ReWalk, Ekso Race to Sell Exoskeletons in Tough Rehab Market

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more are needed, he adds. “We’re not going to grow the industry until we build a lot of data,” says Jasinski.

The first studies by ReWalk and others showed mainly that the exoskeletons were safe and could allow some paralyzed people to walk. But more recently, small studies suggest that using exoskeletons like ReWalk’s and Ekso’s can reduce body fat, pain, and improve bowel function, and more studies are underway.

Going after multiple markets in rehab will be key for the success of the companies—and to do that, exoskeleton companies are also developing new versions of their products for people with other kinds of impaired movement, like stroke patients and eventually, for those with multiple sclerosis and Parkinson’s disease.

ReWalk, for instance, is working on a lighter, cheaper, more flexible “exosuit” designed for people who can still walk, but not very well. (Ekso also recently unveiled a prototype of a lightweight, flexible exoskeleton.) ReWalk has licensed technology from Harvard University to commercialize a fabric-based device that people would put on almost like a piece of clothing. Companies will need to develop new exoskeleton technologies like this to open up new applications, especially given how similar a lot of the current exoskeletons on the market are, says Conor Walsh, the Harvard engineering professor who developed the “soft suit” technology licensed by ReWalk and is continuing to work with the company.

Walsh says his technology is particularly well suited for use in the home and out in the community, which is where he thinks the market growth opportunities are. Using an exoskeleton in a hospital with a therapist for just a few sessions a week “is not the long-term solution for the field,” says Walsh.

Jasinski says the cost of the soft suit will come in at $19,500—a quarter of the price of ReWalk’s hard exoskeleton. The Harvard-based technology works by having motors worn just on the waist, rather than along the legs like in the hard exoskeletons. The motors pull on cables that are attached to fabric wrapped around the calf and to insoles worn on the feet. Walsh’s group has shown in an early study with nine patients that the device can help people with muscle weakness and impaired coordination due to a stroke clear their feet from the ground and push forward as they walk. This reduced the amount of energy they used to walk.

ReWalk plans to start a clinical trial of its “Restore” soft exosuit by early next year, in hopes of securing FDA approval and commercializing it in the U.S. by late 2018 or early 2019—first for use in rehab centers and then, with further tweaks and tests, for home use. The success of the soft suit will be essential for the future of ReWalk, says Jasinski. “To get to the point of profitability, we’re going to need multiple products”, he says.

To do all this, ReWalk and Ekso have had to hunker down over the last couple of years, cutting operating costs by 25 to 30 percent, laying off staff, and raising money by selling shares and taking out loans to cover sales, marketing, and R&D costs. Scheder-Bieschin of Ekso says his company has raised enough funds to last for at least the next two years. Jasinski says he will need to raise more money, probably sometime next year. Profitability for ReWalk remains a few years away, Jasinski adds.

Leaders at ReWalk and Ekso also realize that a little collaboration will be needed to show the benefits of their technology. They and others are working together to reach out to medical and patient groups.

This is a step in the right direction, says Barnes. “Industry needs to come together and fight for the one thing that’s lacking, and that’s coverage.”

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