Podcast: Exoskeleton To Help Parkinson's Patients Walk

In this episode, we talk about how a soft robotic exoskeleton from Harvard and Boston University is allowing patients suffering from Parkinson’s Disease to get their independence back by being able to walk safely without extra assistance.

This podcast is sponsored by Mouser Electronics. 

EPISODE NOTES

(3:55) - Soft robotic, wearable device improves walking for individual with Parkinson's disease

This episode was brought to you by Mouser, our favorite place to get electronics parts for any project, whether it be a hobby at home or a prototype for work. Click HERE to learn more about how exoskeleton are being utilized today to give people superhuman powers!

Transcript

What's going on folks? Welcome back to the Next Byte podcast. Today we're talking about exoskeletons, how you can become Iron Man yourself. But to be more serious, we're talking about how exoskeletons are making the lives of patients with Parkinson's disease a lot better. So, if that's got you interested, buckle up and let's get into it.

I'm Daniel, and I'm Farbod. And this is the NextByte Podcast. Every week, we explore interesting and impactful tech and engineering content from Wevolver.com and deliver it to you in bite sized episodes that are easy to understand, regardless of your background. 

Farbod: All right, folks, welcome back to the Next By podcast. Now, before we get started with today's episode, we gotta talk about today's sponsor, and that's Mouser Electronics. Mouser is one of the world's biggest electronics suppliers, which is pretty cool, because they know what's coming down the pipeline. They know what's going on in academia, they know what's going on in industry, and sometimes they write articles about what they know. So, we're talking about one of those today. This one is very relevant to today's topic. The article was titled, robotic exoskeletons deliver real superpower for real people. What does that actually mean though? Like we've seen exoskeletons, right? If you've seen Iron Man, which we talk about a lot on this show because it inspired us.

Daniel: We're tech geeks.

Farbod: We are tech geeks, right? When 10-year-old Farbod saw Iron Man for the first time was like, oh, I wanna be a mechanical engineer because it's cool. Well, they're talking about how exoskeletons aren't just like science fiction anymore. They are a reality. They exist and they give some examples of how exist and people can use them to get superhuman like abilities. Specifically, they were pointing out how these very rigid exoskeletons made from typically lightweight metals or heavyweight metals can be used for rescue operations to lift heavy materials off of incident sites or very commonly used in factory floors where you have people that need to operate heavy machinery. Now, this can assist them so they're not putting too much pressure on their joints.

Daniel: That's what I was going to say. I've worked in a factory scenario before and I've seen people using like robotic arms and they call them like a lift assist and you see these people lifting like huge heavy 150-pound crates and it looks seemingly effortless and it's awesome that that machinery is an extension of their body. And I think that doesn't technically qualify as an exoskeleton, right? They're using a piece of equipment that's bolted to the ground and they're manning the controls that are a part of that. But I imagine using robotics to deliver that level of convenience, et cetera, onto like a wearable, so to speak. Um, you're, you're basically wearing a robotic arm, or in this case, wearing robotic legs or robotic armor, so to speak, you know, getting closer on, onto the, the level of Ironman that we're talking about, but gives you the opportunity to, to operate heavy machinery, lift heavy things, protect yourself from damage, lift rubble, like you're saying to, to help people in a rescue situation. All that's very interesting and the technology exists seemingly, so it's exciting to see Mouser talk about what it takes to bring that technology to life.

Farbod: For sure, and one of the things I liked about the article is that it goes through, like, what this technology is, the versions of it that currently exist, their use cases, and also leaves the door kinda open at the end and says, hey, typically we've been using these very hard rigid materials because that's what the most popular needs have been, but that doesn't always have to be the case. Exoskeletons don't always have to be made from these stiff composites or metals, et cetera, et cetera. It just depends on what kind of applications you wanna have, which by the way is a great segue, hint, hint, into today's topic.

Daniel: That's what I was gonna say. Today's topic is about a soft wearable device. So, it's an exoskeleton, but not rigid like a skeleton. It's actually very soft and flexible. And the purpose of the device is to improve walking for individuals with Parkinson's disease. Collaborative research between Harvard and BU, go Terriers, Nelly went to BU.

Farbod: Shout out Nelly, shout out Terriers.

Daniel: But in general, Parkinson's disease affects over 9 million people in the world. It affects their dopaminergic neurons, the neurons that create dopamine that can cause motor control issues. One of the major factors and the fatalities that are associated with Parkinson's disease is that people fall a lot, right? They lose their fine motor control. They fall, there's accidents, they get injured and then they can't recover from those injuries and they ended up passing away from them, which is really sad. One of the main causes of these falls is this phenomenon they call freezing.

Farbod: Yes.

Daniel: When people with Parkinson's are trying to walk and their feet kind of freeze, and maybe they have remained or maintained motor control over their arms and their upper body and maybe even their legs, but their feet kind of start to drag and then their steps become shorter and shorter till they end up stuttering and then their feet basically completely stop.

Farbod: Lock up basically, yeah. Did you know about freeze before this article? Cause I didn't.

Daniel: No, I didn't. Nelly's grandpa actually passed away and he had Parkinson's. So, I'm sure their family is aware of that, you know, that did a great job of taking care of him. There's latter part of his life, but I didn't know that freezing happened and also, I didn't know that we don't know really why freezing happens.

Farbod: Exactly, well the reason I was asking is because I was doing some research about Parkinson's disease generally. 10 million people affected worldwide, awful disease. But then there was this little tidbit on the National Institute of Health that was like, I'm just gonna read the quote, freezing of gait, FOG, is one of the most disabling, yet poorly understood symptoms of Parkinson's disease. And once you, again, read about people that are experiencing FOG, you start to understand why it's so debilitating. Like you're saying people lock up when they're trying to initiate a movement or doing a turn, and slowly it starts to take away from your independence. Like, that's awful, you can't do things on your own anymore. In addition to that, there are solutions, like there's existing solutions for it. There's like pharmacological, I hope I said that right. There's a drug, I looked up, it's called Levodopa that can reduce the frequency and the duration of these episodes, but like, you can't eliminate it. You're just trying to lower how often it happens. And there's also surgical, where you have spinal cord stimulation to kind of prevent it, but those are also not very impactful either. So, you can literally do surgery and take the medicine and still not be rid of this thing that is, you know, very annoying to have.

Daniel: That's what I was gonna say is, you call them solutions. The caveat I was going to say, I don't think there's solutions because they're not solving the problem. I think they're treatments, right? They help treat it, but they haven't cured it Pharmacological solutions right taking drugs. I'm sure there are pretty heavy side effects associated with that. Knowing that what they're trying to do is increase dopamine production in the brain. I can only imagine how much…

Farbod: The withdrawal?

Daniel: Yeah, you know the rest of the body the side effects that you experience obviously surgical that's pretty invasive. I don't like the sound of someone cutting up in my back and stimulating my spinal cord and it's still not solving the problem. I know that they also have behavioral types treatments or they try and coach folks that have Parkinson's to say like, maybe you shouldn't be speaking while you're talking or speaking while you're walking, I know that that's one of the things that causes increases the frequency of freezing is if there's a number of additional stimuli, I looked this up researching for the episode, right? If folks are walking outside and there's like a change in terrain and there's a lot of different visual stimuli that can cause increase in frequency of freezing and also if folks with Parkinson's try to walk and talk at the same time, that also tends to cause increase in frequency of freezing. They're not exactly sure why that happens, but I know that they think that some part of the central and peripheral nervous system, the way that you're trying to manage multiple stimuli while also trying to control the muscles, maybe causes some cross talk and then you lose control of your feet. All that being said, existing treatments exist. They aren't very effective. And also, that the root cause is not well understood. So, what this team from Harvard and BU are doing, they're taking technology that exists in soft robotics and also technology that they've used before, I think to help stroke patients recover. Because strokes similarly, you lose your ability to control your gait sometimes and that motor control can be returned if the body's coached and it's retaught to understand how to walk again. So, they've used soft robotics technology in the past to help folks with strokes to recover their gait.

Farbod: But by the way, we said get a lot, gait is like the pattern of someone walking. G-A-I-T. Yes. It's like doors gate.

Daniel: Yeah. That's a good call. And they said that this device is worn around the hips and thighs and it aims to stop gait freezing. When I first heard that, did you ever watch the Wallace and Gromit cartoons? It's like this claymation. Wallace is like a crazy scientist and his dog Gromit is even crazier scientist and they like build a rocket that goes to the moon because they think the moon is made of cheese. And one of these episodes in Wallace and Gromit, they order these techno trousers that are from NASA and it's like robotic legs and then they look like pants and you put them on in the robotics leg, robotic legs that can be controlled remotely. And you know, they go through all their crazy stories and I think the legs get hacked while someone's wearing them. Something's crazy like that, right? I remember watching this as a kid. That's what I expected this to look like. I expected it to look like super ugly. Like if you're wearing this out in a crowd, people would be like, oh my gosh, he's wearing robotic pants. That's not the case. It actually looks a lot more like a weightlifting belt, which I see like people wearing in the gym with bands around the thighs as well. So, obviously I am not affected by Parkinson's disease, but if someone I loved were, or I were, I would try to encourage myself or encourage those people I love to say, hey, this thing that turns out to actually be pretty effective, it also doesn't, it isn't much of an eyesore either. It looks like it wouldn't impede your life as much as I originally thought when they said, oh they're gonna put a robot on your legs and hips and it's gonna help you walk better. This actually looks a lot more like a back brace.

Farbod: And one thing I'm gonna point out here, not exactly the same, but I have a family member who uses hearing aids and when they were younger, even though the hearing aid really helped them, they didn't want to wear it because it stuck out like a sore thumb, right? So even though the solution worked, they didn't want that aesthetic, that view of them needing some sort of an assistive device that doesn't look great. So, the aesthetics from an engineering standpoint, we might just be like, we got our engineering hat on, we're like, why does that matter? No one cares. But the reality of it is, if you want this solution to be used by people that need it, you also need to make it palatable. It needs to be something that they can easily wear and not stand out like a sore thumb. So, I think that's a great thing that you just pointed out because I was gonna gloss over it 100%.

Daniel: Well, so let's talk about it, right? Secret sauce, we've kind of mentioned it, right? You've got a band around your waist, like right above your hips. And then another bands around your thighs. And then there's cables that attach the bands around the thighs to the bigger band that's around the waist. And essentially what they're doing is analyzing motion data, estimating the phase of your gait, right? The pattern of your walking. It can understand when there's freezing and it detects anomalies in the gait. And then it generates assistive forces to basically help lift the leg based on the phase of the muscle movement, the pattern of your gait.

Farbod: It gives you the nudge that you need to finish that phase instead of like starting to stutter.

Daniel: Yeah. Going back to my analogy of like a weightlifting belt, it's interesting. It's like when you're trying to complete a lift and there's someone spotting you, like oftentimes you don't actually need someone like to say that I'm trying to bench like 200 pounds and I'm struggling on my last rep. I don't need someone to pick the full 200 pounds up. As my muscles start to fatigue and stuff like that, I might need you to help me like, just give me a little nudge, help me list a lot lift. Like 5% of that weight to help me get it back and set the bar back on the rack. This is very similar. I think it's, the folks at Parkinson's, when they're experiencing freezing, they don't actually need to generate the entire force to pick up their leg and create the next step. Actually, you just need a little bit of a nudge to help lift the leg, right? And you can imagine there's a cable attaching the band around the waist to the bands around your thighs. And when this detects that you're supposed to be taking a step with your left leg based on the pattern and the phase of your walk. And then they notice that that step isn't happening. It generates a little nudge. It helps pull up that thigh to help maintain the gait. And that little nudge is enough. Effectively, they've seen to basically completely eliminate indoor freezing and significantly reduce outdoor freezing without any special training. So, they didn't tell these folks, here's the operating manual, you'll have to practice with this for a couple hours and then we'll turn up the settings or whatever. They're just like, hey, thank you, patient, for volunteering to be part of the study. Put this on, start walking, and it worked right away, which is pretty crazy.

Farbod: And that's what makes it so promising, right? Again, the friction to adoption there being if you have to train someone for a long period of time, or you need a physical therapist that teaches them how to use this device, then it kind of, it's not very palatable to most people. But in addition to that, one of the things I wanted to say is you made a point of saying, like this thing nudges you forward. The fact that it works in tandem with your actual muscle groups makes it so that people that could not get exercise because of this, like they couldn't independently go out on their own, can do that independently now, but also be able to work their muscle groups and not have to lose that density over time, which then causes more issues. Like it's a domino effect, right?

Daniel: That's something I was gonna mention, is this was originally intended to be a rehabilitation tool for folks that were recovering from stroke. So, it's not intended to walk for the person, it's intended to help the person recover their ability to walk. And I was going down the same path that you were there, like folks, if they have Parkinson's disease and they struggle with their confidence to walk, they're gonna stop walking as frequently. And if they always need someone to help them, or maybe they're embarrassed to use a walker or cane, I definitely could see myself being in that position. If like, all my friends are going out.

Farbod: For sure.

Daniel: I wouldn't want to walk around with a walker for sure. So, this gives them the freedom to continue walking and then their muscles don't atrophy as much because they're not neglecting their ability to walk. It's a great point because that may continue to extend their ability to walk, their muscle mobility that may reduce the long-term effects of Parkinson's disease that may increase their quality of life and increase their life expectancy, all because of a little nudge on their legs to help them keep walking.

Farbod: And the simplicity of the solution is what makes it amazing, right? There's no invasive surgery, there's no tight regimen of drugs that you have to be on that might or might not work, there's no limitation of, oh, like, you can't chat with your buddy when you go on a walk just because you don't wanna risk freezing up. It's just a nudge that allows you to pretty much get rid of this problem as a whole.

Daniel: Well, that's what I was going to say is there's a couple of things that are pretty interesting to me. And it hits close to home, right? Cause I think about Nelly's late grandfather, but one of the things is, obviously like we mentioned it, they're trying not to make it an eyesore. In addition to the engineers, the rehab scientists, the physical therapists, biomechanists working together, they also have apparel designers on the team helping them to make sure that like, it doesn't just fit properly on a human, it also looks proper, right? It fits in fashion-wise, which I think is pretty interesting. And then the second part that I thought was pretty fascinating here, obviously the effects of it, it was able to eliminate indoor freezing, significantly reduce outdoor freezing, significantly reduced freezing that was generated because of walking and talking simultaneously like you mentioned, but one of the things, again, I think it's most fascinating for me is they called it a shift of like a bottom-up approach for treatment as opposed to a top down. So, the top-down approach is like, oh, we understand that there's this neuro generative disorder in your body. I'm going to make you take a bunch of drugs. I'm going to stimulate your spinal cord. I'm going to give you behavioral coaching to tell you what you can and can't do in your life. That's a lot of stuff trying to impact the way that you're using your brain to control your body. In this case, they're able to do treatment that helps your body. And they found that it actually can help the central nervous, you know, by helping the peripheral nervous system, the control of the limbs, it can help the central nervous system as well. It aids in cognition. It helps people to be better at walking and talking. And it's one of the most effective treatments they've seen so far. And it's, regardless of whether you're using drugs or spinal cord stimulation, which are like all these top-down approaches, they're saying like focusing on the biomechanics and the peripheral dynamics of the body, how the body is controlled and moved. If you can help control some of those symptoms, they're wondering if maybe that has like, trickle up effects, right? If you're better at controlling your legs, is that trickle up effects to help reduce the impact of Parkinson's in your brain, et cetera?

Farbod: It's, I feel like instead of trying to force your way into beating the disease, it's trying to kind of accommodate the disease to an extent and remedy, basically make sure it's not impacting your life as greatly as it would otherwise. And again, it looks like their solution is actually beating the top-down approach, so kudos to them for recognizing this flaw and taking a first principle to look at the problem as a whole. In terms of what's next for them, I think this is pretty interesting. Even though their solution is pretty chic, they're looking at developing an even more streamlined version that I think they plan on making more publicly available. The main patient that they work with to do this development and testing was a 73-year-old patient who had actually gone through these other proposed solutions but didn't have much luck. But they saw great promise with this approach. So, I'm wondering if they're also gonna do more trials before they go to market. But I think, I mean, this is one of the early topics that we've done this year. But this is very promising. This is one of those topics that I wanna continue to cover like just see where it goes.

Daniel: Yeah, I agree. And one thing I wanted to say, they mentioned it in the article, obviously we're linking the show notes, you can check it out if you're interested, but the researchers mentioned that the MVPs, the most valuable players of their entire research process was not the engineers or the fashion designers or the physical therapists. It was these patients that had volunteered their time to help test the solution because they mentioned if these folks are already experiencing mobility issues, it's even more challenging for them to get through all the craziness that is the metropolis city in Boston, to get all the way in to the university to help do their study. But they appreciated those folks and their tenacity to one, be willingness to try new things, help development and technology. But that also, they mentioned these core few folks that were willing to test out the technology and its early stages are probably gonna create huge knock-on effects for lots of other people that are also impacted by Parkinson's disease. It's obviously like a warm and fuzzy feeling, a little bit sappy, but I think it's really meaningful to shout out those folks who had to already overcome all their mobility issues to get to the place where they can test the new solution. And I'm sure there was some trial and error to help tune things to make sure that it works properly. Obviously, I don't know if they mentioned the name of that, like their main 73-year-old patient that helped them develop a lot of this technology. Huge kudos to that person, because they're going through a lot more than any other researchers are to develop that tech.

Farbod: And they're paving the way for a brighter future for others like them, so you love to see it. I think that's just about it. We're almost ready to wrap up the episode, but we did promise that we, as always, we wanna shout out our folks worldwide that are making us trend. It looks like we were trending in Denmark, right? And is that right?

Daniel: Yeah. Yeah, okay. I don't know how to say thank you in Danish. You promised.

Farbod: I looked it up. I looked it up, okay? I'm gonna do my best here. To our friends in Denmark, please be nice. I've only been to Denmark once when I was a kid, so you can't hold it against me. But, Tak skal du have.

Daniel: Okay.

Farbod: I really hope that's right. Thank you, guys, so much for listening. We really appreciate the love and support. And as always, we'll catch you in the next one.

Daniel: Peace.

As always, you can find these and other interesting & impactful engineering articles on Wevolver.com.

To learn more about this show, please visit our shows page. By following the page, you will get automatic updates by email when a new show is published. Be sure to give us a follow and review on Apple podcasts, Spotify, and most of your favorite podcast platforms!

--

The Next Byte: We're two engineers on a mission to simplify complex science & technology, making it easy to understand. In each episode of our show, we dive into world-changing tech (such as AI, robotics, 3D printing, IoT, & much more), all while keeping it entertaining & engaging along the way.