“Pretty often actually.”
“Okay, I won’t mention it then.”
…but seriously, it did feel a bit like setting a robotic foot on Pandora!
It feels amazing. The limb movement, the fast patterning, the weight shifting side to side, the moving through space as I go…parts of this are available in the trainer-assisted walker work that I have done. Other parts are involved in Lokomat training, which I am getting back into (machine schedule permitting).
Gait training is one therapeutic aspect which has been extensively documented as critical for nervous system rewiring – and I know I could use more of it. Very rarely, however, have I observed SCI patients become more functional in basic balance work as a result of robot-walking. Focused attention to connecting the fine details of bodily movement is a necessary first step toward integrating them in gait.
2. Ekso was surprisingly unobtrusive.
I expected it to feel like I was wearing a robot. I thought the rigidity of the assistance would distract me from connecting internally, from tapping into what was going on inside my body. In fact, I was impressed how fluid it was. It fit my body really well. Sensors on the robot can tell where my weight falls side-to-side, and the next step is initiated when it senses that I have shifted over enough – or, in some modes, when it senses that I have begun to flex my leg forward.
This is not to say I wasn’t restricted in exploring my own natural movement while upright – as you can see, I’m strapped in like you wouldn’t believe – but in terms of the motions the robot was designed to assist with, it does a good job of supporting me to feel those steps. (See #5, below, on being free.)
We depend on our elasticity. Make your body efficient at storing and releasing energy and your running miles will breeze by. The release of that energy, though, requires a certain time interval, otherwise it’s lost. This means that even though I can connect to my quads or hamstrings, doing so repetitively in the narrow time-window of walking is a different story. Modulating the amount of work I do to add tension with one muscle and back off with the other takes a lot of work. Feeling myself ambulate through space really made that clear. Being able to fluidly execute the pattern is a goal beyond simply ‘connecting to the muscles’.
4. I need to wiggle (and you probably do, too).
Human movement is highly three-dimensional. Even bending and straightening your knee produces slight rotation in the bones of the joint. Also, *my* body does best when it has something to react to. Combine these and I require a certain amount of controlled chaos for moving and standing. Wiggling back and forth in small ways (as I wrote about here) is a crucial part of my body understanding where it is and how it can fire.
Strap me into a machine which doesn’t allow for rotation and things quiet down, and not in a good way. My body says, “Hey, where’d everyone go?” as the proprioceptive signals are not allowed to fire by the tight robot. I depend much more on this controlled chaos than the average person, but everyone needs rotation when they walk. It’s easy to spot someone who, for whatever reason, just doesn’t turn their body. It looks funky. That’s because the rubber-band systems from #3 above require the back-and-forth of the trunk. So, this brings me to…
5. Where could this technology go?
I’d love to see and use (or maybe design?) a device which supports the body even more through a more 3-dimensional movement. “Natural gait” replication in a machine is the Holy Grail of this field, and functionally that won’t happen for a long time. But just as Ekso is leagues ahead of where the technology was a generation ago ,and is currently being implemented to help patients all over, every improvement toward the ‘natural’ ideal will enable the device to resonate on more and deeper levels with the user’s body.
To be able to both support a motion as well as enable freedom is inherently a delicate balance. I was legitimately impressed by how I sensed that the Ekso helped me feel the knee and hip movements of flexion and extension. I’m imagining adding the flexibility to allow for more integration of the body as a whole – think of walking through a forest rather than down a straight hallway – and the thought gives me appreciation for the ways I have found to integrate my movements into patterns, as well as excitement for the others just waiting to be connected...