Exoskeletons on the march
Russian doctors assessed the realities of using exoskeletons
In Russia, about 8 thousand people receive spinal injuries a year, and about 70-80% of them remain disabled. Since most of these patients are people of working age, their rehabilitation becomes a special task. Specialists of NMHC named after N.I. Pirogov eight months ago began a large comparative study of patients with spinal injury. It includes three groups of patients. The first group is engaged with an instructor on an individual schedule. The second one trains on the "Locomat", a stationary robotic complex that helps the patient to carry body weight and activate balance by rotating the pelvis. The third group is divided into two more: American and Russian exoskeletons are being tested.
The most interesting part of the study is, of course, the use of exoskeletons, which, according to the entire medical community, is the future of neurorehabilitation. The most important issue on the agenda is patient safety, since there is a high risk of falling when walking in an exoskeleton. Russian doctors are actively working on methods of walking in exoskeletons, some of whom publicly presented their results on June 1 at the IX International Congress "Neurorehabilitation – 2017". Thus, a group led by V.D. Daminov (Chief Specialist in medical rehabilitation of the National Medical and Surgical Center named after N.I.Pirogov of the Ministry of Health of the Russian Federation) conducted a study with patients who received incomplete spinal cord injuries. The total composition here was divided in unequal proportions – into the testers of the American exoskeleton Ekso Bionics (20% of the composition) and the Russian "ExoaThlet" (80% of the composition).
As a result, a method of walking in an exoskeleton was developed, which is currently at the patenting stage. It was also concluded that the design does not have a critical impact on the cardiovascular system, and wearing the design increases resistance to physical exertion. Basically, the use of the exoskeleton showed exactly the stabilization of functions, and not an improvement or deterioration. It also became clear that it is necessary to timely connect exoskeleton walking training to the patient's recovery process – before he completely lost motor functions.
In addition, there are a lot of technical problems associated with exoskeletons – for example, drives and control units requiring significant improvement, limited battery life. Many of the models cannot walk on the stairs. And in itself, the structure of joints in humans is much more complicated than what is available to modern exoskeletons. For example, only one axis of flexion-extension and drive is responsible for the knee joint in the exoskeleton – respectively, they cannot reproduce the real movement.
"Modern aircraft drives used in exoskeletons from all manufacturers are compact and powerful enough. However, they also impose a technical limitation – a rigid axis around which movement and effort are made. The prospect of recreating a truly human walk at the expense of exoskeletons is primarily associated with the use of composite materials and lightweight structures. And this prospect is far from fantastic. For example, artificial muscles made of composite materials that contract similarly to human ones already exist," said Mikhail Tsykunov, professor at the N.N. Priorov Research Institute of Traumatology and Orthopedics.
Unfortunately, as doctors note, exoskeletons are still a very young technology, its path is just beginning. And, apparently, its real heyday, as well as gaining sympathy among the Russian population, belongs rather to tomorrow.
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02.06.2017