Exoskeletons: Daily living aids with two legs

Interview with John Frijters, Vice President of Sales and Business Development in Europe

Photo: John Frijters

John Frijters; © beta-web/Stöter

By now, exoskeletons have found their place in the treatment and rehabilitation of persons with spinal cord injuries, but also in general use. They provide a special type of therapy by returning a small portion of independence back to the affected parties. And although this is not a cure, the devices provide mobility so patients can move with underarm crutches or walkers.

REHACARE.de has met with John Frijters from ReWalk Robotics at its booth in Hall 4/A05 and spoke with him about the ReWalk System.

Mr. Frijters, how does the ReWalk System work?

John Frijters: The ReWalk exoskeleton is a modern resource and more precisely a type of leg brace that supports the body. It consists of two leg braces, that being a thigh and lower leg module that converge in the pelvic area. These leg braces contain motors and electronics. The user controls the movements by slightly shifting the body’s center of gravity. A forward motion of the upper part of the body is detected by the system and initiates the first step. A repeated shift in body weight triggers a sequence of steps that mimic the natural sequence of walking steps. The gait is customized for each user. The user needs to subsequently learn to stand upright and balance. This is why he or she is also supported by underarm crutches. The entire system is self-supporting so that the user does not feel the exoskeleton’s 25-kilogram weight.

What types of exoskeletons are currently on the market and what type is your system?

Frijters: Generally, they all share one big common denominator: the purpose of an exoskeleton is to hold up a wheelchair user and help him/her to walk again. There are essentially two main types: one exoskeleton is dedicated to pure rehabilitation and one is for personal use, for everyday life so to speak. The latter is our main target audience. Then there are also subcategories, rehabilitation devices for instance that are suited for people with incomplete paraplegia. Other systems facilitate functional electrical stimulation and are used in stroke rehabilitation.

Foto: Exoskelett

John Frijters and a user of the exoskeleton; © beta-web/Stöter

Who is best suited for this therapy?

Frijters: The system is best suited for persons with a complete spinal cord injury or incomplete paraplegia who are no longer able to walk or suffer from limited mobility. You need to have a functional hand since- as already mentioned- an underarm crutch is needed to balance the body. Cognitive function is also essential. The system is not so well suited for persons suffering from traumatic brain injuries combined with a spinal cord injury. What’s more, the patient needs to have stable circulation and normal bone density.

That’s why we offer our customers to try out the system. Whether a training makes sense or not from a medical or therapeutic point of view is not decided until then. There are subsequently hours of practice that offer clues on whether the customer is actually able and willing to use the system. At this point, several health insurance companies pay for the exoskeleton under the umbrella of medical equipment.

Persons with disabilities, in particular, are still critical of exoskeletons. Usually the main reason is that the devices give the impression that mobility can be completely regained again. However, they are only able to accomplish this in a limited number of cases and they are not suitable for every patient. As a manufacturer, how do you approach criticism about exoskeletons?

Frijters: We want to make it possible for persons to live a more comfortable life and not advertise a miraculous cure. This is why we take a proactive approach and visit trade fairs like the REHACARE for example. Many people are open-minded and curious. This is why we also offer test sessions and tryouts. This way, people can make up their own minds. Many are not aware that they are also doing something good for their health aside from walking upright with the exoskeleton. Upright mobility is so much more than that: it promotes bladder and intestinal function, blood circulation and builds muscles. In other cases, there is less pain which automatically reduces the need to take medicine. However, even though the system is able to do a lot, it can’t do everything. There will always be critical voices. We are very open about it. That’s why trade fairs are also very important to us.

You find the booth of ReWalk Robotics Argo Medical Technologies in hall 04/A05.

More about the ReWalk System at: www.rewalk.com
Photo: Melanie Günther

© B. Frommann

The interview was conducted by Melanie Günther and translated by Elena O'Meara.