Partnership aimed at helping paraplegics stand tall
It feels good—it feels awesome to stand up.
UAlberta pilot study explores how ReWalk Robotics exoskeleton changes body’s neural pathways in people with spinal cord injuries.
By BRYAN ALARY
(Edmonton) Four years after a motor vehicle accident robbed him of all mobility below his chest, Denny Ross is standing tall. And he can’t believe the view.
Ross, 35, is paraplegic after breaking his back at the T2-3 vertebrae while driving from Edmonton to a work camp in Conklin, Alta., where he worked as a welder. His spinal cord injury meant months of rehabilitation and relearning tasks most take for granted, such as brushing his teeth or going to the bathroom.
Thanks to a new University of Alberta pilot study that’s looking at how people benefit from a revolutionary exoskeleton that provides powered hip and knee motion, Ross is once again standing on his own two feet.
“I couldn’t believe how tall I was—I thought I was shorter,” he said of the first time he got up from his wheelchair. “But it feels good—it feels awesome to stand up.”
Revolutionary technology holds tremendous potential
Jaynie Yang, professor of physical therapy in the Faculty of Rehabilitation Medicine, wants to improve our understanding about how the ReWalk system changes the body’s signalling pathways and who can most benefit from the device.
Yang recently launched a one-year pilot study in which Ross and other participants with spinal cord injuries are outfitted with the ReWalk device and perform physical activities such as standing upright, sitting, walking down hallways and even climbing stairs.
“What we’d like to do is establish some basic things like who is best suited for these devices, what kinds of changes and improvements can we see—both with and without the devices,” Yang explained. “By training in the device, can we induce changes in the nervous system that would later improve function even without the device?”
Yang said she will be specifically looking at how the ReWalk device creates neuroplastic changes in the body, such as strengthening motor pathways from the brain to the muscles, and sensory pathways from the body to the brain.
“People might get better balance in sitting and standing. People with incomplete injury—injury that has spared some of those pathways—may actually get better at walking even without the device,” she said, noting there are likely other side benefits, such as reduction in spasticity, preservation of bone strength and better bowel routines.
“These are very fundamental things that we don’t have answers to at this point.”
Partnership makes pilot study possible
The ReWalk device being used in the pilot was purchased by the Spinal Cord Injury Treatment Centre (Northern Alberta) Society, or SCITCS, and leased to the U of A for just $1. Without that partnership, the pilot study would not have been possible, said Yang, who hopes to use the data collected to apply for funding for a wider study of a much larger population that will also look at how the devices are used in the home environment.
“Their contribution to this research project is enormous,” said Yang. “I couldn’t have started on this project without the support of SCITCS, who have long been a valuable partner in spinal cord injury research.”
SCITCS president Louise Miller first saw the ReWalk device in action at a demonstration in 2012 and since that time has worked tirelessly to bring one to Edmonton and find a partnership that could do the most good for the most people.
“It’s the only ReWalk device in Canada, so this is a unique opportunity to showcase Alberta and how forward-thinking we are in terms of spinal cord injury treatment and research,” said Miller, the organization’s co-founder, whose previous partnerships with the U of A include the purchase of specialized exercise equipment housed at the Saville Community Sports Centre. “SCITCS doesn’t do research; we just help make things happen, that’s how it works. We’re proud to have a strong partner like the U of A.”
The first time he tried on the device, Ross, who has no feeling below his nipples, says he felt “pretty wobbly” and somewhat scared about standing on his own again. But he said he believes in doing his part to advance research—he’s volunteered for several U of A research studies, with a healthy dose of coaxing from wife Megan. He even quit his job so he could participate in the pilot and spend more time with his children, participating in the research and representing organizations like SCITCS.
“I’m proud to be involved with SCITCS and the great work they do. If it wasn’t for SCITCS and Louise, this study wouldn’t exist,” Ross said.
With new funding, Yang hopes to expand her study over two to three years, working with a larger pool of people with spinal cord injuries. ReWalk, she notes, is one of only two devices approved for use in Canada to help people with paraplegia walk, and the only one approved for use in the home.
“These devices are quite revolutionary,” she says, explaining most devices aimed at helping people with paraplegia walk are impractical because the amount of energy required to operate them is physically exhausting. “This is a big advance. It has tremendous potential—it still needs some careful design and modification—but it is great that some people who currently rely on a wheelchair can now walk.”