PhysioFunction are recognised as experts in the application of Exoskeleton technology which can be used by people with a wide range of mobility impairments enabling them to get the full benefits of moving and exercising while being fully supported and upright.
Robotic exoskeletons provide an external frame with motors providing movement of the knee and hip joints, with various amounts of trunk support, to enable an individual to move in a simulated walking pattern.
Exoskeletons are not condition dependent and can benefit anybody with mobility difficulties, helping to increase the time spent on their feet with less fatigue, practising balance and strengthening exercises in standing and walking with motorised support, to either help improve what can be achieved without the exoskeleton, or provide a means of upright mobility, such as would be required after complete spinal cord injury.
The use of exoskeletons for mobility and weight bearing exercise has been shown to provide therapeutic benefits including improvements in bone mineral density and fracture risk, neuropathic pain, bowel transit times, cardiovascular fitness and range of motion (particularly in the hips and ankles).
There are currently 6 overground robotic exoskeletons within the UK, and at PhysioFunction we work with three: REX, ReWalk and FREEWalk.
REX is a unique exoskeleton in that it is operated by a joystick and does not require the use of the arms, instead being self-supporting. Furthermore, within the REX is it possible to perform various static and dynamic standing exercises, termed REXercises, such as lunges, squats and side steps, as well as incorporating upper body exercises, such as using resistance bands of catching balls, to promote core stability, balance, coordination and muscle strength.
The REX is integrated into therapy sessions here at PhysioFunction to provide additional challenges to our patients to make their rehabilitation more fun, engaging, and effective.
ReWalk is one of the most well established and long-standing overground exoskeletons in the country having launched in late 2011 and now having a community of clinics and over 30 home users.
ReWalk is primarily intended for use by individuals with spinal cord injury resulting in paraplegia, where the individual has full use of their arms and some degree of trunk control. It can however be used in individuals with higher level injuries and other conditions, but alternative devices may be more appropriate.
ReWalk is operated with a wristwatch worn but the user, their trainer or buddy, and a pair of crutches is required to maintain balance when standing and moving in the device.
ReWalk has arguably the highest levels of performance, with greater walking speed achievable than most other devices, as well as the ability to ascend and descend stairs, once appropriately trained.
The FREEWalk, born out of the Industrial Technology Research Institute in Taiwan is a rehabilitation exoskeleton that has wide applications within neurological rehabilitation.
Like the ReWalk, it requires the use of a pair of crutches or alternative walking aid to use unassisted in order to maintain balance when standing or moving in the device but can also be used without a walking aid provided a fully trained operator is providing external support.
The FREEWalk has a high degree of trunk support so can be effectively used by individuals with more limited trunk stability, and also has a half foot plate, meaning that those who have sensation in their feet can feel the ground and use their forefoot and toes to aid their balance and control.
Movement can be controlled by the trainer using a tablet, or by using buttons on the crutches, providing safe and controlled operation.