December 13, 2012

Wheelchairs, Power Wheelchairs, Exoskeletons and Enabling the Disabled

About 10% of the global population, i.e. about 710 million people, have disabilities according to a World Health report. Studies indicate that, of these, some 10% require a wheelchair. It is thus estimated that about 1% of a total population – or 10% of a disabled population – need wheelchairs, i.e. about 71 million people worldwide. In 2003, it was estimated that 20 million of those requiring a wheelchair for mobility did not have one.

About 7% of persons older than 65 years are frail, and that the occurrence of frailty increases with age and may exceed 45% after age 85. By 2050, one in six people will be over the age of 65. This will be about 1.5 billion people. If 7% of them were frail that would be 105 million people. There are other causes of disability (a chart below goes over some of the causes and an older frequency of occurence).

Even if radical life extension and rejuvenation is not developed we will have to aggressively treat frailty, muscle wasting and Sarcopenia (half to 1% muscle loss for each year after age 25. Sarcopenia is to aging muscles like Osteoporosis is to aging bones.

Osteoporosis is an age-related disease of bone that leads to an increased risk of fracture.

The frailty syndrome is a collection of symptoms or markers, primarily due to the aging-related loss and dysfunction of skeletal muscle and bone, that place (mostly) older adults at increased risk of adverse events such as death, disability, and institutionalization.

There is a lot of work with myostatin inhibitors and SARM steroids to increase muscle mass and strength in the elderly.



When we are unable to prevent disability then people will have to use wheelchairs and exoskeletons.

Regular wheelchairs cost in the range of $1000 to 5000.
Powered wheelchairs cost in the range of $1200 to 20,000. Most are in the $4000-9000 range.
Exoskeletons are emerging (perhaps a few hundred are being used in the world now.)

Ekso's rehab exoskeleon model runs $140,000 plus a $10,000 yearly service fee.



Esko Bionics was called Berkeley Bionics. Esko developed the Human Universal Load Carrier exoskeleton which is now being developed by Lockheed for the military.

ReWalk lower body exoskeleton devices costs $87,500. Argo plans to submit a personal version of ReWalk (expected price around $52,500) for FDA clearance by the end of the year.





Rex Bionics (New Zealand) sells exoskeletons for about NZ$150,000.
In mid-2012, 30 people worldwide were using the joystick-operated Rex Bionic device to help them walk. They are researching a thought controlled movement interface.

The power wheelchair markets was valued at $1.1 billion in 2011 and is anticipated to reach $3.9 billion in 2018. There are about 400,000 powered wheelchairs now and that will grow to nearly 2 million by 2018. Market growth comes in large part from demand for mobility from people who might otherwise be bedridden.

According to the lead author of the study, 'Power Wheelchair Market Shares, Strategies, and Forecasts, Worldwide, 2012 to 2018 market research report,' "Reimbursement drives power wheelchair markets." As people and governments pay for medical insurance more money is available for medical treatment and equipment.

Leading companies in the power wheelchair market are: Invacare, Nordic / Handicare / Permobil, Sunrise, Pride, Meyra, Drive.




Japan Hal 5 suit

Cyberdyne began renting the suit out for hospital use in 2012. By October 2012, over 300 HAL suits were in use by 130 medical facilities across Japan. Currently, the suit is available for institutional rental, in Japan only, for a monthly fee of US$2,000.

The Hybrid Assistive Limb (also known as HAL) is a powered exoskeleton suit currently in development by Japan's Tsukuba University and the robotics company Cyberdyne. It has been designed to support and expand the physical capabilities of its users, particularly people with physical disabilities. There are currently two versions of the system: HAL 3, which has bulkier servo-motors and only has the leg function, and HAL 5, which is a full-body exoskeleton for the arms, legs, and torso. HAL 5 is currently capable of allowing the operator to lift and carry about five times as much weight as he or she could lift and carry unaided.

Some Progress to repair spinal damage with electrical stimulation and stem cells

Rats paralyzed by spinal-cord injury can learn to control their hind limbs again if they are trained to walk in a rehabilitative device while their lower spine is electrically and chemically stimulated. A clinical trial using a similar system built for humans could begin in the next few years.

Scientists have reversed paralysis in dogs after injecting them with cells grown from the lining of their nose.

New Scientist - Three people with paralysis received injections of 20 million neural stem cells directly into the injured region of their spinal cord. The cells, acquired from donated fetal brain tissue, were injected between four and eight months after the injuries happened. The patients also received a temporary course of immunosuppressive drugs to limit rejection of the cells.

None of the three felt any sensation below their nipples before the treatment. Six months after therapy, two of them had sensations of touch and heat between their chest and belly button. The third patient has not seen any change.

Muscle boosting treatments are being tested to reduce frailty in the elderly. Muscle wasting — called cachexia — is thought to account for about 30% of deaths in patients with cancer. About 7% of persons older than 65 years are frail, and that the occurrence of frailty increases with age and may exceed 45% after age 85.

A single injection of the soluble receptor into normal mice boosted their muscle mass by 25% or more in a week or two. When it was given to mice implanted with colon cancer cells, their muscle mass returned to normal, even though their tumours continued to grow. Strikingly, all of the animals that did not receive the soluble receptor were dead 40 days after cancer cells were implanted, but more than half of the treated animals survived to this point.

DARPA and Harvard developing soft exoskeleton/suit

The Wyss Institute for Biologically Inspired Engineering at Harvard University today announced that it has received a $2.6 million contract from the Defense Advanced Research Projects Agency (DARPA) to develop a smart suit that helps improve physical endurance for soldiers in the field.


Courtesy of the Wyss Institute. The new wearable system would be made from soft, stretchable, assistive devices, which would help improve physical endurance for soldiers in the field.

The Warrior Web graphic looks less gay by showing cutaway of the suit under a regular uniform


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