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University of California Davis

High-tech hope: Inventions bring the gift of movement

Traci Watson, Special for USA TODAY

The news brought tears of excitement to a family looking for hope: A few days ago, 1-year-old Max Lasko sucked his thumb.

Max has spinal muscular atrophy, a genetic disease that debilitates muscles, and for most of his life, he's lacked the strength to hold his thumb in his mouth. Now he can, thanks to new high-tech arm braces on his wheelchair that use elastic bands to support the weight of his arms.

Aided by the braces, "our son is able to have experiences that other families take for granted," says Max's father, Jonathan Lasko of Derwood, Md., adding that Max has just discovered he could put a block in his mouth. "That's a 13-month-old for you," his father says happily.

A new generation of "exoskeleton" devices that fit onto the body are providing unheard-of levels of mobility to those with spinal-cord injuries, neuromuscular diseases and others. Some exoskeleton technologies, like Max's arm braces, are simple, while others involve miniaturized motors and sophisticated software.

Some are inexpensive enough to be affordable to those who need them; others come with five-figure price tags. Taken together, they offer the hope of ever lighter, cheaper and more capable gear to bring movement into the lives of those stilled by injury or disease.

Max Lasko, born with a devastating genetic disorder that causes muscle weakness so severe that he cannot breathe on his own, takes time to play with his James the Train toy.

There are so many exoskeleton devices that "we're now routinely applying them to clinical populations," says Craig McDonald of the University of California-Davis, and director of a Muscular Dystrophy Association clinic for those with neuromuscular disorders. The technologies can "give (patients) a tremendous increase in degree of independence."

"This is a very exciting time for everyone working in the field," says biomechanical engineer Jose Luis Contreras-Vidal of the University of Houston. "It won't be too long before this is in reach" for those who need it. He estimates that eight or nine lower-limb exoskeletons, which allow those in wheelchairs to walk again, are either in development or in use, along with a half-dozen upper-limb exoskeletons that aid arm motion.

Kristen and Jonathan Lasko with their 13-month-old son Max, born with a devastating genetic disorder that causes muscle weakness so severe that he cannot breathe on his own, has his mobility increased using the WREX, Wilmington Robotic EXoskeleton, a device that incorporates elastic band elevation assists for both the shoulder and elbow to totally eliminate gravity influence on the arms and hands.

At one end of the spectrum is the arm brace used by Max, the Wilmington Robotic Exoskeleton. Despite its name, the WREX (pronounced "rex") contains neither motor nor battery, relying on precisely placed elastic bands to cancel out the force of gravity pulling down a child's arm. That allows children with neuromuscular disease to do something they couldn't otherwise do: raise their arms.

Four-year-old Hannah Mohn, for example, was born with two disorders that have robbed her of muscle strength. Without her WREX arms, she can't lift her outstretched arms past her shoulders. But when she wears the arms, she can feed herself, brush her teeth and reach the top level of her dollhouse.

"The WREX has given her so much independence and freedom," says Hannah's mother, Jennifer Mohn of Lansdale, Pa. "She feels like they are part of her."

The WREX arms became widely available to children three to four years ago. Several hundred children use them already, says biomedical engineer Tariq Rahman of the Nemours/Alfred I. duPont Hospital for Children in Delaware, one of the arms' inventors, and Rahman hopes to expand that number by training staff at other hospitals to custom-fit the arms.

Still newer are the exoskeleton suits that allow people in wheelchairs to walk again. In June, the FDA issued its first approval of the sale of one such suit, and other models are available in rehabilitation hospitals. None are exactly alike, but they tend to have jointed "legs" that strap to the wearer's legs and bands that circle the lower torso. Motors pull on the robotic legs to trigger a step.

In one model, known as the Ekso, the wearer can initiate a step by pushing a button or by moving the hips forward. Those wearing the ReWalk, the model that received FDA approval for sale to those with spinal-cord injuries, command the suit to walk by leaning forward.

The suits' speed is definitely on the slow side of a stroll. But they get people out of their wheelchairs and walking, which could prove to maintain bone density and improve digestion and skin health, says Candy Tefertiller, director of physical therapy at Colorado's Craig Hospital, a leading rehabilitation facility.

Some of those who use walking exoskeletons need no convincing. Derek Herrera has been paralyzed below the chest since a bullet hit his spine in 2012, while he was serving as a Marine special operations officer in Afghanistan. But now he walks one to two hours daily in his ReWalk, a routine that both provides exercise and relaxes his tight muscles. Mostly he walks in his house. But he's working toward a long-term goal, timed to the November ceremony that will mark his retirement from the military.

"I want to be able to walk out, stop, receive my retirement paperwork and walk out," Herrera says. "That way I'll be able to leave the service in the same manner that I entered the service – standing up and walking."

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