Isaac Schreurs races sprint cars and likes to downhill ski. "Not even scared" is his personal motto.
This week, the 24-year-old walked down a long hospital corridor in Minneapolis as his mom and girlfriend cheered him on. A TV crew captured the event. Afterward, Schreurs described the experience as exhausting and overwhelming.
It was the first time the Sioux Falls, S.D., race car driver has taken a walk since a motocross accident 10 years ago left him paralyzed from the chest down. On Thursday, he came to the Twin Cities to test-drive a new medical exoskeleton that helps paralyzed patients walk on their own.
"It's definitely a workout, for sure," he said, sweat shining on his forehead early in the training. "I'm a little tired. I haven't stood up this long in a while."
Schreurs went to the Courage Kenny Rehabilitation Institute at Abbott Northwestern Hospital in south Minneapolis, one of two centers in the state certified to screen potential patients for the ReWalk Personal Exoskeleton. Regions Hospital in St. Paul has been screening ReWalk patients since May, and Courage Kenny started this week.
The ReWalk machine is the only personal exoskeleton approved by the U.S. Food and Drug Administration (FDA) to help patients walk in community settings. The battery-powered device is made by ReWalk Robotics of Marlborough, Mass., and was approved by the FDA about a year ago.
The 50-pound machine consists of two mechanically driven legs that join at the hip, with a seat that folds up when the user stands. A wrist-worn controller switches between walking and sitting modes, but the machine strides and turns by sensing how users shift their weight.
To be eligible to use a ReWalk machine, the FDA says patients should be able to stand using an assistive device like a standing frame and be strong enough to manage the crutches that are required for support while walking. New users typically need 30 to 40 sessions with a physical therapist in the hospital before taking one home.
"It's a pretty intensive course to learn how to control it," said Dr. James Spendley, medical director for spinal cord injury rehabilitation at the Courage Kenny institute in Minneapolis.
High sticker price
Another barrier is the price.
At $77,000, a new ReWalk machine costs as much as a nice BMW, and insurers are hesitant to cover it. None of the dozen patients screened so far at Regions has been able to buy one, although several have set up crowdfunding Web pages to raise the money.
A ReWalk machine is not considered a "curative" therapy because it doesn't restore the ability to move one's legs naturally, Spendley said. But it does provide health benefits.
Research is ongoing to quantify the benefits, including reductions in body fat and muscle spasms, improved bone strength and bowel function, and cutting down on pain and the need for some medications. And those are only the physical changes.
"In many ways, the psychological benefits are just as great as the physical benefits," said Regions Hospital spinal cord injury specialist Dr. Steven Jackson, via e-mail. "Imagine what it's like for our patients to stand for the first time in months or even years. The mental benefits cannot be overstated."
Device could save money
Since the sticker price is unlikely to come down any time soon, according to ReWalk national accounts director Craig Peters, the company is intensely studying how the device creates value by reducing other health care costs.
Insurance companies "care about the bottom line: Is this device going to save them money in the long term?" Peters said. "If we can prove that that is the case, then I think it will be easily justifiable. If we can't, we could have challenges."
Schreurs sees challenges ahead in trying to get his insurer to cover a ReWalk, but he remains confident he can find a way to eventually take one home.
"It took me until I was driving home before I realized what I had done," he said Friday by phone, one day after his first walk in a decade. "Moving forward one foot at a time was unreal."