Bionic exoskeletons: Why haven't they replaced wheelchairs?

Bionic assistive technology sounds futuristic, but technical innovation isn’t the real factor keeping exoskeletons from walking the streets every day

Assistive technology for those with disabilities has never been more readily available. Disability-specific devices like hearing aids and pacemakers are being upgraded often, while tablets and smartphones remove barriers to recording audio and video, uploading data, or operating third-party devices through an app. All technology is designed to enhance our lives, so people with disabilities stand to benefit the most. But one long-predicted assistive technology has yet to arrive.

In 1990, tech futurist Ray Kurzweil predicted bionic exoskeletons could help paraplegics walk by “the early 2000s”. But in 2016, those exoskeletons aren’t even as common as hover boards, which no reasonable futuristic seriously predicted, despite what the movies claimed.

Bionic tech isn’t impossible

Predicting the pace of technology’s advancement is a risky chore. Take the 1997 opinion of Dr. Piet Hut, astrophysicist at the Institute for Advanced Study in Princeton, N.J., when he told the New York Times that Artificial Intelligence wouldn’t learn the Asian board game Go until 2107: “It may be a hundred years before a computer beats humans at Go — maybe even longer.” Less than a fifth of a century later, Google’s AlphaGo beat reigning Go champion Fan Hui.

But Kurzweil’s ambitious vision of exoskeletons as commonly available as ergonomic shoes has yet to coalesce. Has he gone wrong? If so, how?

Google’s Director of Engineering since 2012, Ray Kurzweil was once termed the “rightful heir to Thomas Edison” by Forbes. His predictive powers are certainly well-established. Kurzweil wasn’t wrong about the technical accomplishment of bionic exoskeletons: They work well today, as companies like Ekso Bionics and REX Bionics demonstrate. Their “self-stabilizing robotic mobility devices” encase a user’s legs, hips, and back in a relatively sleek black frame with hip-level hand grips. Ekso’s 45-lb device can handle up to 220 pounds of patient.

But Kurzweil was wrong — at least, so far — about how common these exoskeletons would be. Even a 2012 blog post about Ekso from Kurzweil’s site focused on its still-unrealized plans to expand to personal homes. There’s one big reason why bionic exoskeletons aren’t commonplace, and it hinges on the price tag.

Why you don’t have your own mech suit

The two previously mentioned bionics companies have an incredibly similar business strategy: selling their exoskeletons to rehab clinics designed to help stroke survivors or those with similar paralysis from neurological afflictions.

As one clinical instructor, Heidi Gilbert, explains the immediate recovery process, “a physical therapist would prefer the person to work against the paralysis because this is the critical period when the brain begins the alternate mapping process. If the brain is not challenged, or if it perceives an ‘out’ it will take it.”

In other words, the exoskeletons are used to facilitate walking, termed “gait training,” during the crucial period when the brain needs to be jarred into recovering full mobility rather than letting it lapse. Patients pay a premium to the limited number of locations with bionic devices, letting the facilities recoup the expense of the device. It’s a fine business model, but one that leaves the exoskeleton in a controlled environment rather than walking the streets. Today, exoskeletons aren’t for the masses that Kurzweil envisioned in 1990.

Looking beyond an admittedly limited consumer profile of those with neurological paralysis, Ekso developed a prototype in 2015 to reach a new market: industrial workers who could use a dose of super strength to stave off power tool-generated musculoskeletal disorders. And yes, this means that the 1986 sci-fi thriller Aliens was fairly technologically accurate to feature a cargo-lifting exoskeleton in its final battle, though Ekso’s alien-queen-stabbing ability remains untested.

Ekso’s device retailed at $130,000 in 2012. Even just a tenth of that cost is far more than the typical wheelchair. The average person with disabilities and without a futuristic insurance policy is still on the losing side of technological advancement. They can’t expect to walk within their personal exoskeleton any time soon, and will have to stay within their own wheelchair-accessible portion of the world.

Cheap-but-functional assistive tech easily beats 21th century bionics

Kurzweil’s predictions often emphasize an extension of human capabilities. Some of these predictions seem poised to come true, like self-driving cars, while others, such as fully conscious AIs, are still far off. But since the human race struggles to pay for every update to its well-being, the future will never arrive as quickly as the tech futurists want it to.

Bionic exoskeletons are looking more and more like a futuristic technology that will never be as useful as the tech that has actually headed in the opposite direction.

By taking wheelchairs a step backwards — replacing high-tech sensors and reactive support with a cheap white plastic lawn chair — one charity organization has substantially boosted its impact across many areas of the world. Between 2001 and 2015, the Free Wheelchair Mission was able to donate 872,801 cheap-but-functional wheelchairs within the Eurasia, Latin America, and Africa regions. Components like a plastic lawn chair and rubber tires mean that the device is cost-effective and easy to maintain — descriptors that would never be applied to a bionic exoskeleton.

Kurzweil might be a future-tech prediction savant, but there will always be a (much more easily predicted) gap between those who can afford assistive technology and those who can’t.