Learning to walk again, step by step

December 24, 2019 Providence News Team

Carol Hanna used the exoskeleton to get back on her feet and hopes to resume cooking soon.Carol Hanna used the exoskeleton to get back on her feet and hopes to resume cooking soon.

Written by Sandi Draper

Trouble began for retired pathologist Carol Hanna with what she graciously refers to as a “therapeutic misadventure.” On May 31, 2019, she underwent an outpatient radiofrequency ablation procedure at a different health care facility in hopes of getting relief from neck pain. Something went wrong, and when she awoke from sedation, she was totally paralyzed on her left side and partially paralyzed on her right.

She was rushed by ambulance to Providence Little Company of Mary Medical Center Torrance. Although recuperation has been a long road, she is well on her way due to her own hard work and the EKSO GT robotic exoskeleton at the Rehabcentre at Providence Little Company of Mary Medical Center San Pedro.

The bionic exoskeleton, fondly referred to as EKSO, allows patients to begin putting weight on their legs and start walking again. While commonly used with stroke patients, EKSO also can assist patients with multiple sclerosis, Guillain-Barré syndrome, cerebrovascular injury, range-of-motion issues or, as in Hanna’s case, spinal cord injury.

“It’s amazing. If you can’t walk, EKSO lets you stand up straight and walk. If you’re weak on one side, the machine compensates for that. Now I’m walking with normal strides and follow-through,” says Hanna, who makes her home in Paso Robles with her partner, Pamela Lee. After spending weeks in the medical center to regain overall strength, Hanna was transferred to the Rehabcentre as an inpatient. 

Patient Carol Hanna is assisted on the exoskeleton by physical therapy assistant Jennifer Cowan and rehab technician Brandon Hokama.

Hanna admits to feeling like the Bionic Woman when the machine was first strapped on. EKSO’s computerized “brains” are contained in a backpack strapped to the patient.

There’s a trust-building that takes place between the patient, the physical therapist and the machine.”

“There’s a trust-building that takes place between the patient, the physical therapist and the machine,” Hanna says. “The machine is amazing, but it is the well-trained and skilled therapist that runs the show and makes it all work.”

Acute Rehabcentre received its EKSO in November 2016, thanks to funding from our Providence Little Company of Mary Foundation. Since then it has helped about 150 patients. According to physical therapy assistant Jennifer Cowan, who works with Hanna, “EKSO provides a safe, structured environment to encourage the patient to learn how to stand, weight-shift, lift a leg and finally walk. Few medical centers in Southern California use EKSO because of the expense and the cost of continually educating and training the staff.”

In addition to Cowan, three physical therapists—Julia Mathews, Anne Sheridan and Hindi Cima—are experts trained and certified to work with EKSO and patients.

“When a patient is identified for EKSO, either by an MD or a physical therapist, the patient is evaluated for appropriate physical fit into the device,” Cowan says. Patient and therapist then discuss the patient’s goals and the benefits of EKSO. A typical EKSO session runs for an hour, the first 10 to 15 minutes spent getting the robot onto the patient.

The Rehabcentre treats both inpatients and outpatients. Use has ranged from a patient needing only three sessions to a patient who had sessions for almost a year. “Walking” time during a session is 30 to 40 minutes. 

“That’s a tremendous effort when a patient hasn’t been walking at all or only 50 feet at a time,” Cowan says. “Many small movements all add up to function, which you don’t know or understand until you have lost that function and need to be retaught the movement. EKSO teaches the person by high-performance, high-quality patterns. The patient needs to be willing and accepting of recommendations made by the EKSO and the trained therapist. The overall feeling is one of bonding with the robot. When there is success, the patient and EKSO move as one unit and not as two separate entities.”

While EKSO is a tool, physical therapy is still part of the treatment. EKSO gives therapists detailed reports after each patient’s session, and that information is used to adjust therapy sessions.

Hanna has four to five hours of therapy each weekday. “It’s not a resort here. You’re working,” she says, but adds, “I am so lucky to be receiving care here at Little Company of Mary San Pedro.” 


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