Robotic Walking Rehabilitation Program

Robotic Walking


“Reduction in neuropathic pain”…“Improved bowel and bladder function”…“Psychological benefit of simply being up on my feet and walking”…“ Being able to look people in the eye again instead of the waist” These are just a few significant, subjective patient quotes on the benefits of using Ekso™ -- a wearable robot (exoskeleton) that enables some people who have lower-extremity weakness or paralysis resulting from a spinal cord injury or condition to stand and walk. WakeMed is currently one of just 16 rehabilitation facilities in the United States approved to use the Ekso device to help patients enjoy the benefits of being vertical. WakeMed physical therapists were specially selected to train and perform Ekso therapy.

How Does Ekso Work?
Ekso is an adjustable, portable, battery powered bionic exoskeleton. With patients providing balance and proper body positioning, Ekso allows them to walk (assisted) over ground with reciprocal gait. The physical therapist uses a control pad to program the desired walking parameters, such as step length and speed, as well as control when Ekso stands, sits and takes a step. In addition, the physical therapist operates Ekso with a remote control as the patient walks with the use of crutches or a walker. This allows the physical therapist to teach the patient when to take a step, how to position his or her body for proper balance, and how to shift his or her weight in preparation to take another step.

There are currently three phases of Ekso therapy.

  • FirstStep – Therapist uses a remote control to advance Ekso
  • ActiveStep – Patient uses crutch controls to advance Ekso
  • ProStep – Ekso moves when the patient performs an active weight shift

Robotic Walking device

Who Is Ekso For?
Ekso is for patients with spinal cord injuries or similar conditions resulting in lower-extremity paralysis or weakness. Here are some criteria for Ekso users. Eligibility will ultimately be determined during patient evaluation.

  • Arm function and adequate upper extremity strength to manage crutches or a walker
  • The ability to transfer independently from a wheelchair to a chair
  • 5’2” to 6’2” tall
  • Weigh 220 lbs. or less
  • Near normal range of motion in hips, knees and ankles
  • Currently participating in a standing/walking program

How Are Patients Evaluated for Ekso Eligibility?
First, the Ekso candidate will complete an over-the-phone screening. If he or she is cleared for Ekso use, the candidate must then obtain a doctor’s order for a Physical Therapy Evaluation and medical clearance stating that he or she is able to participate in weight-bearing and standing activities. It is essential that the candidate’s physician is comfortable with the candidate’s participation in Ekso therapy because osteoporosis is a risk factor in those who have limited weight-bearing ability.

Once the proper physician orders are in place, an Ekso physical therapist will perform a comprehensive physical evaluation on the candidate, measuring range of motion, muscle strength and spasticity. The physical therapist will then design the candidate’s comprehensive care plan, which may or may not include Ekso use.

How Do I Get Started?
Call WakeMed Outpatient Rehabilitation at the Health Park at 919-350-8347 to schedule a telephone screening. If you are cleared, a physical therapist will contact you to schedule an evaluation which will take approximately one hour. Please bring the Physical Therapy Evaluation order and clearance for participation that you obtained from your physician to your appointment. Wear comfortable clothes and sneakers.

We look forward to working with you!