Shepherd Center is the lead clinical partner in the critical final stage of trials for a robotics-assisted walking device that could improve the lives of people with limited mobility caused by spinal cord or brain injury, stroke or multiple sclerosis.
Developer Parker Hannifin Corp. describes the exoskeleton device – called Indego® – as a “powered orthosis worn around the waist and legs that allows individuals with spinal cord injuries to stand and walk."
The device is being tested at Shepherd Center and a few other facilities across the nation in people with spinal cord and brain injury, multiple sclerosis and stroke.
Parker hopes to obtain FDA approval for the device in late 2015.
Casey Kandilakis, PT, DPT, NCS, is here to discuss the research and development of this robotics-assisted walking device.
Selected Podcast
Indego Robotic Exoskeleton to Assist Walking
Featured Speaker:
Casey Kandilakis, PT, DPT, NCS earned a bachelor of science degree in exercise science from the University of Tennessee and a doctorate in physical therapy at East Tennessee State University. She also earned a board-certified clinical specialty in neurology in 2014. Dr. Kandilakis has been a physical therapist working in the field of spinal cord injury rehabilitation and research for more than four years. She has lectured at numerous national and international conferences on the use of advanced technologies in rehabilitation. She practices as a clinical research scientist at Shepherd Center, focusing on the use of advanced technologies and exoskeletons for people with spinal cord injury.
Casey Kandilakis, PT, DPT, NCS
Casey Kandilakis, PT, DPT, NCS earned a bachelor of science degree in exercise science from the University of Tennessee and a doctorate in physical therapy at East Tennessee State University. She also earned a board-certified clinical specialty in neurology in 2014. Dr. Kandilakis has been a physical therapist working in the field of spinal cord injury rehabilitation and research for more than four years. She has lectured at numerous national and international conferences on the use of advanced technologies in rehabilitation. She practices as a clinical research scientist at Shepherd Center, focusing on the use of advanced technologies and exoskeletons for people with spinal cord injury.
Transcription:
Indego Robotic Exoskeleton to Assist Walking
Melanie Cole (Host): Shepherd Center is the lead clinical partner in the critical final stage of trials for robotic-assisted walking device that could improve the lives of people with limited mobility caused by spinal cord or brain injury, stroke, or multiple sclerosis. My guest today is Casey Kandilakis. She’s a physical therapist at Shepherd Center. Welcome to the show, Casey. First, let’s start with some of the challenges of people with limited mobility caused by spinal cord or brain injury, stroke, or multiple sclerosis. What do you see in your role as a physical therapist?
Casey Kandilakis (Guest): Well, one of my primary roles is to get people as independent and get them back to their life as quickly and as effectively as possible. After any of those neurological conditions that you mentioned, a person’s mobility can be impacted. They could be required to use a wheelchair for their primary means of mobility. While most people can get very independent with this, there can be places where an individual cannot get with the wheelchair that they could get when they were walking. Additionally, not walking can be detrimental to your just overall health. Walking is really good for your cardiovascular system. It can help with your bone health. There are a lot of reasons why we want to get people back and as mobile as possible.
Melanie: I certainly agree with that. Tell us how you are getting in this clinical trial people up and walking and mobile so they’re not just sitting all the time. What is the exoskeleton device called the Indego?
Casey: We’re using an exoskeleton device called the Indego to help people get up and walk who do not have use of their lower extremity. The Indego is like a legged Segway. Whenever you’re in it, if you would like to start walking forward, you lean forward. Whenever you want to stop walking, you just stop leaning forward. It’s very intuitive for people to learn how to use. It’s also very lightweight. It only weighs about 26 pounds so it’s easy for someone to manage even if they don’t have full use of their core musculature. It’s also small enough that people can wear it within their own manual wheelchair.
Melanie: I was going to ask you about the size. If people have MS or brain or spinal cord injury, is this a big, heavy item that requires them to work on muscular strength just to wear it and get around on it? How does it actually work?
Casey: Well, it comes apart into five different pieces. Just from the perspective of managing fit, none of the pieces weigh any more than about 8 to 10 pounds. It’s light enough that someone even having some difficulties with strength or mobility would be able to manage the different pieces. They would be able to put away the Indego device on in their own manual wheelchair and then stand up and begin walking. The device actually supports its own weight whenever you’re up and walking so you don’t notice how much it weighs. But it is only 26 pounds, which is about half the weight of any of the other exoskeletons that are being researched at this point.
Melanie: How exciting. What have you been seeing as a patient responds to using this, getting up out of the chair or wheelchair and actually working for the first time in maybe a long time?
Casey: Everyone who has been a part of our study has really been ecstatic about the opportunity to get up and walk. A lot of the patients that we see around the Shepherd Center, even if they have not had the opportunity to be a part of any of our research studies, are excited about the future of this device, if and when it will be approved by the FDA to be used in a rehab setting or to be used at home. Everyone is just excited and eager to see where all of this goes in the future.
Melanie: Where do you think it will go in the future, Casey? Do you see that other rehab centers around the country are going to be using this? Is this really something so exciting that it’s going to give hope to many thousands of people?
Casey: Absolutely. I see this exoskeleton as a potential tool for physical therapists to use to help people learn how to walk again if they have some limitations in their lower extremity but have the potential to regain walking function, so if someone who has an incomplete spinal cord injury or stroke or brain injury. I also see it as being a way for people to get up and walk even if they don’t have any lower extremity function, someone with a complete spinal cord injury who would have no other way to walk otherwise.
Melanie: That’s very exciting. So Shepherd Center is the lead clinical partner in this final stage. What do you see as the next step? When do you think this might be approved?
Casey: The company, the manufacturer of the Indego, Parker Hannifin, is hoping to gain FDA approval for use both in rehabilitation centers as well as at home for individuals with a spinal cord injury by the end of this year, by the end of 2015. After that, I see there’ve been many future studies, looking at the use of this device within other populations, the use of this device long-term. One of the biggest things that I think would make this device last in the long term is being able to get insurance companies to consider repayment of this device even if that’s on a case-by-case basis. Right now, all of the exoskeletons that are available or are being researched at this time are very expensive, and it would be very challenging for an individual to purchase one on their own. But as these devices become more well-researched and as we learn more about them, I’m very hopeful that insurance companies will see the potential utility of these devices to prevent secondary health complications in the future as well as to get people more involved and get them back to work and back involved in their community.
Melanie: Are there any side effects, anything that would make it so that this amazing device isn’t something that can be worn daily for long hours during the day and really get people back into a better quality of life?
Casey: Some of the biggest things that would limit people from participating and using an exoskeleton like the Indego would be skin issues. If anyone had any areas of skin breakdown where the device contacts their skin, it would be very dangerous for them to use something like this. Additionally, we really encourage people to assess their bone health prior to getting up in one of these devices, which would be very similar to them participating in any kind of a gait training program. We want to make sure that their bones are healthy enough to be up and standing in any way.
Melanie: It really is amazing, the research that you’re doing. In the last minute or so, Casey, please wrap it up for us about the exciting work you’re doing in the clinical trials for the exoskeleton device called the Indego and why people should look to Shepherd for more information.
Casey: Well, Shepherd really is staying ahead of the game and is going to continue working with the Indego device, both with individuals who have the same spinal cord injury as well as individuals who have, after a stroke or after a brain injury, we’re really hoping that this device will become approved by the FDA so that we can use it within our rehabilitation studies as well as train individuals to be able to use this device at home to better their lives and to improve their ability to get back into their community and get back to their lives that they had prior to their injury.
Melanie: Thank you so much, Casey. For more information about this clinical trial with the exoskeleton called the Indego, you can go to shepherd.org. That’s shepherd.org. You’re listening to Shepherd Center Radio. I’m Melanie Cole. Thanks so much for listening.
Indego Robotic Exoskeleton to Assist Walking
Melanie Cole (Host): Shepherd Center is the lead clinical partner in the critical final stage of trials for robotic-assisted walking device that could improve the lives of people with limited mobility caused by spinal cord or brain injury, stroke, or multiple sclerosis. My guest today is Casey Kandilakis. She’s a physical therapist at Shepherd Center. Welcome to the show, Casey. First, let’s start with some of the challenges of people with limited mobility caused by spinal cord or brain injury, stroke, or multiple sclerosis. What do you see in your role as a physical therapist?
Casey Kandilakis (Guest): Well, one of my primary roles is to get people as independent and get them back to their life as quickly and as effectively as possible. After any of those neurological conditions that you mentioned, a person’s mobility can be impacted. They could be required to use a wheelchair for their primary means of mobility. While most people can get very independent with this, there can be places where an individual cannot get with the wheelchair that they could get when they were walking. Additionally, not walking can be detrimental to your just overall health. Walking is really good for your cardiovascular system. It can help with your bone health. There are a lot of reasons why we want to get people back and as mobile as possible.
Melanie: I certainly agree with that. Tell us how you are getting in this clinical trial people up and walking and mobile so they’re not just sitting all the time. What is the exoskeleton device called the Indego?
Casey: We’re using an exoskeleton device called the Indego to help people get up and walk who do not have use of their lower extremity. The Indego is like a legged Segway. Whenever you’re in it, if you would like to start walking forward, you lean forward. Whenever you want to stop walking, you just stop leaning forward. It’s very intuitive for people to learn how to use. It’s also very lightweight. It only weighs about 26 pounds so it’s easy for someone to manage even if they don’t have full use of their core musculature. It’s also small enough that people can wear it within their own manual wheelchair.
Melanie: I was going to ask you about the size. If people have MS or brain or spinal cord injury, is this a big, heavy item that requires them to work on muscular strength just to wear it and get around on it? How does it actually work?
Casey: Well, it comes apart into five different pieces. Just from the perspective of managing fit, none of the pieces weigh any more than about 8 to 10 pounds. It’s light enough that someone even having some difficulties with strength or mobility would be able to manage the different pieces. They would be able to put away the Indego device on in their own manual wheelchair and then stand up and begin walking. The device actually supports its own weight whenever you’re up and walking so you don’t notice how much it weighs. But it is only 26 pounds, which is about half the weight of any of the other exoskeletons that are being researched at this point.
Melanie: How exciting. What have you been seeing as a patient responds to using this, getting up out of the chair or wheelchair and actually working for the first time in maybe a long time?
Casey: Everyone who has been a part of our study has really been ecstatic about the opportunity to get up and walk. A lot of the patients that we see around the Shepherd Center, even if they have not had the opportunity to be a part of any of our research studies, are excited about the future of this device, if and when it will be approved by the FDA to be used in a rehab setting or to be used at home. Everyone is just excited and eager to see where all of this goes in the future.
Melanie: Where do you think it will go in the future, Casey? Do you see that other rehab centers around the country are going to be using this? Is this really something so exciting that it’s going to give hope to many thousands of people?
Casey: Absolutely. I see this exoskeleton as a potential tool for physical therapists to use to help people learn how to walk again if they have some limitations in their lower extremity but have the potential to regain walking function, so if someone who has an incomplete spinal cord injury or stroke or brain injury. I also see it as being a way for people to get up and walk even if they don’t have any lower extremity function, someone with a complete spinal cord injury who would have no other way to walk otherwise.
Melanie: That’s very exciting. So Shepherd Center is the lead clinical partner in this final stage. What do you see as the next step? When do you think this might be approved?
Casey: The company, the manufacturer of the Indego, Parker Hannifin, is hoping to gain FDA approval for use both in rehabilitation centers as well as at home for individuals with a spinal cord injury by the end of this year, by the end of 2015. After that, I see there’ve been many future studies, looking at the use of this device within other populations, the use of this device long-term. One of the biggest things that I think would make this device last in the long term is being able to get insurance companies to consider repayment of this device even if that’s on a case-by-case basis. Right now, all of the exoskeletons that are available or are being researched at this time are very expensive, and it would be very challenging for an individual to purchase one on their own. But as these devices become more well-researched and as we learn more about them, I’m very hopeful that insurance companies will see the potential utility of these devices to prevent secondary health complications in the future as well as to get people more involved and get them back to work and back involved in their community.
Melanie: Are there any side effects, anything that would make it so that this amazing device isn’t something that can be worn daily for long hours during the day and really get people back into a better quality of life?
Casey: Some of the biggest things that would limit people from participating and using an exoskeleton like the Indego would be skin issues. If anyone had any areas of skin breakdown where the device contacts their skin, it would be very dangerous for them to use something like this. Additionally, we really encourage people to assess their bone health prior to getting up in one of these devices, which would be very similar to them participating in any kind of a gait training program. We want to make sure that their bones are healthy enough to be up and standing in any way.
Melanie: It really is amazing, the research that you’re doing. In the last minute or so, Casey, please wrap it up for us about the exciting work you’re doing in the clinical trials for the exoskeleton device called the Indego and why people should look to Shepherd for more information.
Casey: Well, Shepherd really is staying ahead of the game and is going to continue working with the Indego device, both with individuals who have the same spinal cord injury as well as individuals who have, after a stroke or after a brain injury, we’re really hoping that this device will become approved by the FDA so that we can use it within our rehabilitation studies as well as train individuals to be able to use this device at home to better their lives and to improve their ability to get back into their community and get back to their lives that they had prior to their injury.
Melanie: Thank you so much, Casey. For more information about this clinical trial with the exoskeleton called the Indego, you can go to shepherd.org. That’s shepherd.org. You’re listening to Shepherd Center Radio. I’m Melanie Cole. Thanks so much for listening.