Father builds exoskeleton to help wheelchair-bound son walk
reuters.com
reuters.com
I am fed-up at the lack of options available to individuals. People thought that everyone will get an exoskeleton and be able to walk with it everywhere. But the industry ran into many challenges.
A big one that many dont understand is getting insurance coverage. The way the US healthcare system is designed, it will only cover restoration of mobility, not a restoration of function. So, from their perspective, a wheelchair and some pain meds can do the job easily.
I believe that they key is to start with children, this is where you have families desperate for a solution, higher costs due to them growing and spending their entire life in a wheelchair, and the option to truly have a life changing impact.
But things are changing, people are starting to notice the work that we are doing. We need a lot more people building exoskeletons and similar powered orthotics!!
Well done. This is something close to miracle tech, at least for the people wearing it.
I can't help but feel curious whether they're a viable alternative to wheelchairs, or if it's a temporary feeling (kind of like riding on a rollercoaster, in that you go and do it for the experience and then return to your normal life). But that's just my ignorance talking.
Also, fuck the US insurance system. You won't find many topics that make me talk that way, but as I get older it feels something closer to pure evil. I've met so many people who have been screwed over by that system (and personally experienced my share of it).
There's a woman I've been texting with who I met at a gas station. She was clearly in distress, so my wife and I offered her a ride home. To cut a long story short, she spent her fourth of july miserable, and when I raised the idea of getting prozac or some sort of antidepressant (my own "miracle tech"), she said "Oh, I used to be on that. I can't afford it because no insurance" and I practically flipped my phone onto the concrete. She could be living a normal and happy life.
I can't imagine how much worse it is for parents who otherwise need to spend $thousands for alternative solutions like this. If you can make it in any way affordable, it'll change countless lives, I'm certain.
$1000/mo for a rental. People without insurance need not apply.
Price doesn't mean you haven't changed a lot of lives either: In addition, a lot of folks that can't walk are covered by some sort of government-provided insurance. Unfortunately, it doesn't really help all that much because insurance limitations don't always cover everything or cover enough.
I'll also say that it is a lot for a single person/family: It isn't nearly as much at a daycare, school, physical therapy and other such things. I'd not be surprised if such places weren't their most common home.
Hospital visits in the US average $11.7k for a full stay[1]. Antiviral treatments for Hepatitis C like Harvoni and Sovaldi cost $16k-90k for 12 weeks, though you can go with a generic version for $5k-10k a month.
Hopefully once they get more popular, the government will pay for it to setup in Rehabilitation centers. From what I saw right now it's mostly private centers that are buying it (US/Canada).
If/when anyone runs into this regarding medications, be aware that even without insurance many pharmacies (at least in chains) have significant lists of medications available at very little or no charge. Companies like GoodRX can also lead to much lower prices, particularly on generics.
Meijer has free antibiotics and prenatal vitamins.
Walmart has a variety of medications for many conditions at $4 for 30 days and $10 for 90, as well as inexpensive insulin options (discussed here on HN within the last month or two - maybe not preferred fastest-acting options, but certainly better than 'rationing hoping I don't die')
Walgreens has a prescription savings club for $20-35/year that has 30-90 day supplies of generics at various price points between $5-15 for 30-day supplies and 10-30 for 90 day supplies
CVS has some kind of system that I didn't create an account to look at but is likely similar.
Costco has a Member Prescription Program and has all their medication prices available on the site, and the pharmacy can be used for prescriptions even without a membership.
Kroger has a prescription savings club linked to GoodRX that has prescriptions at $0/3/6/9, with a membership of $36/72 year individual/family.
None of these plans are going to cover the medications being advertised on TV, but they're going to provide coverage for a lot of long-term proven generics that treat conditions that have been around as long as humans have. They may not be AS effective (or perhaps they just lack marketing budgets), but if they weren't at least SOMEWHAT effective they wouldn't still be around as generics.
And if you've read this far and are interested in other information on keeping medical care less expensive, I highly recommend looking up the Arm and a Leg Show podcast for a lot of useful information.
Although Prozac has been generic forever, and depending where you live, you might be able to get a 30 day supply for a few bucks. Walmart has it for $4.
The expensive part is regularly seeing a doctor for prescription refills. Depending on the state and her income, she might be eligible for expanded Medicaid, though.
And not even a good wheelchair. For my wife recently diagnosed with MS, they would only approve of a basic, featureless, uncomfortable one after I would pay the $3000 deductible plus 20% coinsurance. Instead, I got a light-weight folding electric wheelchair with nearly full-day worth of battery (15 miles), with a spare battery, adjustable headrest for $1300 off Amazon. Add an octopus-tripod fan with 10hr battery, golf-cart umbrella, bendable cane holder, bottle holder, and an A/C fan jacket for a total of $200 and now she is able to spend a few hours out with our kids at museums, aquariums, and zoos.
It was literally cheaper for me to buy all of this cash than try to spend 40+ hours getting insurance approval.
I absolutely love how practical and solid your product is. I cannot comment on the pricing because I have no idea what your costs/market is but if my kid needed $999/mo to walk, I would do literally anything to be able to afford it. Hopefully the costs keep coming down for those with a smaller budget. Good luck!
For chemicals, that is, medicines, paying out of pocket is not impossible, but much harder. The $1500 you invested will likely last a number of years. Or it might be a month worth of prescription drugs; cheap generics do not exist for everything (and may sometimes be inferior).
I don't know a good way out of it. The U.S. medical insurance system sucks, but my friends from Germany and Netherlands report that theirs is even worse at providing any remotely advanced treatment.
For example the NHS negotiates drug prices on a national basis, meaning people in the UK pay way less for medicines than in the USA.
The cost of Medicare + Medicaid divided by the number of people in the US - not the number of people covered by those services, has tended to be higher than the cost of the NHS divided by the number of people in the UK.
EDIT:
According to CMS[1], Medicare cost $799bn in 2019, and Medicaid cost $613bn in 2019. The Census bureau gave 328 million people in 2019 [3], or ~$4300 per person for Medicare and Medicaid whether or not they are covered.
According to Kings[2], the NHS cost 150bn pounds in 2019, or ~$208bn (I've not taking into account exchange rate changes). ONS gives mid-year estimate of 66.8m for the UK in 2019 [4].
Which gives $3113 for NHS per person, all of whom are covered.
The point is that if Medicare and Medicaid were allowed to work in the same kind of regulatory environment as the NHS (e.g. Medicare is legally prevented from negotiating best prices for some categories of cover), and was equally efficient, then you ought to be able to take the same budget and extend Medicare cover to every citizen of the US without paying more.
In fact, you'd have 33% more per resident to cover e.g. salary gaps without touching the Medicare/Medicaid budgets.
Americans are effectively paying twice, as money paid in private insurance is at least the same amount over again. It's bizarre to me there are no riots in the streets over this - current US healthcare regulation is corporate welfare to insurers and healthcare providers at the cost of regular people.
[1] https://www.cms.gov/Research-Statistics-Data-and-Systems/Sta...
[2] https://www.kingsfund.org.uk/projects/nhs-in-a-nutshell/nhs-...
[3] https://www.census.gov/newsroom/press-releases/2019/popest-n...
[4] https://www.ons.gov.uk/peoplepopulationandcommunity/populati...
It kind of depends on what you'd consider advanced treatment. I know a few people with chronic illnesses that are dependent on getting their (expensive) medications and they never had a problem with that. Besides the prescription fee of 5€ (not 100% sure on that one) they pay nothing out of their pocket.
But I've heard from people that that they often have problems for example with getting approval for new wheelchairs, accessibility adjustments for their cars, etc.
In general it is true that only necessities are covered by public health insurance. This makes sense in most cases for obvious reasons, but in some cases the limits seem totally arbitrary and are not beneficial to the consumer nor the insurer. Luckily I am young and healthy so my confrontations with our healthcare are limited to my bi-yearly dentist appointments, but I can absolutely imagine how there are gigantic bureaucratic hurdles when needing something remotely special.
I called up the seller to buy more spare batteries and they said the 2 batteries the chair comes with, are under warranty for 1 year. And they should last another 2-3 years easily even with heavy use. So there's no point in buying spares now since the spares will lose the ability to charge over the same time.
We have been out for 2-3 hours per trip many times this year and not once has even one battery run out.
Segway hit the market 20 years ago and it still has not happened. I get that there are a number of complications (getting on and off is a challenge), but it seems like it should be solvable. The technology has only improved over the years, especially the batteries. This should be doable.
https://news.yahoo.com/the-i-bot-a-mission-to-revolutionize-...
Extra mechanical stabilizers are in the way when you finally are on/in and without the Segway was really stubborn and threw me and others off in the beginning. A person without proper sense and ability to balance, will have big problems getting onto it and off again with just the gyros running. Also balancing is a really difficult thing to do if you have the problems that forced you in a wheelchair in the first place.
For people who are ok with the upper part of the body, and can lift themselves onto the machine, you might be right though. Unfortunately there doesn't seem to be a "used Segway" market that is cheap enough to attract hackers trying out new things with them.
Here is a Segway converted to a wheelchair here in New Zealand:
https://www.stuff.co.nz/business/small-business/70065350/han...
I'm picturing the robot in Avatar [1], but with an open top and much less threatening and not weaponized [2], like big robotic pants. If I were to quit my job, it would be to make human robot minotaurs a reality, but then again, what do I know about robots?
[1] https://www.youtube.com/watch?v=F6ttDZFmGqg
[2] https://www.pcmag.com/news/toyotas-latest-humanoid-robot-can...
1: https://d.ibtimes.co.uk/en/full/1386220/wallace-gromits-wron...
FYI, your "Team" link in the footer is not loading properly.
Great job. This is truly Amazing.
That's too much getting in my face without giving me a chance to browse.
If I'm visiting the website, I'm probably going to be able to answer some of those questions without having these distracting offers thrown into my face immediately.
You'll find that countries with socialized medicine won't cover more than that either. It's too expensive, regardless of whether your covered privately or publicly. Socialized medicine is typically much harsher on keeping costs down as well.
I feel like we've made leaps and bounds in prosthetics this past decade but orthotics and exoskeletons haven't been following the trend for some reason. As an engineer I imagine there are some significant design constraints that make it hard but seeing what we're capable of doing in any other industry I can't help but feel the problem has to be something other than purely technical limitations. The price is also a big issue, 10k for the cheapest exoskeletons, 150k for the one in this article.
That's where I'd foresee the limitations - that you'd end up hefting 80 lbs of battery for 20 minutes of operation.
The portable exoskeleton is a pretty big leap though. I think in order to have it be useful anywhere else but at home it would need to be significantly longer on the order of hours. I'm thinking time it takes from getting out of a car to go in to a shop and run an errand and come back (perhaps extra battery packs in the car or a place to recharge from the car)
This would have made a great premise for an Asimov story.
I mentioned fitting similar to spandex because all these other suits are bulky. Sure, this system would still have bulk, but it should be more conforming than mechanical legs that sit several inches outside of the person's natural legs. Good luck fitting on public transportation, airplanes, or even walking through a 32" door if you were a bigger person to start with.
If we abolish patents innovation will finally be possible.
There is a patent for a 3D printer enclosed in a box. A number of plastics print much better when in an enclosure with no drafts and more easily controllable temperatures.
But instead, 3D printers must be sold and function on their own without a box, to avoid the patent. Enclosures are then sold separately and you end up with a 3D printer in an enclosure anyway, but that doesn’t infringe on the patent… so it’s allowed.
I assume you are talking about this Stratasys patent that expired earlier this year, https://patents.google.com/patent/US6722872
> 1. A three-dimensional modeling apparatus comprising a heated build chamber in which three-dimensional objects are built, a base located in the build chamber, a dispensing head for dispensing modeling material onto the base, the dispensing head having a modeling material dispensing outlet inside of the build chamber, and an x-y-z gantry coupled to the dispensing head and to the base for generating relative movement in three-dimensions between the dispensing head and the base, characterized in that: the x-y-z gantry is located external to the build chamber and is separated from the chamber by a deformable thermal insulator. [...]
It's possible to have the device be corded and stay within a room or set of rooms.
Is wheeling the verb for it anyway?
There is progress. Japan has been developing assistance exoskeletons as an answer to elder care problems: power assist devices to allow not-strong people to lift/carry elderly people. Interestingly, much development has gone into pneumatic devices as they are inherently more waterproof than electric.
"In Japan, the commercialization of exoskeletons is already underway. Innophys, a startup founded in 2013 at the Tokyo University of Science, has already dispatched about 1,000 units across the country, in particular to Asahi-Sun, an elderly care supplier. Lighter than ActiveLink's AWN-03, Innophys' Exo-Muscle is a little less quick but offers more flexibility for a similar lifting capacity of 22 to 30 kilos (48 to 66 pounds). But Exo-Muscle uses an entirely different technology: compressed air, which is injected into rubber valves that inflate and contract."
https://worldcrunch.com/tech-science/an-aging-japan-turns-to...
Innophys suit has a compressed-air tank with limited endurance, built to be periodically refilled from a stationary compressed-air system on job sites (since those are common in many industrial settings). Notably, their ad copy says: "Simply fill it with air using the supplied pump and it is ready for use. Therefore it can be used anytime, anywhere, for an unlimited amount of time, easily. When the assistive power weakens, just add more air." i.e. you're expected to be able to pump the thing (they include a hand pump as a last resort!) at any time.
The AWN-03, for its part has one set of high-power motors for when it's connected to AC power and a lower-power motor for battery operation; that Panasonic division, in the 5 years since that story was written, discontinued that product and defined down the problem to less power-hungry assist modes, namely short assistance during particularly strenuous motions.
To be clear (not to be snide, just to improve clarity), increased power density is the ability to discharge energy in larger amounts in shorter time periods (think heavy lift olympians). Energy density is the ability to store large amounts of energy for longer periods of time (think long distance runner). Some applications, like cell phones are quite happy with high energy density, but relatively low power density. Others, like an battery-electric drill, need more power density but can offset the low energy density by swapping out batteries and having a rotable pull.
Great idealic batteries for this application would have both large energy and power desnity. I say this because people often overlook "batteries" that people don't refer to ass batteries because they generally don't come in a self-contained cell (they have subsystems that don't benefit much from cellular architectures). Case in point are Hydrogen fuel cells. I'm not saying their better than Li-ion, but they are for certain applications. Often H2 fuel cells are paired with Li-ion batteries or supper capacitors to provide improved power when transient energy bursts are needed. H2 fuel is stored in some tank - perhaps a pressure tank, perhaps in the form of Aluminum and water reaction, or for this application it may likely be some metal hydride that stores H2 'benignly'. However, to your point, even these metal hydrides have a lot of room and potential for improving energy density.
My only point here is that, cureently, the best answer may not be a single cellular battery, but some hybriid of energy storage technologies.
Bit of a sad story, but it never fails to motivate me past my usual, procrastinating self.
giving someone an exoskeleton might be something much more joyful and inspiring than a wheelchair, it can revive your life
i never meant to deny your own experience, I was mostly sad about the high cost and limits of a wheel chair.
I do not want to talk down on the wheelchair, but what about an exoskeleton as simply another way to get around and do other things, you cannot do in a wheelchair, because not every way is level? That would probably be a further improvement, if the tech would be ready and affordable?
If I ever loose my ability to walk, I really hope walking "wheel"chairs or something like a exoskeleton will be avaiable.
Now that some of the earbud manufacturers are dabbling in processing of environmental sound, some people may be able to use consumer grade equipment, particularly younger Boomers and older Gen-Xers, due more to stigma than anything else.
Unfortunately that probably reduces volume of product for everyone else, keeping the mean price roughly the same but jacking up the high end.
The powered ones are still too expensive for anything but the most niche applications sadly.
Kind of like picking up one leg at a time with your arm, while the other stays locked through some ratchet system.
It's just a hazy idea, but it could definitely help with the power issue. It's pretty much the same principle as a wheel chair in that regard.
People like you are the best hope. Independent inventors aren't bound by manufacturing economics.
Side question: how much power does it take to run existing, mobility oriented exoskeletons?
I imagine an insurance company is heartless enough to believe that a much cheaper wheelchair is "good enough" and there's "no reason" to pay the hefty costs for an experimental exoskeleton.
https://www.ted.com/talks/hugh_herr_the_new_bionics_that_let...
The Exoskeleton's Hidden Burden [0] is a good article that includes the history of exoskeleton development (goes back to 19th c. Russia):
[0] https://www.theatlantic.com/technology/archive/2015/08/exosk...
Why do these designs always have the actuators mounted directly at the joints?
Why not have some high modulus yarn transfer the joint loads (ala a bike brake cable, say with high modulus aramid?)? One could keep the actuators near the center of mass (or a trolley that follows it around), and keep the suit fairly minimal.
Funny you mention that, this guy [1] made an actuator/arm recently doing that technique. Does work but accuracy/flex can be a problem.
Who wants to call a nurse everytime they need to go to the bathroom? An exoskeleton gives you some autonomy and dignity. The fact it is so uncommon despite a growing aging population with stash of money is a mystery to me
https://biodesign.seas.harvard.edu/soft-exosuits
These things are not for the near term so really impressed by this story.
You know what I am wondering, the accelerometers in phones are super small, cheap and there are some sensor systems that incorporate a ton of other sensors (whatever happened to Google's smart jacket they were making with Levis)
Anyway, it would be very interesting to have a textile with a fabric of accelerometers woven into the fabric... Solar panels on the thighs and what not to power the sensors... with a compression-heel in a shoe / boot to ad more power with every step.
Anyone know how much power an accelerometer takes and if you can wire a matrix of them together to a set of controllers that all they do is capture the telemetry from the sensors?
Check out this video on the making of accelerometers
https://www.engadget.com/2012-05-22-the-engineer-guy-shows-h...
As the partner of a wheelchair user, these exoskeletons are a great toy to have on the horizon – but the promise of this has been around for a long time, and while the hope of a better future is exciting, we need change on a much quicker time scale than this. (Not saying people shouldn't be working on this – it's rad that they are).
On a day-to-day level, my partner would much more benefit from:
- A better wheelchair (this will mean something different for every body – for them, someone who uses a wheelchair for chronic pain, an exoskeleton wouldn't even help – much more useful would be a wheelchair where every bump of pavement doesn't rattle your whole body).
- More accessible shops and public spaces. We don't really get to go out much – most often blockades include cracked sidewalks, friend's houses that require a step (or stairs), and inaccessible shops.
- Better safety nets for those with disabilities (it's VERY expensive to be disabled in America – consider how much more these exoskeletons will cost than already expensive wheelchairs).
tl;dr These technologies are exciting and deserve attention and energy – just keep in mind that the notion that these emerging technologies will someday wipe out all of wheelchair users' problems in one fell swoop is both false and does nothing for the many millions prevented from participating in society right now. We need better access today.
"EduExo Pro: A Robotic Exoskeleton Kit for STEM Education The EduExo Pro is an Arduino-powered educational robotics kit that enables you to build your own wearable robotic exoskeleton."
https://www.kickstarter.com/projects/auxivo/eduexo-pro-a-rob...
They had a previous kickstarter that did quite well:
https://www.kickstarter.com/projects/1485976654/eduexo-the-f...
I am surprised Boston Dynamics hasnt made one! If you converted the agility of Atlas into an exoskeleton, that would be pretty interesting...
Though I guess exoskeletons are not uncommon in sci-fi.
Did it get better after those early missions?
[1] https://www.army.mil/article/125315/darpas_warrior_web_proje... (the first image is of BD's system; you can just make out "BOST" around the center of the left thigh)
[2] https://www.globenewswire.com/fr/news-release/2014/10/02/670...
I wonder if anyone has tried amplifying those signals.
Smile on father's face watching his son stand upright: priceless!
I wonder how much money he'll put on that.
This will lead to a revolution of generic complex product availability that ignores patents and trademarks.
An exoskeleton may not be the first type of product to be ordered and assembled from a few blocks away. The amount of QA for safety would need to be high.
However, if the price of such things is 1/10 or even 1/20th that of the branded, official version people will continue to turn to hyperlocal, small-run manufacture for even the most safety-critical products.
Not being snarky, I appreciate a lot what he's doing, and I hope he will succeed in his quest. There's just a glimpse of sadness when I realize that solving the problem in the first world doesn't mean it will be solved for good (same with vaccines, we hope/expect to have solved the COVID problem soon, but it won't actually be the case for a majority of the world population).
I've seen similar arguments from the deaf community about hearing restoration as "correcting" something when nothing is "wrong".
FWIW I think this invention is awesome.
I believe the original ideas around this go back to when a child is born with ambiguous sex organs. Parents and doctors would then choose to "correct" the issue to ensure the baby is either a boy or a girl, when in actuality it may have chromosome's that are not XX or XY. So then this (which is actually a really interesting debate) has cascaded into the greater world of disabilities. So there are currently critical theorists in the universities "theorizing" that looking at disabilities as something that needs to be corrected and not something that is normal puts people with them on the margins of society.
So there is well regarded (by some) literature that fixing deafness is wrong and that society shouldn't see it as a disability - that society should adapt to be seamlessly inclusive for deaf people. And this goes on and on.
In essence, science is racist and it has been white men who have classified what is normal and what is not and who is to say that everyone is normal and "correcting" these things is actually, well, "ableist".
It can get pretty crazy (whoops, that's a naughty word) out there.
So it's just demagoguery.
2) In any event the deaf community is rather unique compared with other disabled groups in general. A substantial number of deaf/hearing impaired people are born that way and grow up in a community with its own language and culture, a community that would be for better or worse disrupted by a "cure." Other disabled groups tend not to have a separate strong cultural identity as such. It is true that there are instances of individual blind people who were "cured" of blindness and found the experience so disorienting that they fell into a deep depression [0], but as far as I know, they didn't advocate for an end to blindness research.
The only time I've heard these types of questions are around people who are deaf. I suspect that the issue is a complex one of language and community. My understanding is that (some?) deaf people consider sign language their primary language, not the native tongue of their country.
It's too bad that the hn downvoters are hitting your post so hard, this could be a useful, informative discussion. It's hard to talk about this kind of thing without crossing political correctness boundaries though.
It's OK, I don't mind - plenty of karma.
I agree it's worth discussing because it's a bigger topic than a lot of people might realize. There's a lot of these types of ideas making a lot of progress in the university right now and they don't intend on being confined to them as theoretical. And in some cases they may have good points and in others maybe not.
Eg, this guy put his kid in a device that could kill him (maybe).
Looking back at the videos from Boston Dynamics, a ton of effort is put in to the failure mode testing. I highly doubt 1) this is dynamic, 2) failure modes were considered much.
The Father here has done a fantastic job, I'm sure his son is thrilled to be able to take some steps -- also the low-tech tether from above solves the falling problem for the moment which presumably lets him get on with solving other issues.
Well done Dad!
Besides, this dad doing it for his son is probably taking more care and precaution than some nameless/faceless engineer.
EDIT: clarity