risk of secondary brain damage due to circulatory instability
no leg movement and thus reduced musculoskeletal and cardiovascular improvement
limited training duration due to lack of patient’s cardiovascular stability
no support for the patient’s cardiovascular system during verticalization
therapists are exposed to physical strain
limited training duration due to insufficient resources
Advantages of Erigo Therapy
Early and Safe Mobilization even in Early Rehabilitation Programs
Mobilization and verticalization of immobile patients with little or no capacity for interaction can be very demanding and challenging—especially in acute care—and can compromise the well-being of patients and therapists.
The Erigo combines gradual verticalization with robotic movement therapy to ensure the necessary safety for the stabilization of patients in an upright position. Due to the unique afferent stimulation provided by the Erigo and the flexible harness, patients can be trained intensively and safely already in a very early stage of rehabilitation.
The robotic leg movement and the cyclic leg loading offered by the Erigo are critical afferent stimuli for the central nervous system.
This leads to muscle activation, improved muscle pump function and venous return ultimately resulting in improved cardiovascular stability. Therefore, patients verticalized with the Erigo generally do not suffer a drop in blood pressure and thus have a reduced tendency to collapse. They tolerate the upright position better than patients treated on conventional tilt tables without a stepping function and cyclic leg loading.
Improved Orthostatic Tolerance Using the
Erigo FES (Function Electrical Stimulation)
The Erigo FES further increases the afferent stimulation of patients and thereby their cardiovascular stability during early verticalization.
The electrical activation of key leg muscles efficiently supports the increase of blood flow in the patients’ lower extremities. This leads to improved venous return which helps to maintain stroke volume and blood pressure, therefore improving orthostatic tolerance. Furthermore, therapy with the Erigo FES improves cerebral blood flow and muscle strength in lower extremities leading to recovery of motor function.
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.
Change in mean arterial blood pressure under orthostatic stress [mmHg]
Decrease in stroke volume under orthostatic stress [mL]
Yoshida et al. 2013
Excellent Clinical Usability
The Erigo is highly mobile with wheels for easy transport between rooms. It can be adjusted to align with the patient bed for supine transfer or even transfer with a patient lift.
The Erigo offers 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 standard rails that the Erigo features. Further benefits include an intuitive user interface on a touchscreen, electronic adjustment of leg length as well as the flexible one-size-fits-all patient harness system.
The Erigo enables a single therapist to provide mobilization, verticalization, and sensorimotor stimulation at the same time, safely and efficiently.
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.
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.”
Early Rehabilitation After Surgery
After a severe fall, Ms. Scaffidi had a traumatic cervical spinal stenosis at C4 and C5 leading to tetraparesis. Just a few days after spinal surgery, she began her rehabilitation with the Erigo at the Centre Hospitalier Universitaire Vaudois (CHUV) in Lausanne, Switzerland. At the CHUV, Ms. Scaffidi was able to benefit from the unique neurosensory therapy and is successfully continuing her rehabilitation with the goal of regaining her gait function.
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.
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 and, due to the improved trunk and head control, participate actively.
Benefits of the Erigo are Recognized All Over the World
The only therapy solution that uniquely combines gradual verticalization, leg mobilization, and intensive sensorimotor stimulation through cyclic leg loading.
Early and Safe Mobilization Even in Acute Care
“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 is safe and may be more effective in improving leg strength and cerebral blood flow than tilt table alone.” (Kuznetsov et al. 2013)
“Patients in vegetative or minimally conscious state tolerate greater degrees of head-up tilt better with simultaneous leg movement.” (Luther et al. 2008)
“Blood pressures and heart rate can be stabilized better with treatment with passive leg movements.” (Taveggia et al. 2015)
Improved Orthostatic Tolerance Using the Erigo FES
“Cyclic FES to the leg muscles can effectively induce venous return, thereby helping to maintain the blood pressure of individuals with spinal cord injury under orthostatic stress.” (Yoshida et al. 2013)
What Experts Say
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 sensorimotor 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
“Erigo training makes it possible to mobilize patients with acute ischemic stroke into an upright position much earlier than with conventional tilt table training. This results in an earlier start in therapy.”