Restoring Mobility to Paralyzed Warriors: REWALK EXOSKELETON

  Words by Bridget Foster.

Most of us wake up each morning and rise out of bed unassisted, giving no thought to having the ability to stand and walk. For those who have suffered spinal cord injuries, what was once considered an impossibility may now become a reality with the help of a robotic machine called ReWalk.

Developed by Argo Medical Technologies Inc. ReWalk is a prosthetic exoskeleton consisting of a fitted, metal brace that supports the legs and lower torso; motors that supply movement at the hips, knees and ankles; a motion sensor similar to that used in smartphones; a wrist-mounted wireless controller; canes for balance; and a backpack containing a computer and lithium ion batteries to power the system.

There are two versions of the ReWalk; the ReWalk Rehabiliation system was designed specifically for individuals in clinical rehabilitation facilities with spinal cord injuries at levels T4 (fourth thoracic vertebra) to T6 (sixth thoracic vertebra). This version is adapted to fit users of different heights and weights and has been in use since 2011.

The second version, the ReWalk Personal System, is customized for people with spinal cord injuries at levels T7 (seventh thoracic vertebra) to L5 (fifth lumbar vertebra). It is designed to be used in daily living situations (excluding sports and climbing stairs) both indoors and out, on a variety of terrains and surfaces. The personal version has been available to the public in Europe and Israel since 2012 and late last month, was approved by the FDA for sale to the public in the United States. The unit, weighing 44 pounds, costs $69,500.

The VA has been overseeing a research program on the device since 2011, studying its effects on the overall health of the wearer, their tissue mass and bone density, all which become compromised from sitting in a wheelchair. About a dozen paralyzed veterans have participated in the study at The James J. Peters Veterans Affairs Medical Center in New York.

The ReWalk operates by a wrist-mounted controller. The wearer presses buttons that command the exoskeleton to pull him (or her) upright out of chair or to lower them to a chair. When the user wants to walk, they lean forward onto the canes strapped to their arms and the motion sensor detects the forward tilt of the torso, moving the legs forward in a series of small steps. Controlled by the computer in the backpack, motors at the hips and knee joints lift and lower the legs in movements programmed to simulate the human gait.

One California Marine, Capt. Derek Herrera, may be the first American to purchase the personal ReWalk, thanks to assistance from the MARSOC Foundation. His health insurance will not cover the cost of the personal device. Capt. Herrera was paralyzed in 2012 from the waist down when he was struck by a sniper’s bullet while on a mission in Afghanistan. He is still on active duty with the 1^st Marine Special Operations Battalion and has until now, been using the ReWalk at the rehabilitation facility at Camp Pendleton.

Being newly approved by the FDA, the Defense Health Agency (DHA) has not yet determined whether Tricare will cover the cost of the ReWalk. Army Maj. Gen. Richard Thomas, DHA director of health care operations, wouldn’t comment specifically on the ReWalk, but stated that the DHA considers “all promising technologies, taking into consideration research and testing.”