conversation. It’s also good for the overall body to stand and move. I generally walk in the device for 30-45 minutes, 2-3 times a week. Living in Minnesota, the winter poses some problems when it gets too cold, or the sidewalks become slippery from ice and snow. Because the Ekso Indego Personal is slim and lightweight, I can get in my car while wearing the device, giving me the option to go to a mall or large store and walk with it during the winter months. 

If you are currently in a wheelchair, I recommend speaking with the physical therapist in your SCID to see if you physically qualify for the use of an exoskeleton. If you do qualify, I highly encourage you to do a trial with your therapist. I know that not every SCID has an exoskeleton in-house. If yours does not, contact Ekso today to make an inquiry.

On a chilly morning more than three years ago, Paul Austin (formerly a rescue swimmer for the U.S. Navy) and his wife Brandi Koltermann were working on a landscaping job. One last branch had to be cut before the trunk before they removed a large 10-foot tree and ticked it off their list. Paul climbed the tree while Brandi waited on the ground, ready to clear away the brush. Unfortunately, Paul slipped, fell from the tree, broke his back, and severed his spinal cord leading to a complete T11 injury.

Paul’s Recovery Journey After the Injury

Brandi recalls the accident vividly. She remembers holding Paul’s head and talking to him calmly while he received treatment. When Paul was told he was paralyzed, he was devastated. It dawned on him he had lost everything he had worked hard for.

Paul believed walking again was not an option. When he started rehab in Richmond, Virginia, he noticed the use of exoskeletons in physical therapy, and he asked about “the RoboCop legs.” As a Navy veteran, he went through the Richmond VA Medical Center. He submitted his name to the research department, expressing interest in the exoskeleton, and six months later, he was called to take part in a nine-month program involving therapy twice a week. “The VA definitely helped with this process. They’ve been so supportive,” said Paul.

Seeing exoskeletons being used in rehab gave Paul a glimmer of hope. And when he first stood up with the help of an exoskeleton, Brandi was overwhelmed with emotion. “You lost the use of your legs, and now this gives that back to you,” she said.

Brandi was able to give him a standing hug for the first time since the accident. Paul especially loved that now he could look other people in the eyes. “It’s an indescribable feeling. It is such a good feeling because in your head, you’re thinking you’re never going to walk again, and I can’t do this or that,” he said.

Discovering the Ekso Indego Personal Exoskeleton

Since the first time Paul saw the Ekso Indego Personal exoskeleton at the 2018 National Veterans Wheelchair Games in Orlando, he knew he had to try it. The device wasn’t as bulky and had fewer components than the one he was using at the time. With the Indego exoskeleton, mobility seemed graceful and very different from his current exoskeleton. After a one-hour trial, he was convinced. The Ekso Indego Personal provided a smoother, more natural gait.

Additionally, it weighed significantly less. The couple wasn’t able to travel with their first exoskeleton, but with the Indego, they could use it on the go. The other exoskeleton felt heavy because of its weight and rigid components, but with the Ekso Indego Personal exoskeleton, walking felt more natural.

The Ekso Indego Personal exoskeleton was very easy to learn to use. He would leave the device charged and assembled in a chair. Then, with Brandi’s help, he would simply transfer in and out as needed. “It does all of the work for you after that!” He did have to get used to walking around at home and on hills and ramps, but after practice, it didn’t take long to get accustomed to the Ekso Indego Personal. Paul now walks three times a week, on average.

A short time after using the Indego, Paul saw extreme improvement in his health, both physically and mentally. His upper body strength, bone, and joint health have improved. And his mental outlook is better. “Thanks to the exoskeleton, there is hope for walking. It’s a great feeling. Everything feels a bit lighter. It’s made a true difference,” said Paul.

With the help of the VA and Indego, the process of acquiring the exoskeleton was streamlined. “As simple as it could be, and the communication was great,” said Paul.

Paul’s daughter is planning to get married, and he fully intends to walk her down the aisle. After learning he was paralyzed, Paul had given up on this dream, but Ekso Indego Personal made his dream possible. As a father, walking his daughter down the aisle is a major life milestone. “It’s a big deal,” he said.

What Does the Future Hold?

The couple still has a positive outlook on life despite all that has happened. They are always looking forward to new possibilities and opportunities. For example, Paul has been able to start electrotherapy after using the Ekso Indego Personal exoskeleton.

What’s next for the couple? The 9/11 Memorial & Museum 5K Run/Walk in New York City. To prepare for the walk, Paul practices distance walking at home. Their quarter-mile-long driveway is the perfect track. The first goal is to be able to walk a mile with a pine tree or mailbox as the end marker. Recently, Paul has begun walking three-quarters of a mile regularly. He’s excited to reach the one-mile mark. Brandi looks forward to the moment she can say, “You know what, Paul, we did this.”

Brandi keeps an engraving near Paul’s National Wheelchair Games medals that states: “An I can’t become an I did.” Over the past few years, Paul has progressed from believing he would never walk to working towards the goal of walking a mile.

Brandi keeps a list of things that Paul thinks he can’t do because he is in a wheelchair, then crosses things off as they accomplish them together. Crossed off the list are: riding a four-wheeler, scuba diving, using a zero-turn lawn mower, going up in a hot air balloon, and walking!

The couple’s mission is now to encourage others. “We are in a place with technology where the question is, ‘Why not?’ At times, things can seem tough, but just never give up hope and always strive to be better,” they advised.

Although life changed after the injury, Paul and Brandi are still running the landscaping business. They keep receiving requests for work but have switched roles in order to accommodate Paul. Now, Paul cuts lawns, and Brandi does the weeding. Paul is grateful he can still do the landscaping work he loves, even though tree removal is no longer an option.

Indego exoskeletons are now available under Ekso Bionics, and if you’d like to learn more or make an inquiry, get in touch with us today.

Spring is near, and the warmer weather opens an abundance of opportunities to get outside! The intention of this blog is to discuss tips to help you, as an Indego Personal user, to prepare for increasing Indego use, especially if your walking time was diminished during the cold winter months. This is also to provide suggestions to clinicians on how to implement outdoor activities in the Indego exoskeleton during patient treatment sessions.

Read below, and add the following tips to your routine or clinical practice to ensure safety and success with Indego Personal this spring.

How to Safely Use Exoskeletons in Spring

1. Stretch

Be sure to incorporate a solid stretching regimen into your routine. Muscles may become stiff or shortened during winter months when users might experience extended times sitting. Some key muscles to target in your stretching routine include your hip flexors and your hamstrings. If you are unfamiliar with these types of stretches, contact your physical therapist for a personalized stretching program to perform at home.

A standing frame is another great option for stretching legs and hips in addition to the many other benefits associated with standing frame use. Begin with 20 minutes and add an additional 5 minutes per session to improve your upright standing tolerance and to achieve a prolonged stretch of leg and hip muscles. For clinicians, if your patients are stiffer this spring from prolonged sitting during the winter months, try having them stretch or use the standing frame prior to their physical therapy session.

2. Conduct Skin Checks

Keeping your skin healthy is incredibly important, especially with Indego exoskeleton use. Remember from your training that skin checks, both before and after each Indego walking session, are an essential step. This is especially true if you haven’t used the exoskeleton frequently in a long time. Regular exoskeleton use helps toughen up skin in areas that come into contact with the device. But if you haven’t walked in your exoskeleton as often during the cold months, your skin might be more sensitive when starting back on a routine.

Check the following locations before and after each Indego walking session: Tailbone, hip bones, shins, ankle bones, and outside edges of both feet. You are looking for redness, skin irritation, or skin breakdown. Redness in these areas following exoskeleton use is common, but as a general rule, redness is expected to disappear between walking sessions.  You can also expect it to disappear after about 10-15 minutes of being out of the device. If you experience significant skin irritation and/or skin breakdown, please contact your physical therapist prior to using the exoskeleton again.

3. Increase Exoskeleton Wear Time

Gradually increasing wear time is just as important as skin checks. If you are returning to exoskeleton use after a break during the winter months, begin with the goal of spending 30 minutes exercising. The 30-minute timer begins when you tighten up the straps and ends when you remove the exoskeleton. You can then start to build up tolerance and ensure your skin stays protected by gradually increasing your usage time. A good rule of thumb for wear time progression is adding 5 minutes to every session, assuming skin checks are clear and all, if any, redness subsides. Abiding by this rule will keep skin safe while building up tolerance.

4. Scope Out Your Walking Area in Advance

As the weather starts to warm up, we encourage you to use your Indego Personal outside. A good approach to exploring new places with Indego Personal is to go to the location beforehand to ensure the terrain is safe for use, including the capability to maneuver your assistive device. Please remember Indego Personal is not safe to use on sand, loose gravel, or any terrain that is unstable or slippery. In addition, find benches, chairs, walls, and railings that may be helpful spots for taking breaks. Having a walking route in mind with these places identified in advance will be helpful if a break is needed. Paths at public parks, community centers, football field tracks, and shopping centers are likely to have many of these options easily accessible.

Conclusion

We hope that these tips help prepare you for warm weather adventures with Ekso Indego Personal this year. If you have questions or comments, please reach out to us.

In an expansion and growth effort, Ekso Bionics successfully acquired the Parker Hannifin Human Motion and Control Business Unit, including the Indego® exoskeleton product line. Indego exoskeletons are now available under Ekso Bionics’ offering, and if you’d like to learn more, get in touch with us today.