How robotic devices are helping people walk again after spinal cord injuries

Walking is a safe, low impact and cost-effective way to exercise and stay healthy. But for people who’ve experienced a spinal cord injury (SCI), walking becomes incredibly difficult, if not impossible. And depending on the injury, many people after SCI rely upon walking aids, wheelchairs or other devices to help them get around.

As you can imagine, being unable to freely move affects the body in multiple ways. Physically, people with SCI often have poor circulation, blood pressure dysfunction, muscle loss and chronic pain as a result of not being able to walk. There is also a mental and emotional toll that comes with relearning how to do basic tasks and regaining independence.

That’s why it’s important to find treatments that improve health and mobility for people who experience spinal cord injuries. To accomplish this goal, our researchers at Baylor Scott & White Research Institute (BSWRI) teamed up with Baylor Institute for Rehabilitation to study the role of advanced technology in rehabilitation.

Benefits of overground robotic exoskeletons

“Today, everyone is living with the benefits of technological advances like cell phones, computers and cars,” said Chad Swank, PT, PhD, BSWRI research investigator and principal investigator. “For me, the exciting thing is the potential for technology to change rehabilitation for the benefit of our patients.”

One such approach to enhancing recovery and mobility in people with SCI is through overground robotic exoskeletons (ORE).

The ORE is a battery-powered device worn over everyday clothing. When strapped in, the device moves the lower body via small motors attached near the hip and knee joints. These motors can be adjusted to give a lot or a little assistance, depending on the person’s needs.

Benefits of using ORE devices include:

• Promote upright posture
• Improve bowel function
• Lessen chronic pain
• Decrease muscle spasticity
• Improve bone health
• Improve quality of life

“Our team combines the expertise of clinicians and researchers to see how ORE helps people recovering from SCI,” Dr. Swank said. “This team effort allows for practical application of our findings to our patients.”

Expanding options to help patients walk again

Outpatient neurorehabilitation clinics across the country, including the ones here at Baylor Scott & White, use ORE devices to help people walk again after SCI. These individuals are often 4-6 months into their SCI recovery and living or working in the community.

Researchers at BSWRI are also interested in studying the use of ORE devices in different clinical settings. One study in particular seeks to understand the benefits of walking with ORE devices versus traditional gait training methods for people undergoing SCI inpatient rehabilitation.

Through this study, researchers hope to gain clear evidence-based guidance to help SCI clinicians identify which gait training approach is best for each unique patient.

“Our research has the ability to directly change the lives of people living with spinal cord injuries,” said Rita Hamilton, DO, SCI specialist and Chief Medical Officer and Medical Director of Baylor Scott & White Institute for Rehabilitation. “Findings from this study and others like it will help our physicians and clinical team create effective treatment plans for our patients and those across the country.”

This innovative work comes at a pivotal time. In January 2024, the Centers for Medicare & Medicaid Services reimbursed the first ORE device for personal use in the community. This landmark action means that you will likely see more ORE devices in the future as this advancing technology becomes more readily available.

Transforming care and recovery for SCI survivors

Baylor Scott & White is recognized as an SCI Model System and Traumatic Brain Injury (TBI) Model System site, making it the only healthcare system in Texas with both designations, and only one of six such centers in the United States.

“Being an SCI Model System Center puts us at the forefront of SCI clinical care and research,” said Ann Marie Warren, Ph.D., BSWRI Research Center Director for Trauma Research and Project Director for the Baylor Scott & White Spinal Cord Injury Model System Center. “It also enables us to transform rehabilitation through innovation and collaboration alongside other national leaders.”

Studies looking at advancing technology are only a few examples of how our teams are revolutionizing care for SCI survivors and their families, expertly guiding them through every step on their road to recovery.

Are you or a loved one recovering from a spinal cord injury? Learn more about SCI care, rehabilitation and recovery.