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This robotic exoskeleton was designed with the goal of allowing people to stand and walk within the home and community after sustaining a spinal cord injury. While the device does just that, there are a few physical and functional prerequisites that must be met beforehand to ensure patient success and safety.
Indications
The ReWalk is intended for use on people with paraplegia or paresis after sustaining a spinal cord injury (SCI). The individual must have remaining or recovered hand, arm, and shoulder function in order to support crutch use. This device is not a “free ride;” it requires that the individual has adequate truck control and is able to complete transfers with minimal assist or less.
After a spinal cord injury, a person will spend most of their time seated in a wheelchair with very little weight bearing through their legs. Therefore, before using the ReWalk Personal Exoskeleton, the person must be able to tolerate prolonged upright positioning – be it in a standing frame, standing wheelchair, the parallel bars in therapy, etc… – as well as healthy bone density in the lower extremities to prevent fractures or injury.
It is important for the individual to have hip, knee, and ankle range of motion sufficient for gait as this device is rigid and although can be configured to some extent for too-tight joints, is tolerated best when full range of motion is available throughout the lower extremities. Lastly, this device is best suited for individuals with a height between 5’3” and 6’2” (this is an average, and ultimately depends on femur length) and weight under 220 pounds.
The most important safety component is that the individual has an available companion. This person (or multiple people) will be able to attend trainings and ultimately assist the individual when walking outside of the clinic for safety and to decrease risk of injury. We do not recommend using this exoskeleton without the assistance/supervision of another person.
Contraindications:
There are a few conditions that are considered contraindicated and may make it unsafe to use the ReWalk. These include:
- History of severe neurological injuries other than SCI (MS, CP, ALS, TBI, etc)
- Severe concurrent medical diseases: infections, circulatory, heart or lung disorders
- Active pressure sores
- Severe, uncontrolled spasticity
- Any unhealed fractures
- Heterotopic ossification that is active or limits motion in the hip, knee, or ankle
- Significant joint contractures
- Psychiatric or cognitive situations that may interfere with proper operation of the device
- Pregnancy
If you feel like you, a patient you work with, or someone you know fit these physical and functional indications please reach out! If you are not quite sure if it is a good match, you should still reach out so we can answer your questions.
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