Answering a need without an Exoskeleton

While exoskeletons get the glamour headlines, a paraplegic engineer has quietly solved a more basic problem for those with spinal chord injuries (SCI): a quick and clean way to have a bowel movement. In fact, one famous survey of quadriplegics and paraplegics found that both groups ranked regaining walking movement below regaining bladder/bowel function.

SCI and other neurodegenerative conditions damage the nerves that control the proper functioning of the colon. As wheelchair users and their caretakers know all too well, the only remedy is a time-intensive combination of laxatives and finger stimulation. As an engineer, Erik Fugunt knew that was the very definition of a sub-optimal solution.

Fugunt, injured in a near fatal 2010 motorcycle accident, developed Paraflush, a bidet-like device to aid in bowel cleansing. It does not make life as easy as it once was, but according to the testimonials on his site, it is a great improvement over what those with SCI had been forced to accept.


Exoskeletons for Seniors

As we noted in a previous post, current exoskeletons are problematic because they require the use of crutches for balance. Their target customer appears to be a young-to-middle-aged person who lost lower limb function through an athletic or war-related injury.

imagesBy contrast, the European Union’s Ambient Assisted Living Program has funded research on exoskeletons specifically designed for seniors. Their criteria for successful development of “Exo-legs,” include:

  • Specialised “hands-free” locomotion support/assistance to allow elderly persons to perform their normal, wide-ranging daily activities in an independent manner.
  • Indoor mobility: moving freely within confined spaces giving considerable added value over wheelchairs, be able to perform stand-sit/sit-stand manoeuvres, climb/descend stairs, step over objects, quiet standing, straight walking, turning for centimetric/metric mobility
  • Outdoor mobility: walking/turning on uneven/unstructured surfaces/soft ground, avoiding traffic, crossing roads, taking public transport (buses, trains) to go to rural/distant places, opening/closing doors, using escalators for hectometric/kilometric mobility
  • Cognitive support: provide information/advice to allow decision making when the elderly person has become lost or confused

The project is due to conclude in 2015.



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

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.




Honey, did you forget the Smart Phone?

An insight into the interactions of senior adults and technology comes from a friend whose mother has Alzheimer’s. She cannot remember that the chocolate-bar shaped thing her son carries around is a phone. It remains utterly novel and incomprehensible, especially because it doesn’t have a physical, numeric keypad. The idea of texting is science fiction to her—phones are for talking, but this “phone” doesn’t seem to have a mouth- or ear-piece.

Yet, what it does resemble is a pad of paper. And since this particular phone is a Samsung Galaxy Note, it can perform like one. Thus, with her son’s help, she happily writes notes on it, which he sends off as texts to his father. Now, even when he’s outside or in another part of the house, she can “converse” easily with her husband.

It’s a wonderful piece of enabling technology for both of them, since her condition has left her almost voiceless, and he suffers from age-related hearing loss. Nevertheless, there has been some pushback. Unfortunately for my friend’s father, “Sorry, honey, I forgot to put in my hearing aid,” no longer works as an excuse.


Offline Memory Aids?

Game developer Martin Kenwright, who sold his company Evolution Studios to Sony in 2007, is doing what serial entrepreneurs do: starting a new company. Called Starship Group, he says it will focus on e-health, children’s gaming, and lifestyle products, according to an interview Kenwright gave to the Liverpool Echo.

We’re interested in what he calls, “Forget-Me-Not,” and describes as a “wearable second brain” that will assist people with dementia and other memory problems. He gives no other details, except to claim, “We need the use of low-energy chipsets in the wearables sector to increase massively before the true power of Forget-Me-Not can be fully realised.”

Our colleague Alfred Poor has commented on the chips. What little else we can glean comes from this quote: “In five years, I fully expect memory aids to be as ubiquitous as hearing aids,” said Mr Kenwright.

So will the form factor be something on the order of a Bluetooth headset? Perhaps like a political staffer, it will prompt you with the name of the person whose hand you’re shaking. We wonder as we often do, to what extent such dedicated hardware is going to be outmoded by apps for cell phones, which are already evolving into wearable devices.

For example, IPhone users can download Cue You, which its 62-year-old co-creator Jane Birdwell describes as, “a powerful communication and monitoring tool that helps to support the independence of individuals with memory loss, developmental disabilities and traumatic brain injury.” By the time Forget-Me-Not comes to market, could it already be outmoded by something like Cue You on an iWatch, in the same way that eReaders may be replaced by apps on cell phones?

But then, maybe our cynicism about dedicated devices goes back to the CueCat. Now there’s a memory challenge, kids.


Yes, this was a breakthrough technology.

Learning Braille with Haptic Gloves

Georgia Tech researchers have demonstrated a way for people to learn Braille, while doing other tasks. The result builds on their previous work that showed we can learn through our fingertips—technically, “passive haptic learning”—without paying conscious attention.

It’s an important breakthrough, because blindness is one of the gravest risks of aging and it’s far harder to learn new languages as we get older.

But if you’re thinking, “Bah! Braille is outmoded now,” it turns out, according to a 2008 article in Education Week, that rather being entirely replaced by such things as speech-to-text readers, Braille’s uses have been enhanced by new technologies:

“Portable devices similar to laptop computers allow blind students to type notes and read them back through a Braille display. Similar devices can render text on a computer screen into Braille, using a refreshable display. And software is cutting down on the time it takes to produce Braille reading materials for students, including textbooks. Just listening to books doesn’t teach a blind child how to read, spell, or write, instructors say.”

Georgia Tech’s method involves wireless gloves that transmit pulses to their wearers as sensory cues about what to do next. In earlier experiments (see video below), people learned to play piano with the gloves signaling which finger to use.

In the current experiments, subjects wore the gloves first with audio cues telling them which letters they were typing. Later, they wore them while playing a distracting game with no audio cues at all. Yet under both circumstances, they learned Braille. In fact, those who felt the glove’s vibrations were a third more accurate compared to a group that only heard audio cues.

In addition, says Georgia Tech Ph.D. student Caitlyn Seim, “People could transfer knowledge learned from typing Braille to reading Braille…After the typing test, passive learners were able to read and recognize more than 70 percent of the phrase’s letters.”


Social Security Gets Ahead of the Curve

The New York Times reports that the Social Security Administration, suffering from budget cuts, is closing field offices. A plan prepared by the National Academy of Public Administration suggests it’s all good: By the year 2025, everybody can just do everything online.

As much as we’d like to share their optimism, we’re a little surprised that they apparently missed last April’s PewResearch Internet Project Report on Older Adults and Technology Use.

The crucial distinction Pew made, echoing our own feelings, is that there are two different groups of “elderly” to consider. Those who are young(ish), well-educated and affluent, and those who are much older, less educated, and sadly much poorer.

The drop-offs are critical:

74% of those who are 65-69 use the Internet, but only 37% who are 80 years or older.

87% of college graduates over 65 use the Internet, but only 40% with a high school education or less.

90% over 65 with a household income of $75,000+, but only 39% with an income of 30,000 or less.

While the age usage will inevitably shift upwards, as far as income and education, the people who will need Social Security services the most are not online. It’s hard to imagine that will change much in sixteen years.

13-internet-usage-for-older-adultsClick on the image to enlarge for a detailed breakdown.

Cool Hearing Aids, Iffy Price

Technology continues to blur the lines among medical prosthetics, consumer devices, and  just plain cool bionics. The latest device on that frontier is the ReSound LiNX system, which boosts hearing by connecting through Bluetooth to Apple iPods, iPhones and iPads.

It takes advantage of the ability to download apps in the Apple ecosystem, so that it can customize to the wearer’s preferred settings in particular environments. Lloyd Alter of spotted them at CES and was loaned a pair by the company. His detailed assessment, which could double as a user manual, makes them seem like an ideal solution.


Now why would we need hearing aids?

There’s just one little problem: When we turn to ReSound’s site, we don’t see prices listed, only that it compares to “premium products.” Fox News reported the prices as ranging from $2,400 to $3,500, depending on the amount of hearing loss. That’s on top of the cost of Apple hardware, leaving LiNX, like standard hearing aids, out of financial range for many of the people who need them most.


Coding Coffee

There’s a wonderful irony to the Jetsons’s domestic robot Rosie: She’s a highly complex machine created to perform simple chores. Real life roboticists would realize that for such tasks you could skip the complicated anthropomorphism, resulting in devices like the Roomba.

01jet03While we understand the Roomba as a domestic robot, thanks to Nespresso’s new VertuoLine, we need to expand the definition to include espresso machines and coffee makers.

The VertuoLine is the first generation of an automated combined espresso/coffee maker—and the only choice you make is which capsule you’d like. Current machines require that you press several buttons to determine how strong or how large you want your beverage to be, and you’d need two different machines if you liked both espresso and coffee. Here, the choices are condensed into one, and the work of remembering steps is done by the machine.

The VertuoLine achieves this by having barcodes around the rims of the capsules, which the machine reads to determine how much water for how much strength that particular capsule needs.

That’s a neat expansion of the use of bar codes for home devices. Instead of a bar code simply being used for identification, here it’s being used as an instruction set. Now, obviously, the idea of loading computer code that gives instructions isn’t new at all. In fact, this is arguably a back-to-the-future reversion to something  like paper tape.

Nevertheless, in this age of constantly having to download apps, we’re intrigued by the ease of use. While the VertuoLine’s price makes it a luxury item, we wonder if the simplicity of bar-coded modules might catch on for other domestic devices that could make life easier for seniors with physical and cognitive challenges.

Rosie animation cell from VanEaton Galleries, and their procrastination-inducing Hanna-Barbera Character Index.

X-treme Wheelchairs

One of the greatest fears of aging is immobility. But a new generation of demanding wheelchair athletes is pushing hard at those limits. Competitive skateboarder Robert Thompkins decided that no mere wheelchair was going to keep him from his passion.

He’s allied with wheelchair technology pioneers Colours Wheelchairs, known for breakthrough lightweight chairs with independent suspension, to develop a prototype wheelchair for chairskating, an extreme sport that is every bit as high-flying crazy as board skating.

As it turns out, one of Thompkins’s biggest challenges is regulations that limit his local skateboard park to skateboards only, another example of older, well-intentioned laws lagging behind current technological realities.