Peter Schreiner, walking to the finish line, with Eberardo Burgos, left, and Michael Elliott, both assistant trainers at the James J. Peters VA Medical Center. Click here to watch the Mount Sinai Future You video.
For months, New York City resident Peter Schreiner trained extensively for the New Balance 5th Avenue Mile, determined to win. With friends, family, and new fans cheering him on, he triumphantly crossed the finish line, first among his co-competitors.
But this was no ordinary race: Mr. Schreiner is paralyzed below the chest, and he accomplished this feat in 44:19 minutes—nearly four minutes faster than the goal he had set for himself—with the help of an exoskeleton, a robotic device that enables him to stand and walk. The event, held on Sunday, September 9, marked the first time that an entire heat was dedicated to paralyzed athletes using exoskeletons.
In September 2017, the 27-year-old former scuba instructor from the Upper East Side fractured his T5 vertebra in a car accident that occurred while he was coming home from a friend’s funeral in Florida, sustaining a spinal cord injury (SCI). He had no sensation or motor function below his upper chest, and until he came to The Mount Sinai Hospital five weeks after the injury to begin a comprehensive multidisciplinary SCI rehabilitation program, he was unable to sit up, talk, eat by mouth, or even drink water.
After the race, Peter Schreiner got a congratulatory hug from his mother, Mary Kate Wold.
His treatment involved rehabilitation nursing, physical therapy—including locomotor training with the exoskeleton—occupational, speech, respiratory, and recreation therapy, counseling, nutrition, and community reintegration. “At the time, this seemed so permanent,” recalls Mr. Schreiner.
“It has been amazing to see Peter’s progress,” says Thomas N. Bryce, MD, Professor of Rehabilitation and Human Performance, and Medical Director of Mount Sinai’s Spinal Cord Injury Program. “When he was an inpatient here, we tried to get him up to use the exoskeleton, and it was very slow. He needed a lot of assistance, but very soon he was racing around here very quickly.”
Finishing the race right behind Mr. Schreiner were two other Mount Sinai patients, Richard “Woody” Woods and Robert Woo, and Heather Miner (U.S. Navy Ret.), a patient at the Veterans Administration (VA) Medical Center in Dallas. All four—in T-shirts identifying them as “Team Bionic Athletes”—wore an exoskeleton device placed on their legs, hips, and torso, and weighing 50 pounds, a weight not felt by the user wearing it.
Among its many components, the powered exoskeleton has motors at the hips and knees, a tilt sensor for detecting body position, a computer in the pelvic band to control the motors, and two batteries, all of which are brought together to provide coordinated leg movement into a somewhat natural gait. Arm crutches help users maintain their balance.
“When you’re sitting in a wheelchair, you are literally looking up at the world, and the world is literally looking down at you,” says Angela Riccobono, PhD, Senior Clinical Psychologist, Rehabilitation and Human Performance, who was part of Mr. Schreiner’s care team. “I cannot overstate the significance of being able to stand up and look at someone eye to eye. It is beyond powerful.”
Ann M. Spungen, EdD, Vice Chair of Research for the Department of Rehabilitation and Human Performance at the Icahn School of Medicine at Mount Sinai, is one of the nation’s top exoskeleton researchers for patients with disabilities caused by SCI. Dr. Spungen is also the Associate Director of the VA Rehabilitation Research & Development (RR&D) National Center for the Medical Consequences of Spinal Cord Injury at the James J. Peters VA Medical Center in the Bronx—with which Mount Sinai has an affiliation.
Dr. Spungen has been studying many aspects of SCI, including paralysis, medical complications, mobility, and quality of life for nearly three decades. In addition to lack of mobility, paralysis causes adverse body composition changes, bowel and bladder dysfunction, and cardiovascular problems. Her research has shown that four to six hours per week of exoskeleton-assisted walking leads to improved bowel and bladder function, reduced fat mass, less fatigue, improved sleep and mood, better pain management, and improved overall well-being.
Before the race, Pierre Asselin, MS, Senior Biomedical Engineer, James J. Peters VA Medical Center, and Assistant Clinical Professor, Rehabilitation and Human Performance, Icahn School of Medicine at Mount Sinai, ensured the exoskeleton device was a proper fit for Peter Schreiner.
Mount Sinai’s Abilities Research Center is expanding the outpatient exoskeleton program, focusing on technologies such as neuromodulation, upper extremity robotics, and lower extremity robotics. This initiative will be overseen by Maria del Mar Cortes, MD, Assistant Professor of Rehabilitation and Human Performance, who specializes in robotic technology and noninvasive brain and spinal stimulation techniques to understand the mechanisms of motor dysfunction and improve motor control. Her team will collaborate closely with Dr. Spungen’s program at the VA Medical Center.
Mr. Schreiner recently completed a Department of Defense-sponsored clinical trial at the VA Medical Center in which he participated in exoskeletal-assisted walking three times a week to determine the effects of exoskeletal use in those with SCI. Says Mr. Schreiner: “Mentally, just being on my feet and moving my legs makes me feel whole again.”
For someone who achieved—and surpassed—one early and significant milestone of competing in the race, Mr. Schreiner continues to set new expectations. “I believe I will be doing all the things that I want to do completely independently, and I am very excited about that,” he says. “Even though I have had setbacks, I am not giving up hope.”