Robotic exoskeleton upgrades physical therapy, patient outlooks at BMC
PITTSFIELD — Terry Robbins suffered an incomplete spinal cord injury during a car crash on his way to the Vietnam War in 1967. At first, he was able to get around with the assistance of a walking stick, but for nearly two decades he had been reliant on a wheelchair to get around.
Today, after undergoing four months of physical therapy with Berkshire Medical Center's robotic exoskeleton, EksoGT, he can walk around his home with the assistance of a walker.
"It reactivated parts of my body that hadn't been active in many years," said Robbins, of Washington. "My body is hungry to get back on my feet, of course."
About 45 patients at Berkshire Medical Center have used the new $160,000 device since January. The exoskeleton helps patients relearn to walk properly, according to Dr. Jessica Dellaghelfa, a doctor of physical therapy at the hospital. Those who might not regain the use of their legs will use the device to strengthen their upper body.
Because the device straps onto the bodies of patients keeping their knees from buckling, fewer physical therapists are needed to hold onto the patients during their sessions.
With the device there is less physical stress on both patients and the physical therapists, and there can be more walking done during each session.
"When we first started, he couldn't walk at all," Dellaghelfa said of Robbins. "Now he walks 20, 30 feet."
Like Robbins, some of the patients haven't walked in years due to spinal cord injuries that limit the use of their lower body. Others, like Kate Plaquet, of Housatonic, have suffered from a stroke and are able to walk, but need assistance in doing so more efficiently.
On Tuesday, physical therapist Thomas Berkery assisted Plaquet into the device and used a remote control to adjust its settings as she walked around a gym in the Medical Arts Complex.
Since suffering her stroke in January, Plaquet has experienced weakness in the left side of her body. When she started with the exoskeleton two months ago, she'd be leaning so far to the right while she walked that she was nearly falling over Berkery said.
"I would watch myself in my shadow because I didn't even know I was walking wrong,"
The device blocks patients from walking incorrectly and, after using it repeatedly, it trains the body to do it the correct way, Berkery said.
Now she can walk more efficiently without assistance, even on the deck of a pool where she teaches swimming, she said.
"When we were first shown this machine, we didn't have a clue of what it could really do," Berkery said. "This is like cooking on a modern stove, where traditional therapy would be like cooking over a campfire."
With traditional therapy it would take three physical therapists to hold up a patient as they walked across the gym, Berkery said. After about 20 steps, physical therapists and patient would need to take a break, Berkery said. While it can be challenging to physically show patients how to shift their weight or use a certain hamstring, the exoskeleton does it for them, Delleghelfa said.
With the device, patients can walk more than 400 steps around the space before taking a break.
But of course, with any technology, there is a learning curve, but after four- to six-hour sessions it feels natural and they see the kind of progress they can make.
"A lot of people fight the machine at first," Dellaghelfa said. "Eventually they learn to work with it."
The device, which is shared between inpatients and outpatients, is currently booked up through September, Dellaghelfa said. It would be ideal for the hospital to eventually acquire another machine so physical therapists don't have to move it between buildings she said.
To show patients and administration the kind of success they see with exoskeleton, the physical therapists take videos of their patients walking on the first day of their therapy and then toward the end of their sessions.
A video of Robbins, who was the first patient to try out the device, show him struggling to pull himself up and take steps during his first attempt to walk across the gym. Another video taken three months later shows him almost effortlessly pulling himself into the device and walking much quicker around the room.
"By the end, it was natural," Robbins said. "It was normal."
"For a guy who hasn't walked in 20 years, for him to be able to walk around their own home, that's a big step," Berkery said.
Haven Orecchio-Egresitz can be reached at firstname.lastname@example.org, @HavenEagle on Twitter and 413-770-6977.
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