Spinal Network News - December 2017

pieces he uses for his many engineering and building projects. At the present time,
this system (callipers and mobility scooter) is independent of any assistance, but it is
very limited. Caines’ goal is to achieve much greater independence as soon as possible
using the far easier ReWalk. Caines was an engineer before his accident, and he
has adapted to building, renovating, and fixing things around his home from his wellequipped
workshop. The exoskeleton not only helps him to walk, but will also simplify
using his lathe, drill press, and other equipment in his workshop—equipment needing an
upright body position.
Getting places is an important adjunct to the use of either callipers or the ReWalk.
Caines’ mobility scooter is being adjusted so that he can soon ride it wearing the
exoskeleton. Another useful development available in New Zealand, is a swivel seat
for the car, with the necessary precision measurements to allow the user to access
and drive the car whilst wearing the ReWalk. This could be a great step forward
into independence once Caines goes solo. The newest version of the ReWalk has
eliminated the backpack, which carries the computer system and batteries. The new,
much smaller pack, attaches to the belt at the waist, and will make using the machine in
conjunction with other transport easier.
Transitioning from callipers to the completely different technique for operating the
ReWalk has required a lot of training; Caines has had to learn how to use his body
differently to control the exoskeleton. It is very different to walking with callipers.
There is a trigger mechanism attached to the waistband of the ReWalk. Caines
must lean forward to start the machine with torso pressure. He must also control the
communicator, with which he can direct the machine to walk, stand, sit, or climb stairs.
Caines is learning to adapt these four commands to a wide variety of situations.
We walked with him and his physio, Henry, for an hour-and-a-quarter, from his home to
Orewa Beach; across pedestrian crossings; and up and down curbs. We could see that
despite the focus needed to work with the machine, the whole process was much less
exhausting than the callipers. Caines goal for the week was to walk 100m in six minutes.
He slashed it to 100m in five minutes, and that time will be constantly improving. When
asked to compare walking with callipers and walking with the exoskeleton, Caines said:
“To walk 300m on callipers takes 40 minutes and is exhausting. To walk 300m on the
ReWalk takes 14 minutes and it’s much easier. The maximum distance I can walk
with callipers is 600m, but with the exoskeleton, I can walk 3km and I’m improving.”
Improving is an important word in Caines’ vocabulary.
Where to from here? Arnold said: “This machine changes lives, and already, more
advanced models are available. It could eventually cost less than the present system
where patients are permanently wheelchair-bound. Potential ReWalk clients
have long-term medical costs. So, it would be advantageous—financially, physically,
and psychologically—for clients to own a ReWalk. Studies are starting to show
large savings in long-term health costs, not to mention a better quality of life for
users.” Funding is going to be the next big discussion question. Once trained on the
exoskeleton, it will be essential for a client to have permanent use of a machine if we are
going to see those health and cost improvements and benefits. At the current price of
$115,000 plus GST per machine, how are we going to get this revolution started?
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