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Erigo^®

Empowering Patients from
the Very Beginning

Patient mobilization in the very early stages of rehabilitation

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Empowering Patients From
the Very Beginning

Patient mobilization in the very early stages of rehabilitation

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Negative Consequences of Immobilization

Prolonged immobilization and reduced mobility have large consequences on the physical health status of the patient and can lead to various musculoskeletal and cardiovascular complications.

Research has shown that immobilization in the early phase of acute medical treatment and after has a negative effect on the recovery process as well as long-term mortality rate.

Limitations of Conventional
Early Mobilization

erigo-problems-with-conventional-early-mobilization

Conventional Tilt Table Training

No leg movement leads to limited musculoskeletal and cardiovascular response which can delay walking abilities in the acute period.
Pooling of blood in the lower extremities which can lead to a drop of the central blood.
Disruptions of therapy due to presyncopal symptoms.

Conventional Out-of-Bed Therapy

Therapists are exposed to physical strain.
Standing up and early gait initiation are labor intensive.
Limited number of repetitions in an upright position

Advantages of Erigo Therapy

Early and Safe Mobilization Even in Acute Care

Safely verticalize and mobilize patients with very reduced or no ambulation ability and/or reduced transfer and standing abilities in acute care settings.

The Erigo gradually brings the patient into an upright position while moving the legs and applying cyclic leg loading. This enables safe verticalization and early functional mobilization of the lower extremity; optionally supported by functional electrical stimulation. Patients can be trained intensively and safely in a very early stage of rehabilitation.⁽¹⁾

(1) Hocoma data on file as of Nov. 2022

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Less disruptions of therapy

Therapy with the Erigo leads to significantly less disruptions of therapy than verticalization with a classic tilt table.⁽¹⁾

Verticalization, passive leg movements and functional electrical stimulation may help in cardiovascular stabilization by reducting the risk of syncope.

(1) Hocoma data on file as of Nov. 2022

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FES supported muscle activation

Increases muscle activation by additional Functional Electrical Stimulation (FES).

Physiologically, leg muscle contractions (muscle pump) propel blood back to the heart, reducing venous stasis in the legs and stabilizing blood pressure. In patients who are immobile, FES-induced contractions of leg muscles could be used to activate the muscle pump and to improve blood flow and venous return. The Erigo FES is fully synchronized with the robotic leg movements. Up to eight FES channels can be operated easily by the therapist on the touchscreen of the Erigo and adjusted according to the patient’s motor abilities.

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Change in mean arterial blood pressure under orthostatic stress [mmHg]

ErigoPro

ErigoBasic

Tilt table

-3

-2

-1

Decrease in stroke volume under orthostatic stress [mL]

ErigoPro

ErigoBasic

Tilt table

-25

-20

-15

-10

-5

Yoshida et al. 2013

Increased Patient Awareness

Verticalization and mobilization with the Erigo leads to a clinically relevant improvement in the state of consciousness in patients with related disorders. ⁽¹⁾

With an increased awareness, patients can actively participate in therapy with the Erigo as well as in those that can be combined with it, such as speech therapy or mobilization of upper extremities. Fast recovery of communication and cooperation skills are a prerequisite to enable and accelerate further rehabilitation.

(1) Hocoma data on file as of Nov. 2022

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Increased Muscle-Strength & Improved Functional Independence in Activities of Daily Living

Patients who are immobile in bed or in need of a wheelchair for mobility can increase their lower extremity muscle strength and achieve greater functional independence in activity of daily living with Erigo therapy.

Excellent Clinical Usability

The Erigo can be used stationary or rolled directly into the patient room. It can be adjusted to align with the patient bed for supine transfer or even transfer with a patient lift.

The Erigo offers a safe training with direct patient contact and the possibility of constant interaction with patients. Hospital equipment such as patient monitoring systems can be safely attached to the included standard rails. Further benefits include therapy control via an intuitive user interface on a touchscreen, electronic adjustment of leg length, as well as the flexible onesized patient harness system.

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Increased Therapy Efficiency

The Erigo enables a single therapist to provide mobilization, verticalization, and sensorimotor stimulation safely and efficiently at the same time.

In specific cases, e.g., with acute patients, more than one therapist per patient may be necessary. In such settings, the efficiency may be increased further by installing more than one device in the same room.

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Success Stories

The Fact That I was Being Stimulated Very Early Helped a Lot

Timothee was a healthy 17-year-old when all of a sudden he was diagnosed with Guillain-Barré, an inflammatory illness leading to malfunctions of the nerves throughout the body. After his admission to the Centre Hospitalier Universitaire Vaudois (CHUV) in Lausanne, Switzerland in June 2013, he spent one month in an artificial coma. Already in the intensive care unit he started his therapy with the Erigo three times per week. “The goal was to activate the brain and the body”, explains Timothee. “At the beginning I didn’t feel my body at all. That changed through the mobilization with the Erigo”. His good physical condition before his illness in combination with the therapy with the Erigo, helped him recover extremely quickly. “First it was the Erigo that moved his legs, and in the end it was Timothee who gave the impulse. That motivated him very strongly”, explains Timothee’s mother Valerie. By end of July 2013 Timothee reached his goals of being able to breathe and eat on his own and to move his legs again. He was able to leave the CHUV and is looking forward to continuing his rehabilitation, including therapy with the Lokomat. “Before my illness I was always healthy and never had to go to the hospital. I’m amazed and happy to see how many great devices there are to help people like me recover again.”

Timothee Rajanoarivo

Patient

Returning to Daily Life

After an ischemic stroke damaged a part of the right side of his brain, Mr. Petithuguenin had a light paresis and a left-sided ataxia. During the 20 days he spent at the Centre Hospitalier Universitaire Vaudois (CHUV) in Lausanne, Switzerland he trained with the Erigo and received physical and occupational therapy that helped him improve his coordination and movement control. After regaining some of his independence, Mr. Petithuguenin was able to return home with his wife and to actively participate in daily life again.

Daniel Petithuguenin

Patient

First Steps Towards Independence

After a hemorrhagic stroke in September 2012, Peter Häberli was hemiplegic and spent several weeks in an artificial coma. In November 2012 he was transferred to the Rehaklinik Zihlschlacht in Switzerland where he trained with the Erigo several times per week. At the beginning he was only able to move from lying into sitting position with the help of two therapists. A transfer into a wheelchair was not possible. He had no head control and was only able to communicate through light nodding. While being monitored, Mr. Häberli was safely mobilized with the Erigo, which made it possible for him to get a feel for standing upright and walking. His progress could be seen soon after: he was able to sit for a longer time, communicate more easily and, due to the improved trunk and head control, participate actively. Just after a month of therapy with the Erigo, he was able to begin therapy with the Lokomat, thereby regaining his gait function and taking his first steps towards independence.

Peter Häberli

Patient

Benefits of the Erigo® are Recognized All Over the World

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The therapy solution that uniquely combines gradual verticalization, leg mobilization, and intensive sensorimotor stimulation through cyclic leg loading.

Product Line

ErigoBasic

ErigoPro

Scientific Evidence

Erigo therapy leads to significantly less therapy disruptions than verticalization with a classic tilt table. The ErigoPro also leads to clinically relevant improvements in the following outcomes in patients with very reduced or no ambulation ability and/or reduced transfer and standing abilities:

Early and Safe Mobilization

“The mobilization by means of Erigo is a well-tolerated method of mobilization and can be considered a safe system of early mobilization of patients with severe brain injuries.”
(Rocca et al. 2016)

“Robotic tilt-table exercise with or without FES [Erigo] is safe and feasible in the post-acute period after stroke.”
(Kuznetsov et al. 2013)

Less Disruptions of Therapy

“No episodes of marked hypotension were observed during verticalization on Erigo with or without FES. In contrast, more than half of the patients in the tilt-table group showed decreases in blood pressure of 20% or more.”

(Kuznetsov et al. 2013)

“Passive leg movements during head-up tilt [with Erigo] can lessen the number of treatment discontinuations due to presyncopal symptoms.”

(Luther et al. 2008)

Improvement in Lower Extremity Muscle Strength

“In ROBO-FES [ErigoPro] leg strength increased more than in control [classic tilt table].“

(Kuznetsov et al. 2013)

Improvement in State of Consciousness

More improvements with Erigo training than with in-bed mobilization on four different scales.

(Frazzitta et al. 2016)

Improvement in Functional Independence in Activities of Daily Living

Verticalization and mobilization with the Erigo leads to a clinically relevant improvement in functional independence in activities of daily living in patients with very reduced or no ambulation ability and/or reduced transfer and standing abilities.

(Hocoma data on file, as of Nov. 2022)

Further Clinical Evidence and Reports

All our solutions have been thoroughly tested and researched. Numerous studies have proven them to be effective. On our Knowledge Platform we provide an overview of all studies.

To find out more, visit knowledge.hocoma.com >

What Experts Say

We Note a Direct Link

"We note a direct link between the intensity of the sensorimotor stimulation with the Erigo during therapy and the recovery process of our neurological patients."

Dr. med. Karin Diserens

Head of Acute Neurorehabilitation Unit, Centre Hospitalier Universitaire Vaudois (CHUV), Switzerland

Unique Training Possibility in Early Rehabilitation

“The Erigo offers the unique possibility to train patients in a very early phase of their rehabilitation process. The Erigo FES efficiently supports this early treatment. I am convinced that the Erigo has a clear beneficial effect in the early phases of rehabilitative care.”

Prof. Dr. Leopold Saltuari

Medical Director Department of Neurology, State Hospital Hochzirl, Austria

Clinical Success with the Erigo

At the Centre Hospitalier Universitaire Vaudois, Switzerland (CHUV), the department of clinical neurosciences treats different health problems, traumas and diseases associated with the brain, spinal cord and nerves. Its unit of acute neurorehabilitation is formed by an interprofessional team of experts who treat these patients within a specific neurosensory rehabilitation program. All patients with neurological lesions are supported according to an assessment of their potential for rehabilitation and their therapy goals following acute care. The Erigo is used during the whole treatment process, starting in acute care, to improve the patient’s awareness as well as motor function by intensive early mobilization. The CHUV is one of the international clinical partners, that provide Hocoma with important clinical expertise and scientific insights in order to help improve the Erigo.

Dr. med. Karin Diserens

Head of Acute Neurorehabilitation Unit, Centre Hospitalier Universitaire Vaudois (CHUV), Switzerland

Improve Efficiency & Outcomes

Facilitates Entry Into Next Phase of Rehabilitation

Improves Efficiency in Mobilization

Excellent Clinical Usability

Improve Efficiency & Patient Outcomes with the Erigo

The Continuum of Gait Rehabilitation

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Empowering Patients from
the Very Beginning

Empowering Patients From
the Very Beginning

Negative Consequences of Immobilization

Limitations of Conventional
Early Mobilization

Conventional Tilt Table Training

Conventional Out-of-Bed Therapy

Advantages of Erigo Therapy

Early and Safe Mobilization Even in Acute Care

Less disruptions of therapy

FES supported muscle activation

Increased Patient Awareness

Increased Muscle-Strength & Improved Functional Independence in Activities of Daily Living

Excellent Clinical Usability

Increased Therapy Efficiency

Success Stories