Exoskeleton Update

Summit Medical and Scientific

My name is Sara Brammall and I am the Managing Director at Summit Medical and Scientific.

We supply innovative rehabilitation and biomechanics equipment in the UK.

I co-founded the company over 25 years ago, and we carefully choose our sales partners to supply our customers with some of the world’s most state-of-the-art devices.

I’m passionate about the power of technology, which is why we are bringing the highest quality rehabilitation equipment to patients, clinics and hospitals across the country.

Evidence-based technology can make a huge difference to people’s lives, giving patients the best chance of recovery and future quality of life.

This is why we’ve partnered with companies like Hocoma and Motek, who have developed evidence-based robotic solutions across the whole continuum of care for upper and lower limb rehabilitation.

This includes some fantastic exoskeletons which we are excited to share with you. These exoskeletons provide intensive, guided, controlled and physiologically correct movement therapy.

Please tell us about the latest exoskeleton to come to Summit Medical and Scientific

We’re delighted to reveal that our partner Hocoma have just launched the new ArmeoSpring Pro exoskeleton.

This is their latest development in upper limb rehabilitation technology, and is based on their original ArmeoSpring therapy concept which has more than 15 years of clinical experience and research to back it up.

The ArmeoSpring Pro’s customisable arm weight support, powered by patented TrueG technology, allows patients to receive precise arm weight support from shoulder extension to shoulder flexion. 

Patients perform a higher number of repetitions of grasp and reach movements with the ArmeoSpring Pro compared to traditional therapy, taking their therapy to the next level.

Who is the ArmeoSpring Pro targeted towards?

The ArmeoSpring Pro is ideal for patients with moderately impaired hand and/or arm function. This could be a result of conditions such as stroke, brain injury, or neurological disorders.

The customisable exoskeleton means that paediatric patients can use the device, along with adult patients. 

The ArmeoSpring Pro also has a wheelchair-friendly wheelbase and has everything within reach for accessibility, comfort and safety.

What challenges do therapists commonly face in treating the upper limb and how can ArmeoSpring Pro help to overcome these?

Despite the hard work of physiotherapists and occupational therapists, in the UK patients are often not receiving the amount of rehabilitation they need after injury.

For example in stroke, NICE recommends 45 minute sessions of each relevant stroke rehabilitation at least five days a week, but this isn’t always being reached.

There are a wide range of reasons as to why this is often the case.

A patient’s severity can limit what movements they are able to practice with conventional therapy, and it’s difficult to keep them motivated to push past their current abilities.

The number of repetitions, and the intensity of the therapy, is limited in traditional therapy compared to therapy involving rehabilitation technology.

Additionally, therapists are required to provide continuous therapeutic guidance and support, which puts them under physical strain and limits the number of patients a single therapist can treat in a day.

With the ArmeoSpring Pro, therapists can be much more efficient with how they deliver quality therapy to more patients, which can lead to better long-term outcomes.

By providing arm weight support, the ArmeoSpring Pro exoskeleton enables patients to use any remaining motor functions to achieve a higher number of reach and grasp movements, based on their specific therapy goals.

All movement is tracked in a 3D workspace, providing real-time feedback and objective assessment.

Therapists can personalise therapy to each patient, blocking specific joints to focus on selective movements and target their areas of improvement. This is a really unique feature of the ArmeoSpring Pro.

Patients can be quickly set up with the device and start practicing movements with the therapist, and then progress from practicing under the supervision and guidance of a therapist to working more independently.

The ArmeoSpring Pro also comes with the Armeo Support Harness which restricts compensatory trunk movements during therapy. This ensures patients complete their therapy in a physiologically correct way.

How do reports and feedback augment the therapeutic process?

With the ArmeoSpring Pro, feedback is given in real time thanks to Augmented Performance Feedback. 

This software encourages and motivates patients to achieve a higher number of repetitions, providing automatic assessment of motor functions and allowing patients to see their progress in real time.

Therapists can track this with in-depth reporting. This includes patient performance during the joint range of movement assessments, and tracking of progress over time.

The ArmeoControl software allows therapists to create a therapy plan tailored to the patients’ therapy goals including cognitive training and increasing the range of motion in 1D, 2D or 3D.

How does Armeo Spring Pro motivate and engage the user?

We now know that intensity and repetition matters when promoting neural plasticity. Keeping a patient engaged throughout their entire therapy session can be difficult, as therapy can be tiring and repeating movements over and over again can be boring.

The ArmeoSpring Pro’s Augmented Performance Feedback keeps the patient engaged in fun and challenging games and exercises, helping them perform more movements for longer.

The tailored arm weight support gives the patient all the help they need to practise and repeat intensive, repetitive and task-oriented movements.

Patients could be painting a virtual picture, rolling a ball around an obstacle course to collect coins, or even using a cannon to shoot skeletons on a pirate ship.

Beating high scores, learning new skills and enjoying therapy keep patients engaged and excited about their rehabilitation.

Do you offer any other exoskeletons for severely impaired upper limb patients?

If you’re looking for an upper limb robotic exoskeleton for severely impaired patients, we’d recommend taking a look at the ArmeoPower by Hocoma.

The ArmeoPower is a highly advanced robotic hand and arm rehabilitation device for acute early-stage patients.

Patients can use the ArmeoPower even before they develop active movement, so even the most severely affected patient can benefit from intensive, repetitive, task-oriented therapy.

The ArmeoPower uses the same Armeo Therapy software as described above so it is easy for patients and therapists to progress from one device to another as the patient makes progress in their recovery.

What other new exoskeletons do you have?

Aside from the ArmeoSpring Pro, the latest exoskeleton launched by Hocoma is the LokomatPro Sensation.

This is a highly intensive physiological robotic gait trainer, suitable for severely impaired neurological patients.

An individually adjustable exoskeleton is combined with dynamic body weight support for safe, controlled and efficient gait training. Speed, loading and robotic support can all be adjusted to optimally shape the intensity of the training.

How does the Lokomat Pro Sensation support rehabilitation?

The Lokomat allows patients to achieve the high number of repetitions and effort required to achieve the intensity that follows research principles of neuroplasticity.

Patients can achieve hundreds, and even thousands, of steps with just one therapist in a safe and enriched environment.

In particular, the LokomatPro Sensation features three special improvements which enhance the patient’s experience, making therapy sessions more fun and personalised for them than ever before.

Intelligent algorithms provide adaptive robotic gait support, allowing the patient to feel the support being given as well as experiencing their performance.

Music and auditory cues are synched with game-like exercises and challenges, boosting motivation, engagement and enrichment for the patient.

Finally, new therapy programs and expansions to existing exercises are offered to individually shape training and see vital progress in real-time.

What makes the Lokomat unique?

The Lokomat therapy concept is tried and tested – with over 1000 installed around the world, and with over 20 years of research and 400 studies to back it up, the Lokomat has been proven to be an effective electromechanical gait trainer.

With recent launches like the LokomatPro Sensation, Hocoma are still innovating their devices to deliver the most state-of-the-art rehabilitation that patients expect and deserve.

The FreeD module that comes with the LokomatPro and LokomatPro Sensation improves therapy even further by allowing for lateral translation and transverse rotation of the pelvis.

Patients can shift their weight completely over the stance leg, activating their core muscles and experiencing balance.

With immersive and engaging exercises, patients can feel and understand the effort they are making, which provides further stimulation and neural feedback for the brain.

What do therapists like about working with the Lokomat?

“I can’t imagine being without it now. You can’t imagine going back to what you did before, but you don’t know that until you’ve had the opportunity to use it.” – Dr Louise Johnson, University Hospitals Dorset.

Therapists find the Lokomat is a real game changer for gait rehabilitation. Patients can stand and step earlier, receive truly intensive therapy, and everything is specific and tailored.

For example, the Royal Bournemouth Hospital Acute Stroke Unit have integrated their Lokomat into the care pathway over the last year and have said they could not go back now to manually helping patients to step.

Therapists are seeing really positive outcomes and benefits for patients. Patients progress quicker, they’re in hospital for less time, and they’re able to go home and continue their rehab in the community more quickly.

There are other added benefits too. The Lokomat enables patients to exercise and help with their cardiovascular fitness, because if you’re immobile it’s difficult to exercise outside of the Lokomat.

Read more therapist experiences in part one, part two and part three of our “Pioneering the NHS rehab revolution with robotics” series with University Hospitals Dorset in the Stroke Rehab Times.

 How can I find out more?

Get in touch with Summit Medical and Scientific today to discuss rehabilitation technology and which devices could benefit your patients.

You can view our entire range of rehabilitation equipment on our website: www.summitmedsci.co.uk/clinical-solutions

You can also get in touch with us by telephone: 01372 459863 or by email: info@summitmedsci.co.uk.

ExoMotus M4: The intelligent exoskeleton

Zen Koh is co-founder, deputy CEO and Board Member of the Fourier Intelligence Group.

The company’s flagship exoskeleton, the ExoMotus M4, was developed with patient comfort and ease of use in mind.

The device has an estimated setup time of just five minutes, making it easier for therapists and patients to focus on what really matters - the rehabilitation process itself.

NR Times got in touch with Zen to learn more about how the technology is transforming outcomes for patients around the world.

How does the ExoMotus M4 support patient rehabilitation?

The ExoMotus™ M4 focuses on gait training to help individuals regain their mobility and confidence after injuries like stroke, traumatic brain injuries, post-brain surgery, spinal cord injury and more.

With patient safety as a top priority, we designed the ExoMotus™ M4 to reduce the risk of falls during therapy.

Its ergonomic balance frame and safety harnesses provide patients with the confidence to move freely without fear, minimising stress and improving overall outcomes.

We recognise the importance of personalised therapy to facilitate effective rehabilitation.

The ExoMotus™ M4 is capable of customising gait parameters based on the patient's stage of recovery, allowing for high-repetition training that is crucial for motor skill relearning.

This personalised approach enhances patient outcomes by providing targeted therapy that is tailored to each individual.

We also understand the benefits of overground walking for patient rehabilitation.

Unlike traditional treadmill-based therapy, the ExoMotus™ M4 allows patients to move freely and interact with their environment, improving their overall sense of well-being.

Patients can adjust their walking speed based on their physical preferences, which leads to greater motivation and engagement during the rehabilitation process.

What do patients like most about ExoMotus M4?

Patient feedback is at the core of our product design philosophy, and we are proud to say that the ExoMotus™ M4 has received glowing reviews from patients who have used it during their rehabilitation journeys.

The device's top priorities are patient safety and confidence during therapy sessions, and our patients have experienced this firsthand.

By stimulating the muscles and allowing patients to feel what walking was like before their injuries, the ExoMotus™ M4 creates a focused and productive environment that supports motor function recovery.

This means that patients can push themselves without the fear of injury or falling, ultimately leading to a more successful recovery.

One of the most significant benefits of the ExoMotus™ M4 is its ability to free patients from the limitations of traditional training methods.

Unlike training on a treadmill or using crutches to ambulate, the ExoMotus™ M4 allows patients to move more freely, reducing stress levels and making therapy sessions more enjoyable.

The device's personalised gait parameters also facilitate high repetition gait training, which is crucial for relearning motor skills.

The ExoMotus™ M4 is an innovative solution that empowers patients to regain their confidence and independence during rehabilitation.

By placing patient feedback at the heart of our design process, we have created a device that meets the needs of those who need it most.

The ExoMotus is just your most recent exoskeleton - how has the tech changed over the years?

Our ExoMotus™ M4 represents a significant step forward in the evolution of exoskeleton technology, addressing the limitations of traditional elbow crutches and providing dynamic support for patients undergoing gait training.

One of the key features of the ExoMotus™ M4 is its dynamic body-weight frame, which frees up the patient's arms and enables a more natural gait.

This not only improves the patient's ability to engage in other activities but also enhances stability and safety during therapy sessions, minimising the risk of falling or sustaining injury.

Furthermore, the ExoMotus™ M4 offers patients a range of personalised training modes, including passive and assistive modes, which can be used for walking on the ground or air-walking.

The step length, height, and speed of movements can be adjusted to gradually increase the patient's level of activity and intensity, generating better recovery results through personalised training.

But the ExoMotus™ M4's benefits do not end there.

Its portability and long battery life enable outdoor use, offering patients a more stimulating and varied environment than traditional confined indoor therapy sessions.

Patients can now experience the freedom of movement and independence they once had, while still receiving the support they need to progress in their recovery.

How do you expect the technology to evolve from here?

The emergence of robotics and artificial intelligence (AI) has brought a significant transformation in the rehabilitation industry, and the future looks even more promising.

The integration of advanced sensors and data analysis has opened up new possibilities for enhanced patient rehabilitation programs that are tailored to meet individual needs.

As we look ahead, the possibilities of 5G technology in remote rehabilitation or telerehabilitation are immense.

Patients who are unable to travel to a hospital or clinic can now receive rehabilitation therapy from the comfort of their homes, enabling them to access rehabilitation services from anywhere in the world.

This approach not only increases accessibility but also makes rehabilitation services more convenient and efficient for patients.

We believe that these advancements in robotics and AI will continue to shape the future of rehabilitation by providing patients with personalised programs that cater to their specific needs.

With the help of these technologies, we can improve the intensity and duration of therapy based on patient progress and feedback, resulting in more effective outcomes.

The future of rehabilitation is exciting, and we are committed to pushing the boundaries of what is possible through innovative solutions that empower clinicians and patients.

We are dedicated to harnessing the power of robotics and AI to make rehabilitation more accessible, efficient, and effective for all.

How did international partnerships support the creation and development of the ExoMotus M4?

Fourier Intelligence has established partnerships with over 20 joint laboratories worldwide, including prestigious institutions such as Shirley Ryan AbilityLab and the University of Melbourne.

We have collaborated closely with a diverse team of experts, including engineers, developers, clinicians, and users, to develop the ExoMotus™ M4 - a state-of-the-art device designed to help individuals achieve optimal results during their rehabilitation journey.

To further enhance the capabilities of the ExoMotus™ M4, we developed an open platform system, EXOPS™ (Exoskeleton & Robotics Open Platform System) which allows all suppliers to plug directly into the Fourier ecosystem and provide better solutions to customers.

By empowering clinicians and patients with cutting-edge robotics and AI technology, we aim to provide more choices, better solutions, and lower costs for those seeking to achieve successful rehabilitation outcomes.

How is the RehabHub making the ExoMotus more accessible to patients?

We're proud to say that our RehabHub™ has become a standard service in the healthcare industry.

Our cutting-edge technology has been installed in facilities worldwide, helping thousands of patients with complex needs improve their daily lives.

Our success is rooted in our commitment to making our tools accessible and affordable, so that everyone can benefit from them.

We're constantly innovating and improving our technology to better serve patients and healthcare providers.

Our Group Therapy Concept, combined with our RehabHub™, utilises software, AI, and robotics to perform repetitive tasks quickly, efficiently, and accurately.

By extracting data from patient movements during rehabilitation, we're able to provide clinicians with valuable insights to personalise treatment protocols and challenge patients in new and engaging ways.

Our approach to integrated rehabilitation robotics is designed to mimic manual clinical interventions with minimum changes to existing clinical pathways.

By automating repetitive tasks, our technology frees up clinical staff to focus on more productive and engaging activities with patients.

We believe that our innovative technology is the future of rehabilitation, and we're committed to making it available to everyone who needs it.

Where is the ExoMotus available today and where will we be seeing it next?

We're proud to offer our innovative ExoMotus™ M4 exoskeleton robot for lower-limb gait training to patients worldwide.

If you're based in the UK and seeking a trusted and reliable rehabilitation facility that offers access to the ExoMotus™ M4, STEPS Rehabilitation in Sheffield and Neural Pathways in Gateshead are ready to help.

We're confident that with the support of these two excellent rehabilitation centres and our advanced technology, patients will be well-equipped to achieve their recovery goals.

Find out more about the ExoMotus M4 at Fourier Intelligence