Israeli-designed device allows paraplegics to walk

As a result of an automobile accident in 2007, Southern California resident Stephen Wilson was only able to enjoy the outdoors from a seated position in his wheelchair for years.
September 17, 2014

As a result of an automobile accident in 2007, Southern California resident Stephen Wilson was only able to enjoy the outdoors from a seated position in his wheelchair for years. But thanks to ReWalk, an Israeli-designed-and-built device that allows some people with spinal cord injuries to stand and walk, Wilson got to go for a stroll again — with an ocean view.

“We walked outside in the marina,” Wilson said of a previous excursion to the San Francisco Bay Area, where he was helping to promote the system. “It was nice to walk along with someone instead of them helping me walk. And it was wonderful to be outside. Usually when I walk, it’s in a clinic setting.”

ReWalk is a wearable robotic exoskeleton that allows individuals with lower-limb disabilities to stand upright and walk. On June 26, it was approved by the United States Food and Drug Administration (FDA) for personal use, the first such device to receive this designation. In fact, the agency created a new category for exoskeletons as a result of ReWalk’s application process.

And the company’s initial public offering on Sept. 12 was a huge success. Shares starting at $12 more than tripled in the first two days of trading, according to news reports.

The system consists of a wearable brace that supports the user’s waist and legs, motors that supply movement at the hips and knees, a motion sensor and a battery-powered computer control system that is worn in a backpack. The motion sensor detects when the user leans forward or shifts weight, and using a computer algorithm, the ReWalk produces hip and knee motions that mimic human gait. Wearing the device, users can sit, stand, walk and turn.

ReWalk was developed by Israeli inventor Amit Goffer, who became a quadriplegic following an all-terrain vehicle accident in 1997. Founded as Argo Medical Technologies, ReWalk Robotics Ltd. has offices in Yokneam Ilit, Israel; Marlborough, Mass.; and Berlin. The system is manufactured in Ma’alot, Israel, by San Jose-based global manufacturing company Sanmina Corp. 

At Precision Rehabilitation in Long Beach, Wilson demonstrated ReWalk in action. With the assistance of a physical therapist, he placed his feet onto foot platforms, put on shoes that go around the platforms, fastened Velcro straps around his waist and legs, and donned a backpack containing the machine’s battery and computer. 

Wilson pushed a remote control telling the device he wanted to stand, and he rose up from the chair. Using crutches for stability, he then began walking, one deliberate step after another. 

In total, Wilson made three loops around the facility, covering about 300 feet and working up a considerable sweat. He said the newer personal systems are easier to negotiate than the older rehab version he used for this demonstration. 

This fall, Wilson will simultaneously pursue an undergraduate degree in mechanical engineering and a master’s degree in biomedical engineering at USC. He intends to work on future medical devices to assist people with spinal cord injuries. 

As she followed behind Wilson, Christy Malonzo, a physical therapist and the co-owner of Precision Rehabilitation, discussed the device’s value. 

“It allows for forms of exercise you can’t get in any other way,” she said, noting that individuals with spinal cord injuries don’t have many opportunities to increase their heart rate and work up a sweat. 

There are two forms of the device, one designed for providing physical therapy at rehabilitation centers, and one custom-fitted for personal use. ReWalk has been in use at rehab centers in Israel and Europe since 2011, and available there for personal use since 2012. Here in the U.S., the personal device costs $69,500. 

Precision Rehabilitation is one of more than 30 rehab centers, Veterans Administration hospitals or private clinics in the U.S. to partner with ReWalk Robotics in distributing the systems and training users. Malonzo said she liked ReWalk because it is the only system that enables users to negotiate stairs, although the FDA has not approved it for that purpose.

Users must meet certain criteria, including height and weight requirements, location of their spinal cord injury and ability to use crutches. They must undergo training and evaluation in order to use the device.  

ReWalk CEO Larry Jasinski said the device is not meant to replace the wheelchair but to complement it. A wheelchair might be more efficient for long distances, he said, but ReWalk allows users to engage in activities such as shopping, attending social functions or working. He described a customer in London who uses his wheelchair to navigate the subway but wears the ReWalk at the office. There, he can walk from one cubicle to another or stand to give a presentation. 

More than 400 personal and rehab devices are being used worldwide, and ReWalk has found its way into more than 50 rehab centers.

Jasinski said companies like his “can do better development in Israel than [in] the U.S.” The culture is faster in early development phases, the Israeli government is supportive, and Technion — Israel Institute of Technology and other entities provide early grants that would be difficult to secure in the U.S., he said.

Exoskeletons have been getting increased media attention lately. The opening ceremony of this year’s World Cup featured a person wearing an experimental device that uses a brain interface to enable walking. ReWalk was featured in the Fox television series “Glee,” when it was used by fictional character Artie Abrams (Kevin McHale).

Jasinski believes the technology eventually will be able to help those with other medical conditions such as multiple sclerosis, cerebral palsy and stroke, as well as aiding the elderly in walking.

Studies documenting ReWalk’s physical benefits are underway. It is expected that they will show increases in bone density, muscle tone, cardiovascular fitness and bowel function, according to Jasinski. 

Jasinski said the emotional benefits for users can be as significant as the physical ones. When he visited one of the first people in the U.S. to purchase a personal ReWalk system, the woman marveled how she was able to walk to the kitchen window and see the view outside and how she could finally reach upper kitchen cabinets without having to ask for help.

People in wheelchairs lose human body contact, Jasinski said. “When you try to hug a person who’s in a wheel chair, you end up leaning over and tapping them,” he said. “Now, they can stand up and put their arms around their loved one and give a full-body hug.

“I’ve been working with medical devices for 20 years,” he added. “This is the biggest in terms of depth of impact on the individual and on those around them. It changes the dynamic of the whole family. It’s incredibly gratifying.”

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