The simple act of walking from one room to another is often taken for granted. For people that have trouble walking or use a wheelchair, these regular movements are sometimes unattainable. Danny Bal, 57, was riding a motorcycle when the driver of an oncoming car fell asleep at the wheel and hit him, crushing three thoracic vertebrae and shredding a spinal nerve. Bal adjusted to life in a wheelchair, making alterations so he can continue his favorite activities.
Bal’s daughter is getting married soon, prompting him to fulfill every father’s dream of walking their daughter down the aisle. To accomplish his goal, Bal visited Brooks Rehabilitation in Jacksonville, Fla., where he donned a medical exoskeleton called Hybrid Assistive Limb (HAL). Designed by the Japanese company Cyberdyne, HAL was approved for use by medical centers and clinics, but the Brooks rehab facility is the only place in the United States that has HAL.
To essentially learn how to walk again, Bal wore a harness to maintain his balance over one of two treadmill tracks installed for use with HAL. When we walk, our brain sends messages to our leg muscles to carry out the movement. When Bal’s brain tried to send those same messages, too many of his nerves were destroyed, which made the signal weak. To remedy this, nine electrodes were placed on Bal’s legs to read the faint signals and send the information to the exoskeleton’s control system. The exoskeleton then aided Bal in making the movements necessary to walk.
The process created by Cyberdyne delivers positive feedback to the brain, telling it that the motion was completed, and further strengthens the signal pathway between the brain and the muscles. It’s the hope that by strengthening the signals between the brain and the muscles that patients could learn to walk without the aid of HAL.
Other exoskeletons on the market help wearers take steps, but they don’t necessarily improve a patient’s ability to move on their own. Unlike other exoskeletons, HAL does not complete the movements for the wearer, rather, once the brain sends out the signal, HAL aids the muscles in carrying out the movement.
Amy Morace, an exercise physiologist and business development specialist for Brooks, says, “The difference is, we’re not just putting people through the motions, we’re strengthening a neurological command.”
Currently, Brooks has accepted 18 patients into their treatment program, screening more than 200 patients who favored interest in HAL. The standard HAL treatment consists of 60 90-minute sessions completed over 5 days a week for 12 weeks. It’s a demanding treatment regimen that costs $24,000 and isn’t covered by insurance.
Brooks is in the process of leading a 3-year research effort with 24 participants to bolster results. Things are expected to go well, and Brooks plans on expanding their facility in 2019 to include 12 tracks for HAL wearers.
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