Clinicians

Paediatric Gait Exoskeleton

The ATLAS 2030 model is a THKAFO-type gait exoskeleton, which supports the child from the trunk to the feet. No thoracic control is required and a head restraint system can be added if needed. The exoskeleton consists of 8 active joints that provide full overground mobility in all directions. The dimensions of the device are easily adjustable to the growth of the child and it can be easily fitted in 5 minutes. It is accompanied by an auxiliary frame that can be attached to the exoskeleton to ensure the safety of the patient and give the child the feeling of walking on their own, as well as providing the therapist with the possibility of interacting with the patient face to face, without the need to stay behind holding them. The exoskeleton interprets the patient’s intention to move in a non-invasive way and responds to this intention at every step. It can also be worked in a passive way, generating a specific walking pattern for each patient. Removable batteries included.
It includes a therapist’s tablet, which collects the patient’s data to generate their own walking pattern and monitors the session information.

Clinical benefits

Extension and maintenance joint range of mobility.

Improving muscle strength.

Potential maintenance, through prolonged use, of scoliosis and improved respiratory function.

Reduction of muscle contractures.

Prevention or delay of musculoskeletal complications of neuromuscular diseases.

Improvement of the ability to perform activities of daily living. In addition to the improvement of self-esteem and well-being.

Clinical Evidence

To date, 4 clinical studies have been conducted with the ATLAS 2030 exoskeleton or earlier models.

Study at Hospital Sant Joan de Déu.

  • Title: Walking training with an exoskeleton in children with SMA type II
  • Collaborating hospital: Hospital Sant Joan de Déu, Barcelona
  • Funding Institution: European Commission (FP7-ICT-601116 ECHORD PLUS)
  • Objective: : Evaluation of the correct functioning of the ATLAS 2020 exoskeleton (research prototype) in the rehabilitation treatment of Type II spinal muscular atrophy. Evaluation of possible adverse effects (AEs).
  • Study design: Open, noncomparative, pilot study.
  • Sample size: N-7 (SMA II patients)
  • Outcome measures: MMT, HFMSE, Brook, SNIP, Skin tolerance, Fatigue.

Results:

  1. Safety and tolerability: The non-serious adverse events recorded were of a mild nature, and were recorded in only 6 of the 30 sessions performed, decreasing progressively. No significant changes were recorded between the physiological measurements taken before and after each test with the exoskeleton. Tolerability was established as the number of times the participant needed to rest during a test and as the degree of fatigue after walking 5 meters (score from 0 to 10, being 0 not at all tired and 10 very tired). Regarding the number of rests, in 79.3% of the sessions no rest was needed. About the degree of fatigue after walking 5 meters, the median was 2, decreasing from 6 in the first session to 0 in the last one.  
  2. Operation: NNo device behaviors were recorded that caused patients any harm in the 30 tests that made up the study.
  3. Benefit: The device allows walking in patients who do not have this ability.

Conclusion: With these results it can be considered that the ATLAS exoskeleton is safe and tolerable in patients with SMA type II.

Study at Hospital Ramón y Cajal.

  • Title: Study on the impact of a walking exoskeleton on the quality of life of patients affected by SMA II (KINDER-2)
  • Collaborating hospital: Hospital Universitario Ramón y Cajal, Madrid
  • Funding Agency: Fundación Mutua Madrileña
  • Objetive: To assess the physiological and psychological implications related to the use of ATLAS2025 (pre-developmental model). ATLAS2030) for a particular use in the home. At the same time possible Adverse Events (AE’s) are evaluated.
  • Study design: : Open, non comparative, pilot study.
  • Sample size: N-3 (SMA II patients)
  • Outcome measures: MMT, HFMSE, RULM, MIP/MEP, SNIP, HHD.

Results:

Significant improvements were seen in the HFSME and RULM scales. Automatic running in terms of tolerance and fatigue. An increase in the duration of the sessions for standing activities was observed. Resistance tests were increased as well as fatigue and psychological impact scales. Absence of EC. Data collection was completed with a qualitative observational study in which a total of 55 descriptive field notes (corresponding to each day and observation) were taken regarding the psychological effects of daily training.

Conclusion: ATLAS2025 is safe in use with SMA II patients and shows signs of functional improvement that can improve patients’ quality of life. The device’s tolerance is acceptable. Improved self-esteem and positive motivation when using the exoskeleton boosted physical activities with the exoskeleton. More research is needed to validate these findings in the long term.

Study at Marsi Care / Hospital Universitario La Paz (on-going)

  • Title: Series of cases to evaluate the rehabilitative effect of the use of a walking exoskeleton in patients with neuromuscular pathology or cerebral palsy.
  • Hospital: Hospital Universitario La Paz, Madrid / Marsi Care-CSIC
  • Objetive: To evaluate the rehabilitative effect derived from the use of the ATLAS 2030 exoskeleton in children with neuromuscular pathology or cerebral palsy, who cannot walk, as well as the evaluation of other physical, functional and psychological parameters of interest. To assess the physical and physiological tolerance of the child to the activity performed with the exoskeleton in the rehabilitation sessions. To evaluate if an improvement is achieved in parameters related to the physical rehabilitation of the patient using the exoskeleton, in the respiratory capacity and self-perceived quality of life (physical and emotional well-being and self-esteem).
  • Outcome measures: AMA, biomechanics of walking, RULM, HMSFSE, EGEN K2, vital signs, BORG, PIM/PEM, SNIP, FVC, TLC, FRC. FEV1, FEV1/FVC, Skin Integrity, Kid-KINDL

Multicentric Study Raymond Poincaré Hospital / La Paz University Hospital (on-going)

  • Title: Evaluation of the safety and use of the ATLAS 2030 exoskeleton in children with SMA and NM (ATLASMA)
  • Hospitals: Hôpital Raymond Poincaré, París. Hospital Universitario La Paz, Madrid
  • Objetive: Investigation of serious adverse events when the ATLAS 2030 exoskeleton is used in children with non-walking AM, including SMA.
  • Study design: Phase 2: Open label, prospective observational study.
  • Sample size: N-15
  • First patient visit (FPFV): 13/01/2019

Frequent questions

If you have any question regarding this product, please send us your query to info@marsibionics.com

What group of patients it ATLAS indicated for?

The ATLAS exoskeleton has been clinically demonstrated mainly in patients with Muscular Atrophy type II, although it has also been tested in patients with spinal cord injury and other myopathies.

What size and weight requirements should users have in order to use the exoskeleton?

The child’s weight must be less than 40 kg, and the height must be between 80cm and 1.4m. This height usually corresponds to children between 4 and 12 years old. Please check limb length limits in the product brochure.

What are your general contraindications?

Joint limitations of more than 20º in the hip or knee, cognitive alteration that prevents following simple commands or communicating basic needs, skin alteration in the lower limbs or thorax, recent bone fractures, osteoporosis, cardiac, infectious or other diseases that make it impossible to do low-intensity physical exercise.

The market launch of the ATLAS 2030 exoskeleton is estimated for the second half of 2020. It will be sold exclusively to hospitals and physiotherapy centres, not to individuals. It is possible at this time to make a reservation, which includes a free demonstration at our Marsi Care center. If you are interested in booking the Atlas Pediatric Exo please fill out the form below.

  • Envio de solicitud

    A través del formulario online de Marsi Care.

  • Prueba del producto

    Si se desea, se puede recibir una prueba gratuita.

  • Oferta económica

    Oferta económica y aceptación (firma) de la oferta .

  • Pago de la reserva

    Pago de la reserva y recepción de la factura y garantía de compra.

  • Recepción del producto

    Recibirá notificación de entrega del producto cuando se produzca el lanzamiento al mercado.

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