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Exoskeletons support people with spinal cord injuries to walk again but a prohibitively high price tag is restricting their use
After being paralysed from the waist down while on duty in Afghanistan, former army guardsman can now walk with the help of a bionic suit. Photograph: ReWalk
James Johnson can still remember the moment he was told he would never walk again.
“It was about six weeks after I’d woken up from a coma,” he recalls. “The doctor explained that the spinal injury I had suffered made it very unlikely I’d ever be able to walk. It was difficult to hear. But I was determined it wouldn’t mean my life was over.”
The former army guardsman was defending a compound on his first tour of Afghanistan in 2012 when he was crushed by a collapsing wall. His injuries left him paralysed from the waist down and consigned him to a wheelchair.
But today, Johnson is able to walk from his flat in Manchester’s Salford Quays down to the local newsagent for a paper, thanks to a ReWalk bionic suit. The remarkable exoskeleton device allows people with spinal cord injuries to stand upright and walk around.
“It’s just so amazing to be given this new lease of life,” says 31-year-old Johnson, who has been using his suit for six months. “I’m still adjusting to it, but hopefully it’s something I’m going to be using on a day-to-day basis.
“It’s the little things that have been special, like being able to walk to the pub with friends, or go for a walk with the dog, or go down to the shop to get the paper. The little things make you feel so much better.”
The ReWalk kit was designed by Israeli inventor Dr Amit Goffer, a quadriplegic. After a car crash in 1997 left him paralysed, Goffer was inspired to begin working on a bionic suit. The device uses motion sensors attached to leg braces and motorised joints which respond to subtle changes in upper-body movement.
“We’re all driven by Dr Goffer,” says ReWalk CEO Larry Jasinski. “We’re all driven by his original thought, which was, ‘There’s got to be a better way than spending a lifetime in a wheelchair’.”
In 2012, Claire Lomas became the first person to complete a marathon in a bionic suit. Photograph: Robin Plowman
Could exoskeletons really replace wheelchairs one day? “At the moment the ReWalk suit compliments wheelchair use,” explains Jasinski. “There will still be times it’s easier to be in your wheelchair, but living in a chair effects you tremendously: you lose bone mass, you lose muscle tissue, your metabolism changes because of the lack of activity.”
“So there are the health benefits to being upright, as well as benefits to the quality of everyday life. For walking around the office, the home, going outside for walk – we wanted to create a device that was perfect for all that.”
Since its introduction in 2012, the ReWalk suit has mainly been used in clinics and rehab centres in the UK, but is also available to buy for everyday use through Yorkshire-based supplier Cyclone Technologies.
The price, however, remains prohibitively expensive. Each suit costs just under $70,000 (£44,000). The international challenge faced by the US-based ReWalk team is to get medical insurance companies to cover the cost for each patient.
In New York City, the James J. Peters VA Medical Centre has agreed to cover costs for injured veterans. In the UK, James Johnson’s suit was funded by the United Jewish Israel Appeal (UJIA) and in Germany, four insurance groups have also been persuaded that the suits helps lower the cost of ongoing medical care.
“It will take time,” says Jasinski. “We’ve seen steady progress with private insurance companies in the US. We just have to keep giving them data from clinical studies. We’re now turning our attention to France and the UK, first to the private health groups, then eventually to the public groups … We’re trying to build support within the NHS.”
“In time we’d like it to become much more widespread,” he adds. “So just like the wheelchair they give you, or the prosthetic, this should be given out the same way.”
In 2012, Claire Lomas became the first person in the UK to get a ReWalk suit, paid for with the help of family, friends and her own fundraising efforts in the equestrian world – a former event rider, Lomas was left paralysed from the chest down after a horse riding accident in 2007.
She also became the first person to complete a marathon in a bionic suit when she walked the London Marathon in 2012, helping raise £210,000 for Spinal Research. “I was just so determined to keep myself fit, to lead a full and balanced life again,” says Lomas.
“This kit has been incredible. It’s the new opportunities it offers. Although I don’t really wear it much when I’m at home relaxing, it’s so nice to be able to go to meetings, or walk around at speaking events and be able to meet other people’s eye-line.”
In 2012, Claire Lomas became the first person
to complete a marathon in a bionic suit.
Photograph: Robin Plowman
Everyone hopes competition between robotics companies will eventually help bring the price down to something more affordable. Ekso Bionics, Rex Bionics and Cyberdyne have all been experimenting with exoskeletons for wheelchair users.
Jasinski thinks it could be a multi million dollar industry, since the technology could be tailored to cater for people with cerebral palsy, multiple sclerosis or those who had have a stroke.
Lomas, now a patron of the Nicholls Spinal Injury Foundation (NSIF), is also excited by recent research breakthroughs, which could lead scientists to renew nerve cells and bring back feeling in the limbs.
“The technology is brilliant in improving your quality of life,” she says. “But ultimately, one day, it would be wonderful to see treatments that could actually cure paralysis. I’d just love to take a bath and feel the hot water again.”
