For more than a decade, MossRehab has taken a leadership role in the U.S. and around the world when it comes to bringing new technology to patients and exploring new ways to meet their unique rehabilitative needs. After leading the way in testing and clinical implementation of a wide range of advanced devices, including the earliest model of ReWalk, robots such as the G-EO System and Tyromotion collections, and the AlterG™ Bionic Leg, MossRehab is now home to one of the largest collections of robots and rehabilitative devices in the world including three Lokomats and several Armeo® Power and Spring.
During the past several months, MossRehab further expanded its impressive collection with several exciting new acquisitions, including Andago®, an innovative portable device from Hocoma, and SafeGait™, a ceiling-mounted dynamic body-weight support system from Gorbel Medical.
Patients at MossRehab are the first to benefit from Andago in the USA, a mobile robot that intuitively follows a person’s movement while enabling them to maintain an optimal upright, hands-free posture during unconstrained gait training. The robot is especially useful for bridging the gap between treadmill-based gait training and level floor walking.
“Andago is intended to provide dynamic support to patients who normally would be at risk for falling, or who previously were not able to maintain stability or have decreased endurance while walking,” says MossRehab Chief Medical Officer Alberto Esquenazi, MD. “With Andago, our patients are now able to walk on a level surface, and are not confined to a treadmill. This is an exciting development because it allows our patients to experience freedom of movement as they navigate a realistic environment.”
Before the arrival of Andago, as many as three therapists were required to support a single patient during a walking exercise, or patients were limited to the use of devices that were attached to a track, which confined their movement. Andago allows patients to feel safe and well supported while they walk in a more natural manner.
“We are currently working with a patient who has an incomplete spinal cord injury, who can walk about 15 feet on his own, using a walker or a pair of crutches,” says Dr. Esquenazi. “He can walk slightly longer distances if a therapist provides assistance when he becomes fatigued, which happens fairly quickly because his endurance and strength are quite limited. When we gave him the opportunity to work with Andago, he more than quadrupled his walking distance the very first time. Now he is practicing with much more confidence and for much longer periods of time, which is very encouraging. And with Andago, it’s possible to optimize the human resources deployed to achieve this kind of progress.”
In part with information provided from our experience with Andago, other rehabilitation organizations around the world will have access to this innovative device this year, as Hocoma recently announced that Andago has been approved for sale in both U.S. and European markets.
In recent months MossRehab also became one of the first clinical facilities in the U.S. to acquire SafeGait™ a ceiling-mounted, dynamic body-weight support system designed to protect patients from falls as they work to establish a normalized gait during locomotor training.
SafeGait offers many of the advantages that Andago offers, but while some walking ability is required to use Andago, SafeGait can be used to help patients with more significant limitations as they move from a sitting to a standing position, practice transfers or practice maneuvers with their wheelchairs,” says Dr. Esquenazi. “It is specially designed to control weight support during use to potentially reduce up to 50 percent of a patient’s body weight. We use SafeGait with patients who have profound weakness—for example, patients recovering from a stroke, and consequently may have very little stamina or strength. In the past, these patients might have required more time before initiating training and the assistance of several therapists, but when they are using SafeGait, our therapists can start earlier and focus on guiding their movements rather than holding the patient up. So with this device we can offer patients substantially earlier, safer therapy and a greater sense of security, with the use of fewer resources.”
Experts at MossRehab also are testing a novel use of SafeGait by allowing patients to use it while learning to achieve balance on two wheels during wheelchair maneuvers.
“Patients who will be long-time users of wheelchairs need to learn how to negotiate obstacles in the environment by learning to do what we call ‘wheelies’,” says Dr. Esquenazi. “You learn to do one by essentially doing what your mother told you never to do—leaning backward in your chair until you are balancing on the rear two wheels. Until patients become proficient at this maneuver, they are at risk for falling backward. We’ve found that we can strap a patient’s wheelchair to the SafeGait system and thereby allow patients to practice this movement safely and efficiently, in a manner that allows the patient to be dynamically supported and protected.”
While patients continue to reap benefits from Andago, SafeGait and a wide range of other rehabilitative devices at MossRehab, Dr. Esquenazi and his team of clinicians continue to test and explore novel applications for rehabilitative equipment currently under development.
“We are collaborating with a number of manufacturers right now,” says Dr. Esquenazi. “Devices that we are currently excited about include some that integrate virtual reality with training activities, and new types of wearable robots, which are designed so that people can eventually use them at home.”