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Japan rehab facilities add exoskeleton robots

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(Bloomberg) — Eyeing a new market of aging populations and concern over rising health costs, companies in U.S., Europe and Japan are developing bionic suits that may some day save labor and help the elderly care for themselves.

Japan’s Cyberdyne Inc. plans to go public this month amid competition from companies including Japanese carmakers in the early stages of developing products, and others such as U.S.- based Ekso Bionics Holdings Inc.

“The demand for rehabilitation robots is very high as societies around the world are aging,” said Mitsushige Akino, chief fund manager at Ichiyoshi Investment Management Co. in Tokyo, who says he is considering buying Cyberdyne shares.

A 54-year-old paraplegic, strapped into a white exoskeleton made by Cyberdyne, recently walked slowly forward — covering about a foot — during rehab at Fukuoka University Hospital before collapsing on his physiotherapist. The suit he used has been approved for use as a medical device in Europe, and Cyberdyne said it may seek clearance this month to sell the product in the United States.

Widespread use of the Cyberdyne device is some distance away. It is presently used in 170 hospitals and nursing homes across Japan, and it costs about 1.8 million yen ($17,700) annually to lease each suit. While founder Yoshiyuki Sankai’s ambition is to make the robots cheap enough for home use, he doesn’t have a specific time frame. For now, a Cyberdyne rehab center south of Tokyo makes them available to individuals at 10,000 yen ($98) per 60-minute training session.

People above the age of 65 will make up 40 percent of Japan’s population by 2060, compared with the present 24 percent, encouraging companies to invest in products for the elderly.

Spun off as a start up from the University of Tsukuba in 2004, Cyberdyne begins trading on March 26 in a Tokyo offering expected to raise at least 4.1 billion yen. It plans to invest in expanding the reach of its exoskeleton suit called HAL, or Hybrid Assistive Limb, globally.

Competitors are springing up across Japan. Yaskawa Electric Corp., a Japanese maker of industrial robots, last year entered into an agreement with Israel’s Argo Medical Technologies Ltd. and plans to start selling Argo’s Rewalk exoskeletons in Japan in 2015 after tests. The Rewalk bionic suit — a type of external frame that supports the legs — helps patients move by sensing shifts in their balance.

Toyota is developing and running tests on types of robots that could help paralyzed patients walk and support independent life at home, spokesman Naoki Sumino said without providing the timing for commercialization.

Rival Honda is developing a device to help post-surgical stroke and orthopedic patients lengthen their strides while walking. The company has leased 100 devices to 50 hospitals across Japan for experimental studies, spokesman Tsuyoshi Hojo said.

“The current insurance system will collapse if cost to care for elderly people continues to rise,” said Hirohisa Hirukawa, director of the Intelligent System Research unit at the National Institute of Advanced Industrial Science and Technology. “Japan needs to change rules, find equipment to save labor and to care for elderly people more efficiently.”

The United States

Other companies globally are also making a push. Cleveland- based Parker Hannifin Corp. in a March 4 press release said it had entered into clinical trial agreements with several U.S. rehab institutions to support testing and development of an exoskeleton called Indego.

California-based Ekso Bionics has about 60 devices in use at 50 centers and the product is available in North America, South Africa, Europe and South America, marketing manager Heidi Darling said. Its suits start at around $110,000 and the company is planning to expand into the Asian market in the next 18 months.

Ekso has approval from the FDA as a medical device as long as a certified physical therapist is present, according to Darling. Cyberdyne, which currently isn’t subsidized by government health insurance in Japan, plans to seek approval for its product as a medical device in its home market.

The Japanese firm hasn’t decided on a price for the U.S., where it would take on competitors such as Ekso as well as cheaper devices. Prices of electric wheel chairs, for instance, start from $1,099 on

Companies still need to improve robots to enhance functionalities such as battery life and also run more studies to show their efficacy, said Albert Lo, epidemiologist and professor of Neurology at Brown University.

“Some of the companies are more advanced than the others, but I don’t think there hasn’t been a paradigm shift yet,” said Lo. “The evidence is pretty pitiful.”

Some Japanese scientists hope to build a body of research with tests on robots. At Fukuoka University Hospital, neurosurgeon Toru Inoue — who isn’t taking funding from Cyberdyne — is collecting data on how the exoskeletons work on his patients. His hospital pays Cyberdyne the 1.8 million-yen annual leasing fee for each robot.

“Evidence suggests early rehabilitation intervention plays a significant role,” said Inoue. “When you use HAL, patients can stand upright soon after surgery, see the progress of recovery on a screen.”

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