Answered Questions is a monthly resource for the Spanish language Disability Community that fills an information need. This month’s question is: I recently had a spinal cord injury (SCI) and have heard that exoskeletons can be beneficial to people with my type of injury. I would like to learn more. What information, research, and resources are available on exoskeletons? This edition of Answered Questions includes items that discuss collaborative exoskeleton research, a clinician-focused overview, possible health benefits, an exoskeleton with a brain-computer interface, robot therapy for gait rehabilitation, quality of life and secondary conditions, the perspectives of people with SCI, and more. More about Answered Questions.
The Texas Model Spinal Cord Injury System (TMSCIS) (English) conducts innovative spinal cord injury (SCI) research to improve outcomes and advance rehabilitation methods, procedures, and technologies. The TMSCIS collaborates with other SCI Model System (SCIMS) centers (in English) funded by the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR) (in English) to produce module projects on exoskeleton use in SCI, which include the experiences of people with SCI using robotic exoskeletons at four of the SCIMS and the budgetary impact of robotic exoskeleton use for locomotor training after SCI.
The Rehabilitation Engineering Research Center (RERC) on Wearable Robots for Independent Living (English) conducts research and development activities that are focused on wearable robots for independent mobility and manipulation. As part of these activities, the RERC explores the potential of simultaneous spinal cord stimulation to improve exoskeleton use by people with SCI. The RERC also has a development project that explores the application of robotic admittance control as a way of allowing users of a lower extremity exoskeleton to have complete control over the movement of their legs.
From the NARIC Collection:
Bionic exoskeletons are among the emerging rehabilitation modalities that claim to provide functional ambulation, reduce medical complications accompanying SCI, and stimulate plasticity of motor pathways after incomplete SCI. Unfortunately, the majority of ambulation assistive technologies are limited by inefficiencies such as putting on and taking off the device and poor gait pattern. The article, Clinician-focused overview of bionic exoskeleton use after spinal cord injury (English) (J78226), provides an overview of current available bionic exoskeleton devices and their utility for people with SCI.
The article, Perspectives of people with spinal cord injury learning to walk using a powered exoskeleton (English) (J81466), discusses a study that explored the expectations and experiences of adults with SCI learning to use the ReWalk powered exoskeleton. The participants shared their experiences of their use of the exoskeleton and they commonly expressed that the exoskeleton allowed them to perform everyday activities. The researchers share that using the perspectives of users with SCI in the design and refinement of exoskeletons will help ensure that exoskeletons are appropriate for users.
Research In Focus:
Robotic Exoskeletons May Provide Health Benefits for People with Spinal Cord Injuries discusses a study conducted by researchers at the Spinal Cord Injury Model System (SCIMS) centers in Colorado, Georgia, Illinois and Texas of physical, exercise, and recreational therapists who were trained in the use of robotic exoskeletons with patients with SCI. The therapists reported that they found several benefits and risks of exoskeleton use that included physical benefits, such as improved endurance; psychological benefits, such as participation in more activities; and risks such as falling and skin sores from repeated contact with the exoskeleton. The researchers noted that future research may be useful to examine the strengths and limitations of exoskeletons as the technology evolves.
The article, The innovative exoskeleton that helped a paralyzed man move his four limbs with mental stimuli (BBC), discusses the story of a man with SCI who received brain implants that would assist him in controlling an exoskeleton. The implants read his brain activity and transmit them to a computer, where a sophisticated software reads the brain waves and converts them into instructions for controlling the exoskeleton. The author notes that this innovative exoskeleton helped the man move his limbs; however, it has limitations, such as the weight of the exoskeleton being prohibitive to full independence.
The article, Robot therapy with the H2 exoskeleton for gait rehabilitation in patients with incomplete spinal cord injury: A clinical experience (Rehabilitación), discusses a study to evaluate the clinical applicability of a new robotic exoskeleton model in the gait rehabilitation of people with an incomplete SCI. Researchers analyzed the appearance of undesirable events and the patients’ perceptions of pain, fatigue, and comfort. They found that the exoskeleton was safe, without undesirable effects, and with good patient tolerance.
Quality of Life:
The article, Examining the Effects of a Powered Exoskeleton on Quality of Life and Secondary Impairments in People Living with Spinal Cord Injury (English) (Top Spinal Cord Injury Rehabilitation), discusses a study that explored changes in secondary health conditions that may result from using a powered exoskeleton as well as their potential impact on quality of life. The researchers found that, after using the exoskeleton, participants had decreased spasticity and pain; however, there were no changes in bowel and bladder management. The findings of this study suggest that the use of a powered exoskeleton may decrease spasticity in people with SCI and suggest that, although there were improvements in secondary conditions, the use of a powered exoskeleton did not result in a significant improvement in quality of life.
- What is an exoskeleton?, from Computer Hoy (Spain), provides a description of exoskeletons, describes who they are intended for, and describes just some of their uses. Written in plain language and includes a video with more information.
- The United Spinal Association Spinal Cord Resource Center (English) provides information and referrals to people with SCI and their families on SCI-related topics, including exoskeletons (English). Provides a description, uses, and examples of exoskeletons.
- The Christopher & Dana Reeve Foundation Paralysis Center (English) provides information, referral, and support services for people with SCI, their families, and stakeholders. They have an informational page on orthotics that includes information on exoskeletons (English). Contact the Paralysis Center (English) for more information and for referrals.
- The National Assistive Technology Act Technical Assistance and Training (AT3) Center (English) provides information about the Assistive Technology Act, State AT Programs, and general AT information. People with disabilities, their families, and service providers can search for their State’s AT programs (English) that can assist in paying for AT, such as exoskeletons.
- The Foundation Center (English), now known as Candid, maintains a comprehensive database on foundation and corporate giving programs (English) for both individuals and organizations and assists with grant application procedures (English).
- Help Hope Live (English) supports community-based fundraising for people with disabilities that have unmet medical and related expenses throughout the country. They provide assistance with the application process and with the fundraising campaign.
About Answered Questions
Each month, we look through the searches on our blog and through the information requests made by our patrons who speak Spanish and pick a topic that fills the largest need. Each resource mentioned above is associated with this month’s information need. We search the various Spanish language news sources and feeds throughout the month to bring you these articles. With the exception of the NIDILRR Projects, From the NARIC Collection, and Further Investigation, all the linked articles and resources are in Spanish – any that are in English will be c