Within the past several years, lower extremity exoskeletons have become available for individuals to purchase. These devices allow individuals to stand up and walk in their home and community environment. It is likely that other devices will also be available for purchase in the future. This blog aims to help potential personal users make an educated decision when considering purchasing an exoskeleton.
Criteria for personal use
Each exoskeleton has their own specific inclusion and exclusion criteria for use (i.e. height and weight, level of injury, etc.). Listed below are some general criteria used to determine eligibility to purchase an exoskeleton for home use:
Height: between approximately 5’1” (155 cm) – 6’3” (191 cm)
Weight: less than approximately 220 lbs (100 kg)
Hand and shoulder strength to manage a stability aid (i.e. rolling walker or forearm crutches)
Skin intact where it contacts the device (i.e. sacrum, legs)
Good range of motion for standing upright
Diagnosis and level of injury requirements vary between countries and exoskeletons
Additionally, in the United States, the user must have a trained individual (called a companion or support person) with them at all times while standing and walking. This individual could be a spouse, family member, or friend and must complete a comprehensive training program along with the user.
Goals for personal use
Each user’s expectations and goals for an exoskeleton will be unique. Prior to purchasing an exoskeleton, it is critical that potential users evaluate and align their goals with the specific features and functionality of each device.
If a user plans to travel with their device, they should consider an exoskeleton that is lightweight, portable, and easy to transport.
If the goal is to stand hands free with the exoskeleton, the user should consider an exoskeleton that does not require use of a stability aid (i.e. rolling walker or forearm crutches).
If a user wants to do a lot of outside walking, they should consider an exoskeleton that can manage a variety of outdoor terrains (i.e. grass, ramps, sidewalks, gravel, etc.).
In addition, speaking with someone who has purchased and is using the same exoskeleton the user is considering can lend tremendous insight into the decision-making process. While situations may be quite different, the current user’s feedback may prove very helpful and bring up questions that had not yet been considered. An exoskeleton training center or the exoskeleton manufacturer may be able to connect a person who is considering purchase with a current user.
Trialing an exoskeleton
Before making a final purchase decision, each user should first trial the exoskeleton. Most people would not buy a vehicle without test driving it first. In the same way, prior to buying an exoskeleton, all potential users should “test drive” the exoskeleton. Ideally, this would include walking in situations similar to how they plan to use the exoskeleton at home or in their community. A “test drive” is also important to ensure the user’s body type fits the device, the device meets user expectations, and the device is not difficult to operate.
Financing an exoskeleton
Purchasing an exoskeleton for home use can be quite expensive. Exoskeletons vary in price and financing options. This must be considered prior to any purchase.
Depending on the user’s location (United States or abroad) and insurance coverage, the device and training fees may or may not be covered. In addition to cost for the device itself, training fees and warranty packages are often separate. Approximately 40 hours of training is often required prior to achieving the skills required to safely use an exoskeleton at home and in the community. Warranty packages are also recommended as this technology is still relatively new.
There are many factors to consider prior to purchasing an exoskeleton for home use. Not everyone will qualify to purchase an exoskeleton, and all exoskeletons may not meet your own specific wants or needs. Carefully evaluate all options prior to making this large investment.
This article was contributed by Casey Kandilakis, PT, DPT, NCS. Casey is a clinical research scientist at Shepherd Center in Atlanta, Georgia. Casey received her Bachelor of Science in Exercise Science from the University of Tennessee in 2007, and her Doctorate of Physical Therapy from East Tennessee State University in 2010. Since that time, Casey has worked in the field of neurological rehabilitation and research, and has lectured at numerous national and international conferences on the use of advanced technologies in rehabilitation and the translation of research into feasible clinical practice. She became a certified neurologic clinical specialist (NCS) in 2014. Her current research focuses on the use of advanced technologies and exoskeletons with individuals who have lower extremity deficits due to neurological injury or disease. Additionally, Casey is a Certified Indego Instructor, and has taught and lectured about Indego to clinicians around the world.
Shepherd Center, located in Atlanta, Georgia, is a 152 bed, private, not-for-profit hospital specializing in medical treatment, research and rehabilitation for people with spinal cord injury, brain injury and multiple sclerosis.