A Woman’s Pioneering Exoskeleton Technology Could Allow Paralyzed People to Move Again

There weren’t many role models for Sam Huynh when she was growing up in Belen, New Mexico. In fact, except for a howling freight train and the surrounding desert mountains, there wasn’t much of anything in the town of 7,000 people.

But as a wildly imaginative and ambitious kid, Sam never had any difficulty finding projects to keep her attention. Fixing stuff came particularly easily for her. She grew up on a farm toying with tractors with her adoptive grandfather, who proudly came from a family of New Mexico cowboys. He nurtured her tinkering knack, and together they rode horses, worked on engines, and baled hay. In high school, Sam raced cars to nowhere and worked at the local mechanic’s shop with her dad for extra cash.

When she was accepted into the Rochester Institute of Technology on a Gates Scholarship, there weren’t many people like her in RIT’s engineering department—or in the field of engineering at all, for that matter. She was a queer woman of color. She was opinionated. And she had been raised in a lower middle-class household by refugee parents.

The marginalization and lack of diversity in engineering became her fuel. As the daughter of a mother who broke out of an orphanage during Pol Pot’s regime and a father who narrowly escaped the Vietnam War, Sam was raised on a philosophy of persistence. Today, with her head half-shaven and the other half sporting luscious bright blue-purple locks, she signals her contempt for the status quo both inside and out. She proudly refuses to wear what she calls the unofficial engineering uniform—a powder blue shirt and “those fucking khaki pants”—instead opting for oversize blue jeans and sturdy, brown workman boots. A mentor once told her why he thought she was successful: “Honestly?” he said. “It’s because you look like you really give a shit.”

In her early 20s, she beat out classmates for an internship at SpaceX working on rocket engines, and then later landed a coveted position at Tesla as a design engineer. It was “the holy grail of mechanical engineering jobs,” she says, but she still searched for a deeper sense of purpose.

Then, in 2012, she came across something that she couldn’t fix.

One of her dearest friends from undergrad got into a dirt-bike accident. Sam and Taylor Hattori had been close since freshman year when they met in the Machine Shop at RIT, a kind of on-campus mecca of drills, saws, and other heavy-duty equipment. It was for the kids, Sam says, who were “more comfortable with machines than with other people.”

Taylor’s accident left him paralyzed from the chest down. They had become the type of friends who could show up on each other’s doorsteps in the middle of the night and expect a place to crash indefinitely, no questions asked. And this was going to be no different.

With the conviction to help her friend walk again, Sam quit her high-flying job at Tesla and turned her mechanical mind toward fixing a much more personal problem. Sam couldn’t build Taylor a spine, so she decided to build him the next best thing: a robotic suit.

Sam has now been designing an upper-body robotic suit—known as an exoskeleton—at University of Southern California for two years as a part of her PhD in biomedical engineering. (It took her three years to begin, as she first had to go back to school to get a Master’s degree in materials engineering.) Her exoskeleton is built with products anyone could purchase for a few hundred dollars, which is a priority for her as she grew up in a family with limited income for medical care.

In contrast, currently available lower body exoskeletons start at around $40,000. These suits are primarily charged by electric motors that provide a set amount of support to the patient, whereas Sam’s suit is charged by pneumatic muscles, which are devices run with air pressure, that adjust during use to more closely mimic the movement of the human body. Sam’s exoskeleton is also different in the fact that it’s guided by the electrical signals from the patient’s own muscles, moving whenever the patient flexes muscles they can still control. For instance, if a patient flexed their left pec, it might send a signal to the exoskeleton to move their lower left arm. Eventually, Sam plans to use this technology to create a full-body exoskeleton.

Her design is based on neuroplasticity, which is the now-accepted belief in the medical community that the brain has circuits that change according to our physical and mental activities. This is significantly different from the previously held belief that the brain has discrete parts for performing certain functions, and that if a certain part is damaged, the functions it controls are simply gone.

The discovery of neuroplasticity means that if the brain is injured—say by a stroke or spinal-cord injury—it can sometimes compensate for lost motions by forming new connections in other regions. With many hours of commitment, patients can fuel this process by repeatedly practicing the motions they have lost.

Exoskeletons assist with this type of therapy by partially supporting patients through the difficult motions they don’t have the strength or control to do on their own. Physical therapists can help them do this, but an exoskeleton could potentially be taken home for more regular practice. As neuroplasticity can only be induced by active movements initiated by the patient, not passive movements done solely by a device or physical therapist, this also gives the patient more autonomy over their recovery. The amount of support an exoskeleton provides to a patient can be adjusted so that, over time, they can use as much of their own strength as possible to move.

There are already three lower-body exoskeletons on the market that were primarily conceived as long-term devices for exercise or as an alternative to a wheelchair. But surprising reports have started coming out of rehabilitation centers that show a small number of patients regaining lost motion through the use of these devices. Sam hopes that by making a cheap model expressly designed to encourage the brain to build new pathways, exoskeletons will become widespread, temporary tools for more patients until they can operate without them.

“I know how much Taylor would hate to be reliant on something that wasn’t himself,” Sam says. “I don’t want people to have to be stuck in my apparatus: I want them to use it so they can learn how to reuse their own bodies.” For Taylor, this might mean a second chance at his original career path testing rocket engines. He now does design and development work for Blue Origin, the aerospace manufacturer founded by Amazon’s Jeff Bezos.

Iona Novak, head of research at the Cerebral Palsy Institute, thinks robotics have “enormous promise” for inducing neuroplasticity. However, she also says it’s “early days” for the field of exoskeletons, and there needs to be larger studies done investigating their potential.

Frank Hyland, vice president of rehabilitation services at the Good Sheperd Rehabilitation Hospital, says there’s already enough evidence to conclude that robotic suits can be a powerful rehabilitation tool. He has used them for more than five years to help patients with incomplete spinal-cord injuries regain lost motion. “I’ve seen it happen over and over again,” he said.

Still, some longtime researchers of paralysis are doubtful about the extent to which exoskeletons can induce neuroplasticity. The Miami Project to Cure Paralysis at the University of Miami’s school of medicine is one of the oldest research programs in the country that is solely devoted to investigating treatments for spinal-cord and brain injuries. “There’s very little credible evidence that suggests that the devices will rewire the brain,” says Mark Nash, the project’s principal investigator. The Miami Project has a small clinical trial investigating exoskeletons, but they, along with researchers around the globe, are also investing in a variety of other promising treatments, from stem-cell therapy to therapeutic hypothermia, which reduces damage after a cervical spinal-cord injury by cooling the body a few degrees.

But Sam is undeterred by the debate—or almost anything. For her, this is just the first step of many on a journey to help her “best buddy.” The jury may still be out about the extent to which robotics can help rewire the brain, but she’s not willing to wait.

“I don’t think there’s anything I wouldn’t do for Taylor,” Sam says. “ If he were to say jump, I’d already be six feet in the air before I asked him why.”