Exoskeletons for Rehabilitation
It’s quite common to see new emerging technology embraced with great enthusiasm - only to find that initial enthusiasm replaced with cynicism shortly afterward.
When it comes to exoskeletons for gait impairment the same situation applies. it would a shame to miss out on the potential of this technology because of the limitations of the first products on the market.
A spinal injury consultant friend of mine was unimpressed with the first exoskeletons he saw offered for spinal cord injured clients - he saw them as little more than “expensive mobile standing frames” and offering few clinical advantages beyond the provision of a simple standing frame. Things have moved on though, and we should distinguish between exoskeletons as everyday assistive products and exoskeletons that have a therapy purpose with an ability to facility some functional recovery.
We are biased (of course) but we feel that the Indego is the best assistive device of it’s type for complete and incomplete spinal cord injury. It’s lightweight, modular construction and flexible software makes it the market leader in providing flexible, functional assistance to the user.
The really exciting aspect of the Indego is it’s ability to act as a therapeutic aid following stroke, MS, head injury and more. Our partners at the Wellington, Royal Buckinghamshire Hospital and More Rehab use the Indego Therapy Kit every day to enable greater functional recovery in these types of patients - taking advantage of neuroplasticity.
The term Neuroplasticity started to feature in clinical conversations around 2007. Before this time it was assumed that the brain’s ability to adapt to insult and injury was somewhat limited and that as we move into adulthood and old age there was going to be an inevitable decline and loss of brain function. The growing body of research on neuroplasticity demonstrated that the brain was always capable of adapting and this was also true following injury.
In many conditions, such as MS and stroke that damage our brain and neurological system, the brain tries to restore function by re-organising neural network connections and “working around' the damaged areas.
The problem we face is that neuroplasticity is an opportunity but it is not automatically good news.
It is an opportunity because the “right type” of therapy provided intensively and frequently can help restore useful function.
It’s more often a problem because most people never receive enough, or the right type of, therapy. The body consequently adapts and compensates to the damaged situation but this often results in a functional deficit. Gait patterns and adaptations take place that become relatively fixed over time. The body simply learns new habits that don’t serve us.
Just stop for a minute.. Imagine if we had a tool that allowed gait to be carefully guided to limit undesirable compensations. Imagine the therapist able to provide just the right dynamic support in the earliest days following injury. Imagine that the tool can adjust to the changing situation as the patient recovers. Intensive therapy for once would mean not reinforcing bad habits.
This is what clinicians can enjoy right now when they deploy the Indego. The combination of hardware and software gives the therapist the best tool available for taking advantage of neuroplasticity.
When the exoskeleton does all the work and the gait pattern is not so good beware of what pattern you are creating and reinforcing. The Indego leads the way in this respect.
By all means seek out and try all the available exoskeletons and think about the control you need to elicit improved function in your patients. Think of neuroplasticity. If you are a clinician actual why not wear each device yourself and “feel” the difference.