Ideal candidates for an Indego?
The Indego exoskeleton is being used around the world by persons with lower extremity weakness due to paralysis or other neurological diagnoses. In the UK is is most likely to be persons with a spinal cord injury or traumatic brain injury that can adopt the Indego for personal use - but this is a function of payment constraints and affordability rather than anything to do with clinical or technical value.
There are basically two ways that people use the Indego - as a Personal Use device which they take home and as part of an intensive therapy programme at one of our Clinical Partner facilities. Using the Indego in therapy opens up this exciting technology to persons recovering from a stroke, trauma, MS and other neurological conditions where walking has been compromised. Whether a Personal user or a Therapy recipient the Indego User must meet a few clinical criteria which we touch on below.
The Indego, after a period of training, allows users to stand up and walk. Walking with Indego requires the use of a stability aid, such as a rolling walker, rolling walker with upper extremity platform attachments, forearm crutches or other stability aids.
Indego can be described as a powered lower limb orthosis as it is worn on the outside of a person's body just like a “conventional” orthosis.. At just 12 kg, the device mimics natural movement through postural cues, similar to a "legged Segway.". Initiating standing and walking can become a “natural” process for the user. The level of independence the user can achieve depends on their physical ability plus the outcome of intensive training.
Anyone who is serious about purchasing the Indego for personal use will have to follow a process that ensures that the user is safe and will be able to use the product effectively.
A typical scenario would involve getting Medical Clearance from a clinical specialist and then attending one of our Clinical Partners for assessment and a four hour Indego experience. It is not hard to imagine that someone who has not walked for sometime may find the experience somewhat daunting.
The Indego Specialist will work with the prospective user to develop the skills to stand and walk with increasing levels of proficiency. For this reason, rather than a quick 5 minute trial - the Indego experience may be up to four hours in a session - perhaps split into two halves. This can be demanding but gives a more realistic feel for the level of independence that can be achieved by using the Indego. The Clinical Partners make a reasonable charge for this experience and some clients have returned for more than one Indego session.
The risks using Indego are similar to those incurred when walking with long-leg braces, a reciprocal gait orthoses, or any other combination of braces and stability aids. Risks may include muscle soreness, joint swelling, skin abrasion, fall, bone fracture or others. Every effort will be made to keep the user safe while using Indego.
Optimal Indego candidates have the following charateristics
Passive range of motion at their hips, knees and ankles to neutral or better
Adequate bone health to tolerate full weight bearing and walking with stability aid without increased risk for bone fracture
Tolerance for being fully upright without being symptomatic (drop in blood pressure to cause dizziness)
Height 155cm to 190cm and weight 113kg or less.
Intact skin where person would come in direct contact the Indego device
Spasticity level 3 or less on the Modified Ashworth Scale (MAS)
Stable cardiovascular health
In addition, the following contraindications have to be considered:
Contractures at the user's hips, knees or ankles
Unresolved deep vein thrombosis
Diminished standing tolerance caused by orthostatic hypotension Uncontrolled autonomic dysreflexia
Poor skin integrity where the person would come in direct contact with the Indego device
Heterotopic ossification that would limit joint range of motion at the user's hips, knees or ankles
Lower limb prosthesis.
Uncontrolled hypertension or hypotension
Cognitive impairments resulting in inability to follow directions.
Visual impairments that would make walking unsafe
Any condition which in the opinion of a medical doctor prevents a person from using the device.
These points are covered in the Medical Clearance Form that must be completed prior to any user trying the Indego.
With more that 150 Indego devices now in use around the world there is a growing body of evidence that shows what can be achieved with routine usage.
If you would like to try Indego, receive a quote or find out more check out our Indego page at https://www.anatomicalconcepts.com/indego and complete the form on that page.