RIC's Matthew Knowlton, DPT, explains how exoskeletons work.
Objective: Evaluate a clinical training strategy that uses a robotic exoskeleton in individuals who have experienced severe stroke.
Up to 80% of stroke survivors experience considerable gait deficits, including reduced walking speeds and asymmetrical walking patterns, which limit their capacity for community ambulation.
Although various treadmill-based motorized (robotic) devices have been developed to facilitate stepping practice in highly disabled populations, current devices only allow walking at a constant speed, and do not impose the balance and postural demands necessary for walking over ground.
This project will test and evaluate a new generation of exoskeletons (designed by Ekso Bionics) that may provide the benefits of over-ground stepping practice, including limb loading and balance and posture control, while simultaneously reducing the need for therapist assistance.
Stroke is the leading cause of adult-onset disability, and there are more than 6.4 million non-institutionalized stroke survivors in the United States.
Currently, stroke survivors are classified based on their self-selected walking speeds as either:
- unable to walk (non-ambulators)
- limited household ambulators (walking speed <0.4m/s)
- limited community ambulators (0.4–0.8m/s)
- community ambulators (>0.8m/s)
These walking speeds are significantly lower than those of healthy controls (1.3-1.5 m/s).
Recent statistics show that 40% of all stroke survivors experience moderate to severe impairments that require special care while an additional 10% are admitted to skilled nursing or long term care facilities and categorized as non-ambulatory (wheelchair-bound) or limited household ambulators. These individuals are unlikely to walk again. Thus, there is a compelling need to develop mobility-training strategies for survivors of severe stroke.
Individuals who have experienced a severe stroke and are unable or have a limited ability (i.e., self-selected walking speed <0.4m/s) to walk.
Call for Research Participants
The Max Nader Center for Rehabilitation and Outcomes Research is conducting a study involving chronic stroke patients. The purpose of this study is to develop safe and effective training techniques for walking using a robotic exoskeleton. Participants will take part in 90-minute sessions (2-3 times per week) for 10 weeks.
Participants must meet the following criteria:
- 6 months or more post stroke
- Weight under 220 pounds
- Be able to tolerate upright standing for a minimum of 30 minutes
- No contractures
- No severe osteoporosis
- Age 18-85 years
For additional information, please contact:
Raquel Minarsch, DPT at (312) 238-2080 or firstname.lastname@example.org.
Read more about the study here.
Resources & Statistics
Resources & Organizations
National Institute of Neurological Disorders and Stroke
Centers for Disease Control and Prevention
RIC LIFE Center
Stroke Facts - Centers for Disease Control & Prevention
National Stroke Association
Stroke Survivors Empowering Each Other (SSEEO, RIC Support Group)
Walk Again Project (Nonprofit)
A New Industry Flexes Its Servos (Fortune, August 2014)
The World Cup's Mind-Controlled Exoskeleton (The Atlantic, June 2014)
Wearable Robots, Now Lighter and More Versatile, Help People with Paralysis Become Iron Men and Women (Daily News, May 2013)
Grimaldi, G., and M. Manto. 2013. "Functional Impacts of Exoskeleton-based Rehabilitation in Chronic Stroke: Multi-Joint Versus Single-Joint Robotic Training." J Neuroeng Rehabil 10:113. doi: 10.1186/1743-0003-10-113.
RIC Researchers Explore Promising New Robotic Technology (RIC Press release, September 2012)
Dutch Engineers Make 'Robot Legs' for Stroke Patients (BBC, September 2011)
We will update this page periodically with project news and related interviews.
Wearable Robotics Association, NIST Workshop 4: “Ergonomic issues for Wearable Robotics”; speakers included Arun Jayaraman PT, Ph.D., Rehabilitation Institute of Chicago) and “Design Challenges in Interfacing and Controlling Wearable Robots”; speakers included Tommaso Lenzi, PhD, describing aspects of the lightweight leg (Project D4). Scottsdale AZ., February 12, 2016.
Jayaraman A., “What to expect and not expect from robotic exoskeletons” Invited Speaker, 7th Middle East Physical Medicine and Rehabilitation Conference. Dubai, UAE, January 2016.
Scanlan K & Jayaraman A., Identifying training strategies for progressing exoskeleton users towards everyday functional ambulation. Special Interest Session; 4th ISCOS and ASIA Joint Scientific Meeting. May 2015, Montreal, Canada.
Winstanley A & Jayaraman A., Effect of Wearable Robotic Device in Outpatient Physical Therapy for Gait Training in Individuals with Stroke. General Sessions; Midwest Chapter of American Academy of Orthotists & Prosthetists, May 27th 2015.
Scanlan K & Jayaraman A., Identifying training strategies for progressing exoskeleton users towards everyday functional ambulation. General Sessions; Midwest Chapter of American Academy of Orthotists & Prosthetists, May 27th 2015.
Jayaraman A., Decentralized Neurorehabilitation – the Next Step for Technology Intervention. International conference on Rehabilitation Robotics (ICOR), August 11-14, 2015, Singapore
Jayaraman A., Robotic Devices: What we thought, what we can, and what need to International conference on Rehabilitation Robotics (ICOR), August 11-14, 2015, Singapore
Jayaraman A., Forrest G, Kozlowski A, Evans N, Hartigan C, Spungen A. Exoskeleton-Assisted Walking for Persons with Neurological Conditions: Clinical Application, Health and Fitness, and Personal Mobility.
Symposium. ACRM annual Conference, Dallas, Texas, Oct. 28th 2015.
Jayaraman A., “Wearable robotics and the future”, Keynote talk at the Artificial Intelligence and Robotics Meeting, Washington D.C., October 2015. Jayaraman A., “Rehabilitation Robotics: From Science Fiction to Everyday Life”; Invited Keynote Speaker for Annual Science Fair, Rehabilitation Robotics, Loyola University Chicago IL, October 2015.
Arun Jayaraman took part in symposia entitled “Exoskeleton-Assisted Walking for Persons with Neurological Conditions; Part I: The State of the Science and Part II: The state of the Art” at the American Congress of Rehabilitation Medicine (ACRM) meeting, Oct. 7-11 2014; Toronto, Canada
Arun Jayaraman presented "Development of expertise in use of exoskeletons for walking in individual with spinal cord injury" at the MARS-RERC Recovery Machines Pre-conference Workshop; 36th International Conference of the IEEE Engineering in Medicine and Biology Society (EMBS) conference; Chicago, August 26-30, 2014.
"The Effects of Mobility Training Using Robotic Exoskeletons on Functional Recovery in Individuals with Severe Stroke." (2014 RESNA Conference Presentation, updated PDF version)
Arun Jayaraman, PhD, Principal Investigator. Dr. Jayaraman is director of the Max Nader Center for Rehabilitation Technologies & Outcomes Research within the Center for Bionic Medicine at the Rehabilitation Institute of Chicago, and an assistant professor in the departments of Physical Medicine & Rehabilitation and Medical Social Sciences at Northwestern University. His research focuses on developing and executing both industry-sponsored and investigator-initiated research in rehabilitation robotics, prosthetics, and other assistive and adaptive technologies to treat physical disability. He specifically focuses on using quantitative outcome measures to improve the real-world use of rehabilitation technology. Dr. Jayaraman received his PhD in Rehabilitation Sciences from the University of Florida.
William Zev Rymer, MD, PhD, Co-Investigator. Dr. Rymer is Director of the Sensory Motor Performance Program (SMPP) at the Rehabilitation Institute of Chicago, as well as a professor of biomedical engineering at the McCormick School of Engineering, and a professor of physiology at Northwestern's Feinberg School of Medicine. He received his PhD from Monash University in Australia and his MD from the University of Melbourne. Dr. Rymer's research interests include regulation of movement in normal and neurologically disordered human subjects; physiological effects of spinal cord injury; sources of altered motoneuronal and inter-neuronal responses in spinal segments below a partial or complete spinal cord transaction using electro-physiological; pharmacological and biomechanical techniques; and rehabilitation robotics.
Chaithanya Mummidisetty, MS, Engineering Project Leader.
Mr. Mummidisetty is a research engineer at the Center for Bionic Medicine within the Rehabilitation Institute of Chicago. He earned his bachelor's degree in biomedical engineering from Osmania University in India and an MS in biomedical engineering from the University of Miami. His research interests include gait rehabilitation for Stroke & Spinal Cord Injury patients, signal processing, new technology development, and outcomes research.
Raquel Minarsch, PT, DPT, NCS. Dr. Minarsch is a research physical therapist in the Max Nader Rehabilitation Technologies & Outcomes Lab as well as an inpatient clinician on the Patient Recovery Unit at the Rehabilitation Institute of Chicago. She received a BS degree in Health Sciences and a Doctorate of Physical Therapy from The Ohio State University. Her research interests include robotic exoskeletons used for rehabilitation or personal mobility, gait training for stroke and spinal cord injured subjects, and outcome measures research.
Additional staff members: Susan Deems-Dluhy, PT, DPT, NCS; Kate Scanlan, PT.
Project Alumni: Matthew Knowlton, PT, DPT