SINGAPORE: Mr Henry Tan, 66, a retired engineer, has congenital muscle dystrophy, which weakens his muscles. It gave him a poor gait and he recalls shuffling around, hunched over a walking stick. Things got worse in October 2018, when he suffered a stroke and lost strength on his right side and became wheelchair-bound.
But treatment with the EksoGT suit – a robotic exoskeleton – is helping him improve his range of motions. He has already gone for six sessions of rehabilitation with the suit.
Said Mr Tan: “Before this, I used to swing my leg too much to one side and walk with my feet open. And I waddled like a penguin because my muscles are weak. But now (this suit) pulls my legs straight.”
The suit is made by US-headquartered company Ekso Bionics, which specialises in exoskeleton bionic technology to enhance soldiers' mobility when carrying heavy loads. It evolved the technology beyond military applications, when it found that it could be useful to paraplegics as well.
Right now, the National University Health System (NUHS) - which comprises healthcare institutions such as Alexandra Hospital, Ng Teng Fong General Hospital, Jurong Community Hospital and National University Hospital - has three Ekso suits under its care.
This allows a physiotherapist to increase the intensity of gait training for patients. A patient in an EksoGT suit can take up to 500 steps in a 20-minute session. This is compared to an average of 50 to 100 steps taken without it.
NUHS on Monday (May 6) launched a programme called Improving Mobility via Exoskeletons Programme, or iMove. The two-year programme, which is supported by Temasek Foundation and Trailblazer Foundation, will study the use of exoskeletons beyond inpatient rehab at hospitals. It aims to also see how robotic exoskeletons can be used for outpatient rehab in community hospitals and nursing homes.
iMove will then evaluate how patient outcomes from using robotic exoskeletons compare with current standard care and assess if scaling up the programme is viable.
The plan is to enroll up to 400 patients in this study. Out of these, 100 will be part of a control group and will not use the exoskeleton suit.
Data from the patient’s performance before, during, and after using the suit will then be collected. So far, 68 patients in Singapore have used the suits. Thirty-six of the patients had data from their sessions on the suit recorded for the iMove study.
Six have of these patients have already completed the course of the study and two-thirds of them have shown an improvement in at least one category of functional mobility, said Dr Effie Chew, chief of rehabilitation services at Alexandra Hospital.
Mr Gandhi Mailvahanam, a former marathoner, is one such patient who has seen results.
The 65-year-old had suffered a traumatic injury eight years ago which affected his spinal cord. He was left bed-bound after a surgery went wrong two years ago.
“I find (I’m) lighter. I can move my body from left to right, right to left. Before these two years, if I wanted to move myself, I had to find somebody to push my body backward and forward. After 15 sessions I feel my body is lighter,” he said.
The exoskeleton suit has also helped Mr Mailvahanam regain enough muscular strength to get back on his feet.
“I can even hold my wheelchair and stand up at least 50 times. Before this, I couldn’t even do it five or 10 times.”
The suits will be deployed to healthcare institutions and sites with physiotherapists trained in their use. These include Alexandra Hospital, NTUC Health, St Luke’s Eldercare, St Luke’s Hospital and Stroke Support Station.
Dr Chew said it is hoped an encouraging outcome for the study will justify the use of the technology such that it becomes commonplace in the community.