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Exoskeletons and More

Technology is becoming an important player in the quest to help people with spinal cord injuries regain function. Exoskeletons are a key component of this quest. Recently having been approved by the FDA, these assistive walking devices are finally becoming accepted by the medical community.

Many people with spinal cord injuries dream of one day getting an exoskeleton approved for home use. However, most insurance companies are still hesitant to approve exoskeletons, forcing many to raise the funds for one on their own. Learn more about exoskeletons for people with spinal cord injuries below.

How They Work

Powered by steel and electricity, an exoskeleton helps people with paralysis stand up and walk. Many refer to exoskeletons as ‘bionic legs.’ Most paraplegics are able to use an exoskeleton, and some quadriplegics can use them too, depending on their overall mobility. Each exoskeleton has a battery pack that powers the machine for several hours. Enabling people to stand up and look someone in the eye, exoskeletons can help people with spinal cord injuries in social situations, but they can help in many other ways as well.

Many people want an exoskeleton so they can be independent at home. Exoskeletons can help people be independent and active in their community, too, which is beneficial due to the frequency of wheelchair-accessibility issues in public places. They also help people return to a career that may require standing. An exoskeleton gives people the freedom they once had to move independently and without obstacles. Expect to see more exoskeletons in the public in the coming years.

How to Get an Exoskeleton

In 2014, the FDA approved the first exoskeleton for personal use: the ReWalk Personal System. This design integrates a wearable brace support, a computer control system, and motion sensors, which is now the standard design for most exoskeletons. This exoskeleton comes from Israel and costs $70,000.

If you are a veteran, you have a higher probability of getting an insurance-approved exoskeleton. The VA recently announced its intentions to approve exoskeleton payments up to $50,000. To get an exoskeleton approved for home use, you will need a physical therapist and a doctor with great writing skills to write a persuasive letter about your medical needs, detailing why an exoskeleton would be essential in your daily life.

Although not many people have had been approved for exoskeletons yet, things are slowly starting to change. Also, it never hurts to try!. If your insurance turns you down at first, you can always appeal the decision. You can try doing an online crowdsourcing fundraiser, as well, to raise money for your exoskeleton.

Exoskeleton Manufacturers

There are several exoskeleton manufacturers around the world. Here are the most reputable manufacturers to consider when looking at exoskeletons for people with spinal cord injuries:

– ReWalk Personal System: Designed in Europe and Israel, this was the first exoskeleton approved by the FDA. The wearer must use crutches to operate it. A ReWalk Person System costs approximately $70,000. https://rewalk.com/

– Ekso Bionics: Designed and sold in California, this exoskeleton was approved by the FDA in 2016 and ranges from $75,000 to $80,000 in cost. Ekso Bionics has reported that with continued use of their product, people have improved their overall balance, gate, and fluidity. Crutches are required to use this exoskeleton, as well. https://eksobionics.com/eksohealth/

– Parker Indego: A lower limb exoskeleton made for paraplegics with full torso control, this exoskeleton has also been approved by the FDA. Parker Indego is also supplying exoskeletons to the Department of Defense for a study on exoskeleton benefits in a rehabilitation setting. Crutches are required for use. http://www.indego.com/indego/en/home

– REX Bionics: The only exoskeleton on the market that does not require crutches is the REX exoskeleton from Australia. People with severe disabilities are able to use this exoskeleton, as it is completely self-supporting and is operated using a joystick. Currently, this exoskeleton is not approved by the FDA for home use, but it is approved for clinical use in the United States. The approximate cost is $150,000. https://www.rexbionics.com/

– Hybrid Assistive Limb: Also known as HAL, this exoskeleton is currently only available in Japan and is for people with paraplegia to use in their day-to-day life. https://www.cyberdyne.jp/english/products/HAL/index.html


– Watch: ReWalk exoskeleton device. walking after 12 years https://spinalpedia.com/video/W9JRPBK81Am

– Watch: EMG-Driven Hand Exoskeleton for SCI Patients: Maestro https://spinalpedia.com/video/OvzRa6J5DrQ

– Read our blog: Most Afforable Walking Exoskeleton To-Date Debuts https://spinalpedia.com/blog/2016/02/affortable-walking-exoskeleton-date-debuts/

The Importance of Moving Your Whole Body

Traditional inpatient rehabilitation usually lasts no longer than a few months, and then you are sent home for outpatient physical therapy. Within a few months, however, outpatient physical therapy ends as well. Without attending inpatient or outpatient rehabilitation, staying active while living with a spinal cord injury can be extremely difficult. 

Fortunately, there are many ways you can still move your body and live an active lifestyle in spite of paralysis. These methods may not help you walk again, but they will help you keep your legs, arms, and overall cardiovascular health in great shape.

Activity-Based Therapy

Activity-based recovery programs focus on continued exercise after a patient is discharged from both inpatient and outpatient rehabilitation. These programs can help you increase your strength, as well as fight depression. Activity-based therapy has increased in popularity over the last 15 years, but unfortunately, most activity-based therapy programs are not covered by insurance. However, some people will use crowd-sourcing fundraisers to raise the necessary funds to take part in activity-based therapy. Several nonprofit organizations across the country also provide funds for activity-based programs for patients with financial need.

The therapists at activity-based facilities will help you stand using adaptive equipment, as well as walk using locomotion therapy. Getting out of your wheelchair and completing a serious workout is also a major part of this therapy, which unfortunately is not something you typically see in a traditional rehabilitation setting. Many people who participate in activity-based therapy see improvements in their overall muscle strength, balance, and coordination.

Learn more about activity-based therapy from the Christopher & Dana Reeve Foundation: https://spinalpedia.com/video/Wze1z35lyN2 


FES therapy, or functional electrical stimulation therapy, is designed to help people with severe paralysis move their bodies. FES therapy uses low-energy electrical pulses to stimulate muscles in people with paralysis. FES can be used on nearly any area of the body, causing the muscles to contract. People use FES to produce limb functions such as grasping, walking, and standing. Many patients will also use FES to help with chronic pain, as well as build up muscle to prevent pressure sores.

Many patients find that if they participate in FES therapy regularly over time, they develop the ability to move some muscles without FES assistance. FES can also help restore bladder and bowel function. However, one of the most extraordinary things FES can do is help people walk. A product called Parastep FES System helps people with paralysis walk again by combining FES therapy with the use of a walker. FES can also be used at home to maintain muscle mass and improve strength. Learn more about FES therapy here: https://www.cyclonemobility.com/product/xcite/


A passive method for moving paralyzed muscles is the use of exoskeletons. These life-enhancing machines help people stand upright and walk, and provide patients with the benefits of osteoporosis prevention and cardio strength. Fortunately, there are two exoskeleton models, developed by Ekso Bionics and ReWalk, now approved for home use by some insurance companies. 

Learn about Ekso here https://eksobionics.com/ and ReWalk here https://rewalk.com/

Elliptical Standing Frames

Standing frames have improved a lot over the last 15 years, with one of the biggest advancements being the standing frame that has an elliptical workout built-in (it will help you move your legs back and forth). As you stand, you can also move your legs, which helps with blood flow into your skin, and this helps prevent pressure sores. An elliptical standing frame also helps prevent osteoporosis. EasyStand standing frames are the #1 manufacturer of this design.

Moving your body on a regular basis after a spinal cord injury is key to maintaining your physical health. Staying active after sustaining an SCI may be difficult, but it is not impossible. Moving your whole body ultimately increases your physical health, improves your mental health, and can provide you with a sense of satisfaction and fulfillment.