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Exoskeletons for paraplegics

Rolf Wenkel / cdDecember 9, 2013

Paraplegics at a clinic in Bochum, Germany are learning to move again at a rate doctors consider remarkable. The catalyst? A robotic exoskeleton with a futuristic form of steering.

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A hand grabs a wheelchair wheel
Image: Fotolia/apops

Philipp von Glyczinski was one of the first patients at the Bergmannsheil university clinic's "Center for neuro-robotic mobility training" in Bochum, Germany. An accident left the 35-year-old confined to a wheelchair. Now, with the help of modern medical technology, the architect is learning to walk again - step by step.

"You're not being walked; rather, through the impulses, you're walking on your own. And you feel something again that you didn't feel before," he told DW.

Sensors affixed to the hips and legs give patients a sense of stability during ambulatory exercises. The robot suit contains numerous sensors that recognize nerve impulses as they flash across the skin. Via a small motor, the suit converts those impulses into motion.

A man walks on a treadmil with the help of a robotic exoskeleton on his legs and torso.
Philipp von Glyczinski hopes to regain the ability to move without his wheelchairImage: Hoelken/GBRCI

"The brain sends a signal out that typically arrives at the muscle via nerve systems," said Thomas Schildhauer, the professor who's leading the team of experts at the clinic.

"With a patient who's not entirely crippled, small impulses can still be discovered in the muscles. And they can be measured and recorded on the skin. That signal is then amplified in the robot and moves the motors of the exoskeleton," he told DW.

Lean on me

Robots like those used by Glyczinski can open up new means of movement not only for paraplegics but also for patients with muscular problems due to Parkinson's disease or a stroke. Commands sent by the brain that are no longer capable of driving muscle movements are received instead by the high-tech apparatus.

Such robot-supported training, Schildhauer says, "seems to build up and expand the remaining muscle functions, and the brain structures, too, that haven't been used for a long time." Movement patterns, he added, are then re-trained. "It seems to cause the patient to fall back into many of the old, usual cycles of movement, and results in them being able to walk again."

And an ever-graying society will need to lean on such medical technologies to ever greater extents. The field already accounts for 21 billion euros ($28.8 billion) in annual revenues in Germany alone. That number will rise with the unveiling of new products aimed at improving patients' lives.

At the Cyberdyne Care Robotics GmbH, the German-Japanese joint venture developing the robotic exoskeletons, the working team is composed of doctors, therapists and technicians. After trial runs at the nearby university clinic, Bergmannsheil, the company will bring its robot to the European market.

Rollstuhlfahrer Student Park
Leg muscles - and the nerves that direct them - may have to be retrained after years of disuseImage: Fotolia/D. Ott

For hire: robot walkers

In terms of marketing the high-tech instruments, the German-Japanese joint venture plans to utilize a leasing model for clinics and rehabilitation centers. Modern medical technology does come at a price: In Germany, a two-hour training session for a paraplegic using the equipment costs roughly 500 euros.

The venture is supported by NEDA, an organization under the umbrella of Japan's Ministry of the Economy, Trade and Industry. To better inject robot therapies into European hospitals, NEDA loaned the team 24 robot suits worth a combined 2.3 million euros. They've named the futuristic mobility technology "Hybrid Assistive Lab" (HAL), developed by scientist and professor Yoshiyuki Sankai.

In Sankai's home country, the robots are already being used in 160 clinics, rehabilitation centers and assisted care facilities. For them to be used in Europe, however, adjustments must first be made to the design. Nor was it an accident that the Japanese partners chose Bochum and the nearby Bergmannsheil clinic. Embedded within the Ruhr-Universität's sprawling health campus, the area offers many opportunities for cooperation with research facilities as well as for-profit companies.

Doctors in Bochum point to remarkable progress. Patients who previously sat in wheelchairs have been able, after five months of training, to move around safely with the help of a walker.

For Philipp von Glyczinski, that is his goal - as soon as he's done with his robot-assisted training sessions.