Clinical trials provide UIU staff member uplifting experiences

Nearly eight years after being paralyzed from the mid-chest down, Markus Hawes ’18 has benefited from some of the most recent robotic technology. As part of an exoskeleton clinical trial, the Upper Iowa University (UIU) Tutor Center manager found himself rising from his wheelchair, standing and walking with assistance in the clinic halls and on the sidewalks outside of the Mayo Clinic Hospital in Rochester, Minnesota.

Hawes was accepted into the clinical trial in the fall of his senior year at UIU. The Indego® Therapy exoskeleton is an electronic-powered device that fits an individual’s lower body and limbs. With the assistance of therapists, the robotic equipment enables people with spinal injuries similar to Hawes’ to perform walking functions.

Hawes suffered his injury in 2011, just five days after graduating from Waukon (Iowa) High School. The then Indians starting shortstop broke his C7 vertebrae after sliding headfirst and colliding with the team’s catcher during baseball practice. Hawes was transported by ambulance to Veterans Memorial Hospital in Waukon and then airlifted to Mayo Clinic in Rochester.

Hawes exhibited his fighting spirit when he spent only six weeks in physical therapy and was discharged from the hospital a month ahead of schedule. He also continued with his initial plans to major in agricultural engineering at Iowa State University. Unfortunately, he was soon forced to drop out of college after discovering he needed to dedicate more time to physical therapy and adjust to his new daily life.

Hawes later earned an associate degree at Northeast Iowa Community College (NICC) in Calmar, Iowa, before achieving his bachelor’s degree in mathematics at UIU. While attaining his education, he also tutored at UIU’s Tutor Center and Waukon’s middle and high schools.

Now serving as UIU’s Tutor Center manager, he is the main point of contact for Peacock students seeking tutoring services. He currently oversees 14 student tutors who focus on helping other students with subjects related to their respective majors. An online tutoring platform is also available to all students.

Hawes participated in the two-stage Mayo program from January 2018 to September 2019. The purpose of the study was mainly to weigh the health benefits of the exoskeleton versus its use as a mobility or exercise device by people with spinal cord injuries.

“I have to admit that I initially signed up for the trial because of selfish reasons,” Hawes said. “But I quickly saw the bigger picture, and I felt extremely privileged to have the opportunity to do something that so many other people couldn’t do.”

After being fitted with the exoskeleton, the 28-year-old noticed how it provided support to his lower back and equal weight distribution across the center of his body.

“It felt awesome,” Hawes said. “The exoskeleton kept me stable, especially in areas where my orthotic braces did not provide support. It provided me more comfort and put me in a better mood.”

During the first stage of the trial, Hawes walked the hospital halls in the exoskeleton with assistance from the research staff. The exoskeleton could provide different amounts of assistance to participants, depending on their tolerance and progress. The second phase of the trial included use of electrical stimulation to activate the leg muscles during walking.

“My injury causes incomplete sensations below the waist,” Hawes said. “I have sensory feeling in my lower extremities, but I don’t have much motor function. I tried to think through the walking motion to make the sensory motor function stronger. The exoskeleton sensory unit knew where my legs were in space, caused them to properly contract and provided me a more normal gait.”

“Both stages were mentally draining, but I became more physically drained during the second stage because it was more taxing on my body,” he added.

The robotic device cannot go up stairs, and for safety reasons, a research staff member helped during all walking sessions. Hawes tested the exoskeleton on different surfaces. Researchers tracked his number of steps, as well as changes in his weight and muscle mass.

Acknowledging that he has a very slim to no chance of ever walking again, Hawes realizes that without these or similar clinical trials there would be far fewer success stories. With this as his motivation, he signed up for and was accepted as a participant in a transcutaneous and epidural spinal stimulation study at Mayo.

The purpose of the study is to compare transcutaneous electrical spinal stimulation (TESS) and epidural electrical stimulation (EES), while the focus will be the motor activity enabled by each method and any potential health benefits.

“These trials give people hope, and I want to give something back in honor of everyone who has helped me since I was injured,” Hawes said.