Exoskeleton
Information for patients
Spinal Injuries
What is Ekso GT?
Ekso GT is a robotic human-assisted exoskeleton that is designed as an
assisted walking device for individuals with impaired walking ability due
to neurological disorders such as Spinal Cord Injury. The fully
weight-bearing walking pattern is achieved by the push of a button by
trained therapists or the user’s weight shift which triggers sensors to
initiate the next step.
How is the Ekso GT used?
• It assists people with motor incomplete spinal cord injuries to
re-learn a normal walking pattern.
• It provides a means for people with a neck injury as high as C7 and
below with complete paralysis to stand and walk.
• However, some preservation of hand grip strength is needed to
manoeuvre the walking aid.
• Patient reported benefits of using the Ekso GT include reduction in
muscle spasms, improvement in local circulation, improvement in
balance, improvement in bladder and bowel function, and
maintenance of bone health.
What are the eligibility criteria?
Anyone under the care of a Spinal Injuries
consultant at the Princess Royal Spinal
Injuries Unit, Sheffield.
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How do I get referred?
If you are an inpatient:
• You can be referred through your named physiotherapist for an
assessment.
• If appropriate, a signed medical release form will be obtained from
your named consultant and the Ekso trained physiotherapist will
arrange for an assessment.
If you are an outpatient:
• You will be referred through an outpatient clinic appointment
under your named consultant.
• If appropriate, your consultant will refer you to the Ekso trained
physiotherapist for an assessment.
What are the criteria for the use of Ekso GT?
You will need to be able to fulfil all of the following criteria:
• Independently transfer from a wheelchair to a regular chair, ideally
by completing a “lift and shift” manoeuvre or a standing pivot
transfer
• Currently undertaking an active standing programme with a
standing frame i.e. Oswestry Standing Frame, for longer than 15
minutes
• Sufficient upper limb function to be able to grasp and release
objects in your hands
• Sufficient range of movement to tolerate sit to stand and walking
• Sufficient arm strength and sitting balance to assist with balance
in standing with a frame and/or crutches
• Motor complete paralysis (Asia A/Asia B) C7 or below or
incomplete motor paralysis (Asia C/Asia D) C2 or below
• Weigh 220 pounds (100 kilograms) or less
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• Between 5’2” and 6’4” (157 to 188 cm) tall
• Standing hip width of 17.5” (44.45cm) or less.
What are the conditions that would prevent me using
the Ekso GT?
• Range of motion restrictions that would prevent you from
achieving a walking pattern or a sit-to-stand movement.
• Spinal instability
• Unresolved clot in the leg i.e. deep vein thrombosis (DVT)
• Unable to tolerate standing for more than 15 minutes due to a
drop in blood pressure or dizziness
• Significant osteoporosis that prevents safe standing. This is
diagnosed by a DEXA scan
• Previous leg fractures less than 6 months ago
• Uncontrolled spasticity in your arms, abdomen or legs
• Uncontrolled Autonomic Dysreflexia (AD)
• Insufficient arm strength to assist with balance with frame or
crutches
• Leg length discrepancy above
recommended values set by Ekso
Bionics.
• Skin problems i.e. pressure sores or
fragile skin in areas in contact with
the device
• Some conditions affecting memory
and following instructions
• Pregnancy
If you are unsure, speak to your
consultant, physiotherapist or the Ekso
trained physiotherapist for advice.
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What is the package of treatment?
• Initial assessment will include obtaining measurements of range of
movement, strength, spasticity, and functional mobility; as well as
measurements of your hips and lower limbs. It may involve a
variable amount of treatment.
• The therapist will then assess body contact points with the suit,
standing balance and, if appropriate, stepping with weight
transference with spotters during the initial treatment sessions.
• Final assessment which will include measurements as above and
completion of a feedback form.
If you are an inpatient:
You will be offered up to 3 one-hour sessions per week until your
discharge from hospital or for 12 weeks, whichever is sooner. This will
include putting on and taking off the Ekso GT suit, balance re-education
and gait re-education.
If you are an outpatient:
• You will be offered a 12 week programme of 60 minute sessions,
although this can vary according to your needs.
• Treatment sessions can be negotiable and flexible to best meet
your needs. However, this is dependent on the inpatient service
demands.
What do I wear?
• Wear something comfortable and breathable.
• Wear the same shoes worn for your initial assessment and each
Ekso GT treatment session.
• If you have a catheter in situ, ensure the bag is emptied prior to
each session.
• It is important that you check your skin closely after each Ekso GT
session and report any markings from the suit to the therapist.
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Can I take images of myself in the Ekso GT?
It is accepted that you may want to have photographs or videos taken
of yourself in the Ekso GT. However, as the Ekso GT is used in a clinical
environment where other patients and staff may be present, we would
appreciate it if you refrain from sharing images or videos taken of
yourself in the Ekso GT on social media sites.
If you would like to take images of you
in the Ekso GT, please speak to one of
the Ekso trained therapists to assist.
What happens if I cannot attend an Ekso GT session?
We appreciate there may be times when you are unable to attend, for
example due to illness or poor weather conditions for travel. However,
it is your responsibility to inform the therapists if you are unable to
attend so that an appointment may be offered to another client. This
enables us to make the best use of the therapy timetable.
The Ekso programme will require your full participation for best results.
Please raise any concerns you might have about the programme with a
member of the team at the earliest opportunity.
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What if I want to continue to use the Ekso GT after
discharge from hospital?
After completing the programme as an inpatient at the Spinal Injuries
Unit, there is an opportunity to complete an outpatient programme.
For further information regarding this service, please contact:
• Suk Wong, Senior Physiotherapist, Ekso Service
– 0114 271 5673
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© Images provided by Ekso Bionics
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© Sheffield Teaching Hospitals NHS Foundation Trust 2017
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PD8124-PIL3422 v2
Issue Date: April 2017. Review Date: April 2019