RUSNANO Group Supports Disability Rehabilitation Company
Access to a comfortable urban environment, including for low-mobility citizens is its inseparable quality. However, accessibility is not only the availability of ramps, special elevators, lifts, the so-called “non-threshold” environment, but also the availability of the technologies capable of helping people with disabilities to regain movement, adapt, and feel themselves as the full-fledged users of a fast-changing urban environment.
The RUSNANO’s Fund for Infrastructure and Educational Programs has decided to support the ExoAtlet domestic company—developer of a unique medical exoskeleton (training equipment) for people with disabilities. Together with the Moscow State University of Medicine and Dentistry, ExoAtlet has developed an educational program for medical rehabilitation of patients using the ExoAtlet robotic complex.
“Western rehabilitation practice tends towards complete restructuring of the living space around the disabled person to suit his/her new needs,” says Elena Pismennaya, Scientific Director of ExoAtlet. “We believe that a person can and must be restored. We make the body work and come to life. It might do it as well.”
ExoAtlet is the first Russian mass producer of exoskeletons that can return the moving ability to people who have once been considered to be confined to a wheelchair.
The ExoAtlet development is an exoskeleton, a hard metal frame that can hold a person upright. Electronics activates mechanisms that force a person’s immobilized legs to take steps again. Experts say that “a natural walking pattern is imposed” to a person. The legs of a patient who has been motionless for a long time send the “I’m going!” impulses to the brain which also has a powerful therapeutic effect.
Elena Pismennaya is sure that their invention will help to put patients with cerebral palsy on their feet and make them almost completely independent. In Russia, 1.5 mln people live with this diagnosis. The inability of conventional movements for patients with cerebral palsy is associated with incorrect control of the motor apparatus brain, which often leads to stiff muscle spasticity (a combination of spasm, muscle paralysis, and muscle overexertion). The exoskeleton helps to cope with this problem.
“When a child with cerebral palsy has a locomotive pattern ‘stitched’ into the brain, he/she uses it without hesitation,” explains Elena Pismennaya.
Another 400,000 people who suffer a stroke each year could be added to the 1.5 mln cerebral palsy patients whom the exorehabilitation can help. 150,000 more Russians live with multiple sclerosis, and at least 100,000 have traumatic spinal cord diseases (TSCD). According to experts, exorehabilitation can help all these patients. ExoAtlet is currently conducting research to work with patients after endoprosthesis replacement.
Sedentary or even more shut-in lifestyle leads to a lot of new complications for a person with problems of the musculoskeletal system: the blood supply to the muscles is disrupted, bedsores appear, calcium is washed out, and internal organs begin to work incorrectly resulting in the mass of diseases associated with a sedentary lifestyle.
“All doctors, when talking about their experience of exorehabilitation, note the unexpected effect of patients coming out of depression,” says Elena Pismennaya. “This is typical for patients with cerebral palsy, strokes, and spinal cord diseases. A desire to live appears in people.”
Some public clinics already include exorehabilitation in the list of services that patients can use under the Compulsory Health Insurance Policy (CMI). But as a rule, we are talking about a two-week course once a year. This is not enough for everyone, since there should be more than 30 trainings in a row to obtain full rehabilitation.
In ExoAtlet, the way out of the current situation is seen in the creation of a network of exorehabilitation centers in walking distance, similar to fitness centers, but designed especially for the disabled people. This will allow patients to undergo rehabilitation in a training format. Such a project has already been developed and is called ExoGym.
The project can be successful from both the social and also the economic point of view. With an average cost of an exoskeleton of RUB 3.5 mln, an hour of classes in the most expensive private clinic in Moscow costs about RUB 5,000. With a broader offer or inclusion of the service in the CMI, the price of an hour can be significantly reduced. In case of its enough intensive use, the exoskeleton will pay off in one or two years.
“In assessing the cost-effectiveness of the equipment implementation, it is necessary to represent the balance between the three components of the result: economic, medical, and social ones,” explains Yulia Martynovich, Chief Medical Officer of the SAA Zhukovsky Medical Center in the Bryansk Region. “The analysis shows that ExoAtlet is a representative of the rehabilitation equipment range capable of keeping this balance in equal parts being the best option.”
However, experts are sure that for the widespread exorehabilitation it is necessary to overcome one more obstacle—the lack of qualified personnel.
“We are a start-up, a small company, we are not enough to train and control the correct actions of instructors,” says Alina Zvereva, the Head of Marketing of the ExoAtlet’s Russian office. “You won’t get to the clinic in Vladivostok for every little thing. Doctors often change; independently teach each other thereby contributing to the accumulation of errors.”
Therefore, the start-up turned to the RUSNANO’s Fund for Infrastructure and Educational Programs, which has extensive experience in creating intensive refresher courses for high-tech sector professionals. The Moscow State University of Medicine and Dentistry develops the Medical Rehabilitation of Patients using the ExoAtlet Robotic Complex program.
In ExoAtlet, the creation of an educational program is seen as only the first step towards forming a single platform for learning and data sharing between the medical communities, which they call ExoEdu. The company believes that the program will become a kind of constantly updated and replenished directory, which can be accessed at any time.
Different locomotive violations require special recovery methods. Therefore, using the same tool, but different accessories, the instructor of physical therapy should be able to choose an individual treatment scenario for each patient.