These two robotic devices will facilitate earlier and more efficient recovery for patients with mobility difficulties in their legs. HUB has this equipment for the first time thanks to a global purchasing programme by the Department of Health, which has acquired 13 for centres with Clinical Expertise Units (UEC).
With the two exoskeletons, physiotherapists from the Rehabilitation Service at Bellvitge Hospital will be able to start the rehabilitation of patients who have suffered a severe impact on their ability to stand up and walk due to a neurological condition, such as a stroke, or other, including rare, disorders, earlier and more efficiently.
Specifically, one is a device for bilateral gait impairment and the other for unilateral (single-leg) impairment.The service's professionals are already being trained in their use, so they can be immediately incorporated into the rehabilitation of neurological patients who are temporarily unable to walk, but have a prognosis for improvement.
As Dr. Rosa Planas, Head of the Rehabilitation Service at Bellvitge Hospital, points out, "Regaining the ability to walk is very important for these patients. Beyond mobility, standing up has a whole range of multisystem benefits for these patients, including cardiovascular, digestive or urological benefits. Being in a wheelchair entails associated multisystem problems."
The exoskeletons will be a decisive aid for physiotherapists to begin patient rehabilitation as early as possible. The bilateral device acquired by CatSalut is a proprietary development of the Catalan company ABLE Human Motion. It integrates a structure with motors in the hips and knees, powered by two batteries and software that controls the movements and collects data from each session. Before its first use, the patient's basic parameters (limb and pelvis size) are entered into this software to adapt the exoskeleton's functional response.
The physiotherapist monitors and assists the patient at all times during the use of the exoskeleton. The professional can decide when to initiate each step using two buttons, for greater safety and control, and manages stops, walking speed or the amount of assistance provided by each of the motors from a mobile application located on the back of the device. After initiating the gait, the patient learns to take steps autonomously by shifting their weight forwards and laterally. The robotic device also incorporates turning assistance for rotating on the spot in tight spaces, as well as the ability to take steps backwards.
‘The exoskeleton allows a complex task such as walking to be performed early on, in a controlled and safe manner. It keeps the patient standing at all times, which is very important because sometimes we physiotherapists find it very difficult to carry out this rehabilitation due to the neurological impairment,’ highlights Helena López, Head of ABLE's Clinical Department and responsible for training the service's professionals in the use of the new device.
The growing development of robotic devices could mark a significant step forward in the rehabilitation of people whose mobility has been severely affected. Exoskeletons will begin to be used with inpatients who have the potential to improve, but Dr. Planas does not rule out them being extended in the medium term to outpatients and, as the costs of components and manufacturing fall, in any rehabilitation unit.
The Department of Health, through CatSalut, has carried out the purchase of the 13 exoskeletons through the Recovery Plan, Transformation and Resilience, financed by the European Union's Next Generation funds, This initiative is part of Catalonia's model for the care of rare diseases, which is based on coordination between the different health services under the umbrella of the networks of clinical expertise units (XUEC).