Kollin Galland. Photographs courtesy of Jodie Galland.
Kollin Galland was 14 years old and had just finished his first week of high school when he broke his neck doing a double backflip on a trampoline. The accident left him paralyzed from the chest down. Being confined to a wheelchair was not going to stop this teenager though. “Don’t tell him he can’t do something,” says Kollin’s mother, Jodie Galland. “He’s always been a fighter and a perfectionist.”
In the nearly two years since Kollin’s accident, he has rarely been still, says Galland. “He was very athletic and very coordinated before his accident, which has really helped with his recovery,” she says of the youngest of her five sons. In addition to being an expert on the trampoline, Kollin played football and soccer and was a “big-time” skier before his accident, his mother says. Since Kollin’s injury and recovery process, he has started to play wheelchair rugby and has taken up sit-skiing.
Fortuitous Timing for Mobility-Aid Approval
Hope for increasing Kollin’s mobility came about a year after his accident in the form of a newly approved mobility aid. In 2014, the U.S. Food and Drug Administration (FDA) approved ReWalk Robotics’ (formerly Argo Medical Technologies) ReWalk™ Personal System for use at home and in the community. ReWalk is a wearable robotic exoskeleton that provides powered hip and knee motion to enable those with lower-limb disabilities, including spinal cord injuries, to stand, walk, and turn, says Larry Jasinski, CEO of ReWalk Robotics. The device was developed by Amit Goffer, PhD, an Israeli scientist who has quadriplegia following an ATV accident in 1997, and allows for controlled, independent walking and mimics the natural gait of an able-bodied person, Jasinski says.
When Kollin’s parents learned that the FDA had approved the exoskeleton, it seemed natural to them that given their son’s determination to become stronger and more independent following his injury, he would qualify. But there was a caveat. The exoskeleton was designed for those with paraplegia, not for someone who has quadriplegia, like Kollin.
Meet “Steve”
Last fall, Kollin began travelling from his home in Provo, Utah, to the University of Utah Community and Outpatient Rehab Services, also often referred to as University of Utah Sugar House Neuro Rehab, for physical therapy. The clinic is more than an hour away from his home, but it is the only facility in the state and the surrounding region that has a ReWalk Rehabilitation system for patient use and has personnel trained in its use, says Kristen Black-Bain, PT, DPT, NCS, clinical coordinator at Sugar House.
Phil Astrachan with ReWalk works with Kollin to make some adjustments to his new exoskeleton.
Black-Bain helps him learn to walk using the ReWalk exoskeleton.
Gary Galland shares a lighter moment with Kollin. Galland has devoted nearly all of his free time to help his son learn to walk again.
Black-Bain says she had her reservations about whether a ReWalk exoskeleton would work well for Kollin. “There are specific screening criteria that users have to meet in order to qualify to even trial the device,” says Black-Bain, who became Kollin’s physical therapist specifically to train him to use the exoskeleton.
“I was a bit skeptical at first on how he would do using the robot.” Black-Bain says her hesitancy was due to Kollin’s diagnosis of a cervical spinal injury, which didn’t meet the criteria—on paper. That was before she saw the teenager in an actual therapy setting.
“She was blown away by Kollin,” Galland says.
The system weighs about 46 pounds, is powered by a battery housed in a backpack, and carries its own weight; the user only feels the weight of the five-pound backpack. Black-Bain says she was pleasantly surprised by Kollin’s ability from the beginning. “He demonstrated good upper-body strength and could support himself by his upper extremities, so I agreed to let him get in the device and see how he did. I actually didn’t think it would work and that he wouldn’t qualify. But the first day we got him in it, he did great and qualified to continue training, with the goal of achieving the skills required to be able to take his own device home.”
For patients who qualify to purchase their own exoskeletons, the company allows them to submit deposits, and their exoskeletons are delivered to certified ReWalk training facilities so the patients are able to train using their own devices, Jasinski says.
The FDA requires the user to have a companion present whenever he or she is using the exoskeleton, Black- Bain says. In order for Kollin to be able to take “Steve,” his exoskeleton, home, he and his parents had to pass two sets of criteria. (His mother says Kollin named his ReWalk “Steve” because her son and one of his physical therapists, Mike, greet each other by saying “Hi, Steve,” which she says comes from the movie Duplicity.)
Basic tasks in which Kollin and his parents had to demonstrate competence included being able to don and doff the device; use the computeroperated watch to walk, sit, and turn; and to walk in the device at a specific speed. In addition to these basic skills, he and his parents had to pass a test in more advanced skills that included walking across the street within a specific amount of time, walking through timed doors, walking across different thresholds, and conversing while walking, Black-Bain says.
“Kollin did great and figured out things pretty quickly. Being active has really helped him to be more in tune with his body, which was partly why he was so successful using the ReWalk,” she says. “His therapy really focused on getting as much return and function after his injury, with really no limits on how far he can be pushed.”
Kollin and his parents were able to take Steve home in February. The cost of the exoskeleton was divided between his father’s eight siblings.
Benefits Beyond Mobility
Jasinski says the exoskeleton will work well for someone like Kollin because he is so young. “Kollin has a lot of years ahead of him,” he says. “This will be of great value to him, long term.”
Black-Bain says Kollin has done well with his exoskeleton because not only is he young and active, but he is determined. “He is absolutely a determined kid,” she says. “If you tell him he can’t do it or he’s not doing well, he will figure out how to prove you wrong, then smile about it after.”
Kollin is the youngest person in the United States to have purchased the exoskeleton. Though the device is available to those who qualify, the majority of those who have purchased one have been between the ages of 20 and 30 years old, Jasinski says. He attributes the demographic profile to the risk-tolerance that seems to be more typical of younger users. The exoskeleton offers users benefits beyond mobility, however, according to Jasinski. “The technology is able to give someone back the ability to stand and walk, to look someone in the eye, [to] be able to give someone a hug,” he says. “These are things many of our ReWalkers did not think they would do again.”
Galland says the same has been true for her son. “It’s been wonderful to be able to give him a hug standing up,” she says.
There are other physiological and psychological benefits as well, such as improvements to cardiovascular health, fat loss, increased lean muscle mass, and better bowel function, Jasinski says. “ReWalk is a user-operated system,” he says. “If the user doesn’t initiate movement, the sensors are not triggered. The system moves with the user, it does not walk our users for them. The effects are seen with the many health benefits our users experience.”
In Kollin’s case, Steve has helped him to maintain some of the muscle tone in his upper body and lower limbs, his mother says. Kollin’s weight dropped to 100 pounds after his accident. Today, he weighs 140 pounds. “All of it muscle,” Galland says.
A Reservoir of Support
The night Kollin had his accident changed the course of his life, but Kollin has been able to come as far as he has because he and his family have had a tremendous amount of support, his mother and Black-Bain agree. “A support system is huge in any rehabilitation process,” Black-Bain says. “There are ups and downs, physically as well as mentally, and having people there to help you through that is extremely beneficial and critical in any recovery process. Kollin’s family has been there for him since day one.”
Betta Ferrendelli is a freelance writer based in Denver.
