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The ReWalk Powered Exoskeleton to Restore Ambulatory Function to Individuals with Thoracic-Level Motor-Complete Spinal Cord Injury

Esquenazi, Alberto, MD; Talaty, Mukul, PhD; Packel, Andrew, PT, NCS; Saulino, Michael, MD, PhD

American Journal of Physical Medicine & Rehabilitation: November 2012 - Volume 91 - Issue 11 - p 911–921
doi: 10.1097/PHM.0b013e318269d9a3
Original Research Articles

Objective The aim of this study was to assess the safety and performance of ReWalk in enabling people with paraplegia due to spinal cord injury to carry out routine ambulatory functions.

Design This was an open, noncomparative, nonrandomized study of the safety and performance of the ReWalk powered exoskeleton. All 12 subjects have completed the active intervention; three remain in long-term follow-up.

Results After training, all subjects were able to independently transfer and walk, without human assistance while using the ReWalk, for at least 50 to 100 m continuously, for a period of at least 5 to 10 mins continuously and with velocities ranging from 0.03 to 0.45 m/sec (mean, 0.25 m/sec). Excluding two subjects with considerably reduced walking abilities, average distances and velocities improved significantly. Some subjects reported improvements in pain, bowel and bladder function, and spasticity during the trial. All subjects had strong positive comments regarding the emotional/psychosocial benefits of the use of ReWalk.

Conclusions ReWalk holds considerable potential as a safe ambulatory powered orthosis for motor-complete thoracic-level spinal cord injury patients. Most subjects achieved a level of walking proficiency close to that needed for limited community ambulation. A high degree of performance variability was observed across individuals. Some of this variability was explained by level of injury, but other factors have not been completely identified. Further development and application of this rehabilitation tool to other diagnoses are expected in the future.

From MossRehab, Elkins Park, Pennsylvania.

All correspondence and requests for reprints should be addressed to: Alberto Esquenazi, MD, 60 Township Line Road, Gait & Motion Analysis Laboratory, Elkins Park, PA 19027.

Supported, in part, by Argo Medica and MossRehab. The ReWalk devices used were provided by the study sponsor. The device manufacturer did not have any role in the subject selection, access to the data and was not involved in the data analysis or publication.

Presented at the 2010 Annual Assembly of the American Academy of Physical Medicine and Rehabilitation in Seattle, WA (preliminary version).

Financial disclosure statements have been obtained, and no conflicts of interest have been reported by the authors or by any individuals in control of the content of this article.

An online-only Data Supplement movie is available for this article at

© 2012 Lippincott Williams & Wilkins, Inc.