Exoskeletons: Bionic Breakthroughs and Thoughtful Objections

Exoskeletons are touted as the breakthrough that will get those with spinal cord injuries to walk again. An academic prototype, controlled by brain waves, was featured at the beginning of the World Cup, and ReWalk, a commercial version from an Israeli-American company, recently became the first exoskeleton approved by the FDA for daily use in the United States. It’s been sold in other countries for three years already.

Yet nearly every person we’ve seen pictured wearing one was young or at most middle-aged. Worse, exoskeleton users need to balance on crutches, which actually leaves their hands less free than using a wheelchair. In fact, ReWalk’s own developer isn’t a candidate for it, because he can’t use his arms.

Granted, for hiking, as TEDx speaker Amanda Boxtel plans to use the Ekso Bionics’s exoskeleton, the crutches would serve nearly the same function as hiking poles.

Charles Engelbert Photography (970) 379-2005 mvoyage@comcast.net charlesengelbertphotography.com

Amanda Boxtel in Exoskeleton. Is this geniunely as cool as it looks?

As robotics advances, no doubt exoskeletons will become less cumbersome and their batteries will last longer than a reported two-to-three hours. Already since ReWalk’s 2008 prototype, the controller has shrunken from covering half the forearm to the size of a wristwatch. Perhaps lighter, sleeker, stronger versions will make the devices more suitable for those who are too frail to haul themselves on crutches. Perhaps later versions will not require crutches for balance. Most of all, perhaps later versions will cost considerably less than the nearly $60k of these first generation units.

Or perhaps none of that is necessary. Despite Time magazine naming it “among the top 25 best inventions in 2013,” not everyone who uses a wheelchair is exulting over exoskeletons. New Zealand teacher Red Nicholson says, “I have no more desire to be strapped to a robot than I do to go swimming with great white sharks”

Anthropologist and disability rights activist William Peace, author of the blog “Bad Cripple,” questions their value with some very serious number-crunching. What’s truly important for those with SCI, both he and medical experts agree, is to reduce “secondary medical complications caused by an extreme sedentary lifestyle,” such as life-threatening infections caused by bed sores and urinary and bowel dysfunctions.

In contrast to the 60k cost of ReWalk, writes Peace, the price of the required equipment to ensure exercise would be: “$11,000 wheelchair, $500 wheelchair cushion, a $5,000 handcycle, a $4,000 sit ski… Total material costs are a little over $20,000.”

That’s three complete packages for the price of one ReWalk, a device that isn’t even suitable for everyone who uses a wheelchair.