Sydney resident Mariam had always admired her mother’s strength and energy, until Manooshak, 77, suffered a severe stroke in July 2020.
The stroke affected Manooshak’s ability to eat, drink, swallow and walk properly. It was a devastating blow to her family.
“When it happened, I got a call from my sister at 11pm. She lives in Melbourne and was distraught she couldn’t come because of COVID,” Mariam said.
“Thank God my brother was there with Mum and Dad when she had the stroke.
“Everything of Mum’s had been affected – it was explained to me that the brain is like a tree with all its branches, and Mum’s stroke basically hit the trunk of the tree – everything was fried or gone.”
After some initial signs of recovery, Manooshak then undertook six months of rehabilitation at Sydney’s Royal Rehab.
“You know, people don’t tell you what you have a right to, so there was a lot of advocating we had to do, and this was all new to us – we basically had a crash course in this stuff and I was just trying to stay strong,” Mariam said.
“It was exhausting and I know Mum was sick of hearing the words ‘lift your knee’ from me a hundred times. And just when I thought, ‘How are we going to get past this?’, this machine comes along.”
Made in the United States by Ekso Bionics, the EksoNR is advanced exoskeleton technology that helps patients stand and walk following incomplete spinal-cord injuries, acquired brain injury, stroke and other neurological conditions, including Parkinson’s and multiple sclerosis.
Mariam described the robotic device as a breakthrough.
“Our physio Stephanie showed us a picture of this suit and I thought, ‘What the hell is that?’
“I had mixed feelings – I was relieved but at the same time a bit angry because we hadn’t found it sooner. But you know, it was exactly what we needed,” she said.
“Mum had developed a walk that was off-balance and this machine helps perfect her walk – it forces her body into a position that is going to retrain those muscles.”
For Royal Rehab's senior physiotherapist Jason Redhead, the EksoNR is a “pretty cool” piece of new-generation technology.
“As a physio, this is so amazing, it’s really active and engaging with the client and we can program the suit to set goals for the clients,” he said.
“The device is powered by four motors, at each knee and each hip, and it uses the motors to move the client.
“It’s an active therapy, and we can program how much support we give to each client. It can be a full assist, or 50 percent, or no assist, the full spectrum."
Unlike previous exoskeleton technology, the machine can be controlled by a a tablet computer and it provides live data feedback.
“Often there are movements that are so minor, we as physios can’t feel them but the machine can see that and give us feedback," Mr Redhead said.
"It can give us something for the client to work on, and as a clinician it’s amazing to have that.”
He said the EksoNR had made his team “better clinicians”.
“For a client, small gains can make a big difference. This is individual medicine at its best, and whatever the injury is we can do an entirely individual program,” Mr Redhead added.
Mariam said the sessions with the EksoNR were helping her mother regain her life.
“My Mum has always been so strong. She’s always cooked and cleaned, and she takes meals to people if they’re struggling – you come to her house, and even if you’re not hungry, she gets out so much food you just start eating.
“As soon as you put your cup of tea down, she’s pouring you another one.
“I’ve always said she’s a machine and when I saw this exoskeleton thing, I laughed a bit and thought, 'Well, now she really is one!' ”
Mariam said her Mum had been more than keen to get into the exoskeleton.
“Mum was really excited about it. Our physio Steph was really good, she’s such a happy person and so knowledgeable, so she really explained it to Mum and it motivated her,” she said.
“Mum was telling all her friends, 'I’m going to be a robot'. She wasn’t scared at all.”
Mr Redhead said the team at Royal Rehab had plenty of inquiries from interstate about the EksoNR and he hoped more clinicians would be trained to use it in the future.
“The feedback from clients is great, the freedom they feel when they can stand or move, for them to have that is amazing,” he said.
Mariam said the past eight months were a long and challenging journey, but she urged anyone in similar circumstances to keep going.
“A lot of people would give up, or just accept that this is your life now,” she said.
“But this exoskeleton has been amazing for Mum. The staff at Royal Rehab were fantastic, I dealt with a lot of people in eight months, and everyone there was fantastic.
“My advice to anyone would be to try this, don’t be scared, it’s incredible. There is support and help out there, so ask for it and take it all.”
The EksoNR is available through Royal Rehab’s services including Royal Rehab Private Hospital, Community Rehabilitation Services, and specialist brain and spinal injury units, and is coming soon to MetroRehab Hospital.