Last Christmas, fans of the TV show 'Glee' were wowed when Artie, a paralyzed character, was able to walk with the help of a robotic exoskeleton. The show catapulted the ReWalk into the national spotlight, and this summer Philadelphia-area residents will be the first to use the device in therapy.
The ReWalk was invented by an Israeli company, but its U.S. clinical trial has been run by Moss Rehab in Philadelphia. Jean Altomari, 32, is the final participant in that trial.
'Closest thing I've done to walking'
On a recent afternoon, Altomari walked down an empty hospital hallway at Moss Rehab, part of Albert Einstein Medical Center. She was strapped into the ReWalk, which looks like a pair of leg braces attached to a small backpack. A sensor in the pack measured the tilt of Altomari's torso. When she leaned forward with the help of a pair of crutches, a microprocessor sent signals to motors in the hip and knee joints. They bent and then extended her legs at each step.
"It's frustrating because you don't just get to get up and do it," Altomari said. "For someone who had everything come easy to them, this is not easy to do."
Altomari is still learning to use the device, so she moved slowly, with the help of aides. Her steps were awkward and halting, and she had to stop and re-start often when she fell out of rhythm. She was sweating in the hot hallway, but still smiling.
"As odd as it sounds, it feels normal," Altomari said. "This is the closest thing I've done to walking since I got hurt."
Two years ago, Altomari made headlines for delivering a baby in a car on I-95 while working as a Pennsylvania State Trooper. Just three months later, a car accident while she was on vacation broke her back, paralyzing her. Altomari had not taken a step in a year and a half when she was strapped into the ReWalk for the first time.
"The first time I stood up in it I thought, 'Oh my God, I should have brought someone for moral support, because I'm gonna cry and I don't want to cry in front of these people I just met!'" Altomari said.
Still, she worried she was setting herself up for disappointment.
"It's a double-edged sword. Part of me understands that I have to adjust and adapt to this new part of me that's going to be my life," Altomari said. But her worries did not stop her from jumping at the chance to walk again, if only for a few months, and for a few hours a week.
"I just think its something that you kind of have to prepare yourself for," Altomari said. "I'm going do this, I'm going to love it, I'm going to miss it, I'm going to want to keep it, and I'm just going to have to deal with it."
'A big leap forward'
Based on the clinical trial that is still ongoing, the FDA approved the ReWalk for institutional use earlier this year. Moss will be the first place in the U.S. to use the device in therapy, starting at the end of July or beginning of August.
Dr. Alberto Esquenazi is the chief medical officer at Moss Rehab. Esquenazi helped develop the software for ReWalk, and ran the trial. Besides giving people who have been in wheelchairs for an average of 8 years the opportunity to walk again, he said the trail has revealed other health benefits.
"What we've found so far is most of these patients report a reduction in pain, a reduction in spasms," Esquenazi said. "The other thing that has been reported is a sense of improvement in well-being."
Esquenazi said longer use should help slow the bone-density loss that comes with inactivity, and allow a population that often finds it hard to get exercise to work out more easily.
A similar device created in Berkley, California is currently in testing. Together, the devices represent the next step in thinking about mobility for people who are paralyzed.
"I don't think it's at all an exaggeration to state that what ReWalk and Berkley Bionics are doing right now really does represent a big leap forward," said Grant Elliott, who researches robotic exoskeletons at the Massachusetts Institute of Technology.
The ReWalk costs about $90,000 for hospitals to buy. Elliott said the next generation of similar devices will need to be cheaper, able to handle more difficult terrain and help people walk less robotically, more naturally. But he sees them as the future of mobility.
"I think in the coming decades you're going to see devices like this become more commonplace, especially in cases where they can replace wheelchairs and the sorts of existing mechanisms that we take for granted," Elliot said.
Jean Altomari said she is OK with giving up the ability to walk, once again. She will have more time for hand-powered cycling, wheelchair racing and swimming. And maybe a little more time for another hobby.
"You used to people-watch, look at people's outfits, people's hair," Altomari said. "Well, I people-watch from the waist down, and all I do is watch their feet go by."
Altomari continues to work as a state trooper. She is now a gaming enforcement officer at Harrah's casino in Delaware County.