Exoskeleton technology comes to Cottage Rehabilitation Hospital, helping injured Central Coast patients walk

When Larry Bartley fell out of a 30-foot tree in his backyard in Santa Barbara, his legs were pretty much the only things he didn’t break—and yet, they were unusable.

Bartley sustained spinal cord injuries that essentially wiped out his body’s memory of how to walk. He had to start from square one.

“I was in a coma for about five weeks, and during that time I lost 43 pounds,” Bartley, 62, told the Sun. “Most of that was muscle mass in my core and my legs. In combination with the muscle mass and the spinal cord injuries, I’m having to relearn how to walk.”

click to enlarge Exoskeleton technology comes to Cottage Rehabilitation Hospital, helping injured Central Coast patients walk
PHOTO COURTESY OF COTTAGE REHABILITATION HOSPITAL
WALKING AGAIN: Santa Barbara resident Larry Bartley uses a robotic exoskeleton to help his body re-learn to walk after sustaining debilitating spinal cord injuries.

For Bartley and spinal cord injury patients with similar prognoses, the process of learning to walk again usually starts with a physical therapist, who provides stability as the patient practices putting one foot in front of the other.

But in Bartley’s case, another option cropped up. Bartley was admitted to Cottage Rehabilitation Hospital, where he’s worked as a patient care technician for 13 years. As it turned out, Cottage was one of only a few hospitals offering Ekso GT technology, which uses a wearable robotic exoskeleton to help patients suffering from stroke or spinal cord injuries learn to walk again.

Ekso has been around for about five years, according to Cottage Physical Therapist Noah Gaines, but it’s been improved in the last two years to sense how much work the patient is putting in and to supplement it as needed. Cottage is the only hospital between the Bay Area and Los Angeles offering Ekso technology, and Gaines said it works well for patients who need help beyond what a physical therapist can give.

“We strap it to the patient, and it has motors that control the knees and the hips, and it can help them stand, and it’s able to sense how much help they’re doing and it can modulate how much help it gives them,” Gaines told the Sun. 

For Bartley, his most successful attempt at walking with a physical therapist got him 15 feet—but when he used the Ekso for the first time, he walked about 170 feet.

“For me it was amazing, because I had not walked that far before,” Bartley said. “Believe me, that felt like a miracle and a marathon.”

Gaines said the Ekso both strengthens patients’ bodies and helps to rewire lost connections in their brains, helping to increase the possibility of walking in their future. Some patients do better after just four or five times in the exoskeleton, he said, while others use it more than a dozen times to achieve the same results.

“With any sort of rehab, it’s different for everybody,” Gaines said. “And also this isn’t something where you use it and you’re magically cured. This is just one thing we have, one tool we have in our toolbox that we use to help people get back to walking.”

Unfortunately, it’s a “very expensive” tool, and it requires a week of training to learn to use it, Gaines said. For this reason, only a few facilities have invested in Ekso.

Cottage got its exoskeleton in March and has since used it to treat 17 patients, mostly from the Tri-Counties area, Gaines said.

“It’s amazing,” he said. “I’ve seen patients do really well. I’ve seen patients take their very first steps in the exoskeleton after their injury. I’ve seen them go walking, every time they get in the exoskeleton they go farther and farther, I’ve seen them progress to the point where they’re walking outside the exoskeleton and don’t need it anymore.”

But the treatment isn’t for everybody, he said. It’s ideal for patients who are likely to walk again but have been struggling to do so, and who meet certain height and weight requirements, can describe to staff what they’re feeling, and whose legs are around the same length.

Luckily for Bartley, he met the specifications and has so far had success with the exoskeleton.

“It was a whole paradigm shift,” he said. “It was as if I could almost feel something switching on in my consciousness that totally changed my perception of recovery, and that was initiated by walking in the exoskeleton.”

The toughest part, he said, was fatigue, which kept him from maintaining proper posture and cadence—which the exoskeleton monitors.

“In some moments it felt like a lot of work, but when I did it just right, I could glide down the hall and it felt great,” Bartley said.

Having worked at Cottage for so long, another tough spot for Bartley was the transition from staff member to patient, he said.

“For a long time, I was the one giving care to the patients,” he said. “I was the one answering the call light. I was the one helping people walk. And all of a sudden, I was on the other side. I was the patient that needed help. I was the patient receiving the care. It was a distinct role change for me, and it took some getting used to.”

Bartley’s currently in a transitional living facility that specializes in spinal cord and brain injuries, he said, but he’ll return to using the Ekso at Cottage when he goes to outpatient therapy.

“It’s empowering,” he said. “It’s empowering to feel that and go, ‘Yes, I can do this, and my muscles can move this way.’ It’s incredibly helpful to have the exoskeleton as your tutor in proper posture and the proper way to walk, and re-teaching my body something it had lost the ability to do.” 

Staff Writer Brenna Swanston can be reached at [email protected].

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