Improving mobility using exosuits - a feasibility study on patients with incomplete spinal cord injury

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Mobility and thus independence are key determinants for quality of life. The main cause for mobility limitations are unstoppable reductions in physical capacity with increasing age. Multiple diseases that affect the respiratory, the circulatory or the musculoskeletal system will have a strong influence on the physical capacity in addition. Also neurological diseases causing paresis or paralysis will reduce mobility. We believe that elderly and especially impaired young and elderly can highly benefit from a powered locomotion assistance that helps to overcome lost physical capacity.Lower limb exoskeletons and exosuits might provide a possible solution to increase user mobility. 0They have the potential to shift the disability threshold to a higher age or to avoid it over the whole life course. Industry and research focused on the development of systems to assist load carrying, lifting of heavy objects, and manufacturing. For medical purposes, rehabilitation systems to regain walking after injury and systems to assist walking in daily life are developed. Such systems can include the whole leg or single joint assistance. Lightweight single joint assistance showed promising advantages for several movement tasks. Especially so called soft exosuits show high potential for clinical rehabilitation and daily life usage for impaired and elderly.The desired project aims at testing the prospects of an existing novel exosuit prototype to support walking and standing up from seated position. As the first target group, for proof of concept, incomplete spinal cord injury patients are selected. Both, walking and standing are the top priorities for this population. So far incomplete SCI patients use wheelchairs to compensate missing walking ability. But stairs and slopes can limit wheelchair mobility in urban environments. The proposed concept combines the use of a wheelchair and a powered lower limb exosuit. The wheelchair should be the main tool to solve daily life mobility requirements. If necessary, the patient can use the exosuit to stand up and walk for shorter distances. Thus the user will be able to challenge steps and stairs. In addition, standing up will help to increase reaching height. During the 1 months of internship it is planned to evaluate the newest version of the exosuit designed by the Sensory-Motor Systems Lab at ETHZ. In a first stage the exosuit assistance and the control should be tested on healthy subjects for standing up and level walking. In the second stage standing up and level walking should be tested with incomplete SCI patients at the University Hospital Balgrist. Next to incomplete SCI patients, several further patient populations might take advantage of the envisioned developments.