This year's patient lecture

Imagine not being able to move your legs anymore – for the rest of your life. This is the result of a spinal cord injury. Now, imagine a future where you can walk again, using an exoskeleton that can take over the function of your lower body, thereby improving your physical health issues and giving you the opportunity to stand eye to eye with your friends and family again. How would that feel?

You most likely don’t actively think about performing everyday activities, such as walking, climbing stairs or grabbing something from a high cupboard. However, those activities are hard(er) to perform while in a wheelchair. These tasks require more time, effort and preparation. Although rehabilitation learns you how to be mobile in a wheelchair again, the freedom of movement stays limiting.

Besides the evident impact on mobility, having a spinal cord injury leads to some secondary physical health effects as well. Muscle strength and bone structure declines, impaired cardiovascular issues result in affected blood flow and the control over bladder and bowel function is lost. These conditions lead to increased risks on for example osteoporosis, fractures and thrombosis. Besides the physical consequences, obvious mental challenges arise as well, such as feeling like people are always looking down on you.

Daan van der Heyden is 32 years old and has a complete T5 lesion, which means that he is paralyzed from below his chest. In 2017, he suffered a spinal cord injury as a result of a sports accident and has been wheelchair bound ever since. Daan’s expertise lies in orthopedic shoemaking. This gives him a better understanding of walking patterns. Daan also plays wheelchair basketball with team Ossnabrück, in Germany.

Daan rehabilitated at the Sint Maartenskliniek in Nijmegen, a hospital specialized in the field of motion disorders. Ilse van Nes and Hennie Rijken are both working at the spinal cord injury department of the Sint Maartenskliniek, Ilse as a rehabilitation physician and Hennie as a physical therapist. In 2020 Ilse participated in the Dutch tv-program ‘Topdokters’ and she is also editor of the Dutch textbook ‘Dwarslaesierevalidatie’. Hennie has contributed to the development of gait training and the use of innovative gait training equipment at the Sint Maartenskliniek, from his position as a physical therapist and research associate. In this lecture they will share their experience with the use of exoskeletons for paraplegic patients, including the training program, patient characteristics and home use.

Project MARCH, a Dream Team from the TU Delft, builds an innovative exoskeleton for people with paraplegia. The team works together with Daan and the Sint Maartenskliniek to make this possible. An exoskeleton is a powered robotic suit attached to the outside of the body that takes over the functionalities of the lower part of the body. An exoskeleton enables someone with paraplegia to stand up and walk again, taking away a piece of dependency. Besides, regular standing and walking in an exoskeleton helps reducing the secondary health issues and, most importantly, gives people with paraplegia the ability back to stand eye to eye with their loved ones again.

Daan is extremely motivated to explore the limits of exoskeleton technology. He will showcase the innovations of Project MARCH to the world during the CYBATHLON 2024 in October, a worldwide competition for assistive technology mimicking the daily life activities we have to face everyday.