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James A. Haley Veterans’ Hospital - Tampa, Florida


Staff trains for exoskeleton research project

JAHVH physical therapist train with the INDEGO exoskeleton as worn by volunteer Jeff Wagner.

JAHVH Physical Therapists William Haven, Michael Firestone and Lisa Goff assist volunteer Jeff Wagner with the INDEGO exoskeleton while trainer Clare Hartigan observes. The INDEGO allowed Wagner, a paraplegic who has been confined to a wheelchair since 2008, to stand and walk.

By Ed Drohan
Thursday, July 14, 2016
James A. Haley Veterans’ Hospital physical therapists recently completed training in preparation for a new research project – joining two ongoing similar projects – on a medical device designed to help people who are confined to a wheelchair stand and walk with mechanical assistance.

The latest project revolves around the INDEGO, a powered lower limb exoskeleton that can enable people with spinal cord injuries to walk. The INDEGO joins two other similar devices being studied at the hospital – the ReWalk and the Ekso Bionics Suit.

According to JAHVH Health Scientist Samuel Phillips, researchers are looking at similar things for all three devices.

“All three of these devices are in what I would consider a first generation of a clinical device, so all of them have strengths and weaknesses and that’s why we’re investigating the use of all three devices,” Phillips said. “We believe that there are benefits to physiological changes, so we’re actually measuring blood lipids and bone density, and these are benefits generally associated with standing and walking. We believe that since they’ll be standing and walking using the exoskeleton, that they’ll also see those benefits.”

The INDEGO research project is funded by the Department of Defense. JAHVH is partnering with Vanderbilt University and the Mayo Clinic in the three to four year study, Phillips explained.

The JAVH physical therapists completed three days of training on the proper fitting and use of the INDEGO system with the help of volunteers like Jeff Wagner, who was paralyzed in 2008 after cancer treatment. INDEGO master trainer Clare Hartigan, who works with the Shepherd Center rehabilitation facility in Atlanta and who’s been working with the INDEGO for several years, provided the training.

The hospital received one therapy kit, which consists of three exoskeletons in small, medium and large size. The device is modular, so parts from each size can be mixed and matched to fit each individual.

“You never know what patient is going to walk in,” said Steve Carlson of Parker Hannifin Corporation, maker of the INDEGO. “Each INDEGO weighs about 26 pounds and they’ll accommodate any patient from the size of 5 feet 1 inch to 6 feet 3 inches, or 150 centimeters to 195 centimeters. They’re capable of lifting a 250 pound person from a sitting position to a standing position.”

Once the research project begins in earnest in July or August, it will involve eight patients who will be trained on using the exoskeleton. The study will actually be in three parts.

“The first part is an outpatient setting with the exoskeleton,” Phillips explained. “The second part is very similar to the first part in that it’s also in an outpatient setting but it’s with the exoskeleton and then added in functional electrical stimulation – you use electricity to stimulate the muscles to make them work. And then a third part is a take-home trial.”

The research participants will have 28 training visits and three testing visits to the hospital over eight weeks, and then will be back for occasional follow up visits over the course of the study, Phillips said.

While the researchers will concentrate on the physiological benefits of exoskeletons, people like Wagner also say there are psychological benefits as well. As soon as he stood for the first time with the assistance of the INDEGO, a huge smile crept across his face and he joked that he was “…the tallest guy in the room now.”

Wagner, an entrepreneur and motivational speaker who was a triathlete before losing the use of his legs but who still maintains a healthy and active lifestyle, hopes to eventually raise enough money to buy one of the exoskeletons for his own use. It was easy to see why from Wagner’s response when asked what it was like when he first stood again.

“It feels like I’m in heaven.”


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