OBSTACLES FOR EXOSUITS IN HEALTHCARE

•  Health Insurers do not pay for them due to the high cost.
• The cost of an exosuit is up to $99,000.
•  Exosuits must be tailor-made for each user.
• Short range and short battery life of an exosuit is only a few hours.
•  Exosuits are uncomfortable to wear due to hard materials and cumbersome design.
•  Exosuits must be strictly regulated.

RESEARCH FOR EXOSUITS IN HEALTHCARE

• In 2018 the Wyss Institute was researching exosuits made out of soft materials.
• In 2018 the Wyss Institute is researching to link exosuits with devices such as smartphones and incorporating software that monitors health into their designs.
• Several companies are researching to incorporate exosuits into clothing to reduce standing out.
• Cyberdyne's exosuit HAL can accommodate different sizes of people and is linked with the thoughts of the user.
•  Bristol University was researching in 2018 different methods of creating artificial muscles in exosuits such as air muscles and constricting gel muscles.

EXOSUITS AVAILABLE ON THE MARKET AS OF 2019

• The ReWalk Personal 6.0 was released by ReWalk Robotics in 2015.
• The Ekso GT by Ekso Bionics is used by 19,500 patients in 2019.
• The Indego by Parker was approved by the FDA in 2016.

EXOSUIT PROTOTYPES AS OF 2019

• The Hybrid Assistive Limb or HAL is from the Japanese company Cyberdyne.
•  HAL is only available in one Floridian hospital but is expected to expand to 5 more hospitals in the US during 2019.
• The Walking Assist Device by Honda was approved by the FDA this year.

ReWalk Robotics Ltd.

• Founded in 2001, ReWalk has offices in the U.S., Israel and Germany.
• ReWalk is a platform exoskeleton that combines a patented tilt-sensor technology with an on-board computer and motion sensors to drive motorized legs that power movement. Their product ReWalk 6.0 is designed to improve the functionality of spinal cord injury patients.
• The FDA has approved ReWalk's use in the United States as a Class II prescription device with special controls under 21CFR Part 801.109 regulations. The exoskeleton is powered by a battery and features motors at the hip and knee joints, which are controlled by subtle changes in the wearer’s center of gravity.
• In June 2019, ReWalk received FDA approval to one of its new medical devices, ReStore. The device will cost $28,900, with leasing options available.
• ReStore is designed to help patients relearn how to walk through physical therapy. Its target market are patients who suffered strokes.
• ReWalk stock was up 132% after the announcement.
• The company's total revenue for the first quarter of 2019 was $1.6 million, with its gross margin improving to 59% in 2018, compared to 43% in the previous year.
• They have several training center using ReWalk on spinal cord injury patients across the world.
• ReWalk battery lasts for about eight hours in an office setting (where the user sits, stands or walk in intervals) or for four hours of continuous walking. (Source 3)
• In order to qualify to use the ReWalker, each individual must go through medical screenings. One of the main requirements is to have enough upper body functionality and control to use arms and shoulders to maneuver the crutches.
• Estimated price: $70,000 — $80,000 

Ekso Bionics

• Founded in 2005, this US company is now providing research for the advancement of R&D projects intended to benefit the U.S. defense capabilities.
• Their commercial efforts are in two areas represented by EksoHealth and EksoWorks. The first being an FDA-cleared exoskeleton for stroke and spinal cord injury rehabilitation and the later is a fatigue reduction exoskeleton for overhead manufacturing, assembly and construction.
• In 2018, Ekso announced a partnership with Ford to further develop the EksoWorks, with plans to increase the supported arm weight to 15 pounds. 
• In January, Ekso entered into an agreement with Zhejiang Youchuang Venture Capital Investment to establish a joint venture design to develop the exoskeleton market in China and other Asian markets.
• EksoHealth is present in more than 260 rehabilitation centers across 30 countries and has helped over 19,500 patients.
• Their exoskeleton, EksoGT, is only available in certified rehabilitation centers and cannot be purchased for personal use.
• EksoGT is the first exoskeleton cleared by the FDA for use with stroke and L5 to C7 spinal cord injuries.
• In May 2019, Ekso announced that the National University Health System in Singapore started a groundbreaking clinical study using the EksoGT to study patient outcomes and access the viability and potential for scaling-up the use of exoskeletons.
• Estimated price: $100,000 

SuitX

• SuitX was founded in 2012, in California. SuitX has received Series A investments, been awarded two National Science Foundation awards, and won a Saint Gobain Nova Innovation Award.
• The lightest of its kind (12.25 kg), the Phoenix exoskeleton can remain active for 4 hours continuously or 8 hours intermittently.
• Phoenix is considered an investigational device and is currently not available in the U.S. but it is available in Europe.
• Phoenix is priced at $40,000.
• Their industrial Exoskeleton MAX is already on the market and has over 350 units deployed in the US.
• In 2018, one of the first trial patients of the Phoenix exoskeleton made a presentation of the device at SXSW.

Rex Bionics

• Rex Bionics is the first commercially-powered exoskeleton that can allows individuals with complete spinal cord paralysis to move.
• Rex Bionics offers two types of exoskeletons: Rex, for clinical use, and Rex P, for personal use.
• The device is used by physiotherapists on people with mobility impairments and is available in rehabilitation centers in the US, the UK, the Middle East, Australia, and New Zealand.
• Rex is one of the few devices that do not require the use of crunches.
• Rex P is not registered for personal use in the U.S.
• Price is only available upon request.
• Founded in 2014, the Australian company reported a loss of $2.77 million since March 31, 2018.
• Estimated price: $150,000

Indego

• Approved by the FDA in 2017, it is one of the lightest exoskeletons on the market (26 pounds).
• Only intended for paraplegics, levels T3 to L5, and it cannot be used on stairs.
• This exoskeleton allows the patient to perform the following functions: sitting, standing up, and sitting down. It is programmed to make swift transitions between the different movements.
• It is available for clinical and personal use in the U.S. and Europe.
• The device also has a wireless operation option, where an app allows the patient to control operation, change settings, and capture data.
• Estimated price: $80,000

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