How does the Tek RMD compare to other mobility devices on the UK market?

The Tek RMD distinguishes itself from other mobility devices through its unique design philosophy, functionality, and target user needs. This doesn't mean that it is the perfect choice for everyone. Individuals with weak or paralysed limbs will ultimately have different physical abilities and functional goals. The Tek RMD allows individuals who are suitable to use it, to stand and move in their environment and to do this in a way that will enable them to do more than if they just were using a standing frame. They can stand for lengthy periods, interact at eye level with others and uniquely engage in their environment. We know that standing is good for health but most candidates for the Tek RMD or standing wheelchair want to do more.

Choosing the right product requires thoughtful consideration. It’s important to assess each option’s physical suitability while carefully evaluating its strengths and weaknesses in relation to the user’s functional goals.

Here's a comparative analysis based on some key aspects:

Let's consider this based on five aspects

1. Design & mobility approach

2. Target users & health benefits

3. Accessibility & practicality

4. Cost

5. Unique advantages of the Tek RMD

Design and mobility approaches

The Tek RMD is often compared to other devices designed to help individuals with weak or paralysed limbs stand and move, such as standing frames, "standing" wheelchairs and exoskeletons. However, as the saying goes, it’s like comparing apples to oranges. Each device has its strengths and limitations, and the best choice ultimately depends on the individual's specific goals and needs.

The Tek RMD might open up some new opportunities for independence

Maintaining an active lifestyle is essential for overall health, and individuals with spinal cord injuries are often encouraged to incorporate a standing routine into their lives. While many of our clients have previously used standing frames, they usually grow weary of “just standing.” This is where the Tek RMD stands out, offering the ability to stand and the freedom to move—a feature many find appealing. Of course, every product has its features and limitations, and as responsible providers, we have to help clients navigate their way through the potential choices.

A significant advantage of the Tek RMD lies in posture. The Tek RMD is designed to support users in a well-balanced, upright posture, which is often preferred by therapists. Of course this is possible only when the potential user has no fixed joint contractures that would disallow upright standing. Also, with higher-level spinal cord injuries, the Tek RMD may not provide enough trunk support to allow the user to be "hands-free" when using the product.

In contrast, standing wheelchairs may require users to tilt backwards for stability, potentially limiting what can be done while standing. Standing wheelchairs tend to optimise the wheelchair function and allow occasional standing. This is fine if it matches user requirements. The upright and balanced position provided by the Tek RMD allows for greater interaction with the surrounding environment, making it a more practical and functional solution for many users.

On the other hand, it is reasonable to imagine someone who delights in using an exoskeleton because it, after all, allows someone to walk. Perhaps this feature outweighs everything else. It comes down to user values and thinking through what matters to the individual.

We’ve compared these three types of devices in the table below.

Target Users & Health Benefits

Tek RMD

• Ideal for paraplegics with intact upper-body strength and function(T6–L5 spinal injuries).
  The original Tek RMD relied on a manual lifter, requiring users to squeeze a handlebar lever and pull with their arms to transition from a seated to a standing position. This design demanded significant arm strength and grip, limiting its accessibility. However, the introduction of the electric lift has transformed usability. Now, users can operate the lift simply by leaning on the handle, eliminating the need for strong arms. This innovation has expanded the device's reach, making it accessible to a broader range of individuals beyond paraplegics. That said, its use is still influenced by the user’s core strength. For instance, individuals with cervical-level spinal cord injuries may find the Tek RMD challenging to use effectively due to insufficient trunk support.

• Benefits: Promotes bone density, bladder/bowel function, and psychological well-being via standing.
  These benefits are regularly cited and would relate to prolonged standing or walking however this is achieved.

• Limitation: Transfers on and off the product, which must be boarded from the back, require a thoughtful approach. We spend quite a bit of time reviewing this process with our Tek RMD clients. Some grip strength is helpful for transfers and joystick control.

Exoskeletons (Indego/Ekso):

• Suited for gait rehabilitation in incomplete spinal injuries or stroke patients.

• Benefits: Step-induced bone preservation, muscle activation and strengthening.
  For some individuals, the ability to stand and walk brings immense satisfaction, making the higher cost of an exoskeleton well worth it. Unlike traditional standing devices that hold the limbs in static positions, exoskeletons enable dynamic limb movement, offering a more natural and engaging experience. Additionally, certain exoskeletons allow for adjustable support from their joint motors, providing assistance tailored to the user’s needs. This adaptive functionality helps users regain strength and promotes the restoration of movement and functionality, far surpassing the benefits of passive limb motion.

• Limitation: High cost (~$80k–$120k) and intensive training of user and potentially a carer for safe use.

Standing Wheelchairs:

• Static standing with limited therapeutic mobility.
  A larger footprint may make indoor use more difficult.

• Benefits: Emphasis on wheelchair-style mobility and comfort
  While the Tek RMD focuses on enabling users to stand for extended periods with proper posture, standing wheelchairs are primarily designed to provide seated mobility with the option for occasional standing. For individuals with higher-level spinal cord injuries, this approach may be the most practical way to combine mobility with the benefits of standing.

• Limitation: Poor standing posture, with users leaning backward, and limited maneuverability are common issues. Powered models are priced similarly to the Tek RMD but are more affordable than exoskeletons. Additionally, a few manual lift versions are available at a lower cost..

Accessibility & Practicality

In the table below, we compare the three approaches to standing and mobility from three points of view.

1) How easily does the product fit into a typical home?

2) Is the product suitable for outdoor use?

3) What is the range of these products?

Home modifications

During home demonstrations of the Tek RMD, evaluating whether the product can be effectively and safely used in the home environment is essential. This includes assessing the user’s transfer resources and ability to perform these independently and securely. We also examine accessibility, from entering the home to navigating outdoor spaces like gardens. Key factors such as corridor dimensions, flooring types, door widths, and room layouts are systematically reviewed to ensure compatibility and ease of use. As the table suggests, the Tek RMD has the advantage of being narrower and shorter than a wheelchair. The standing wheelchair may be more challenging to manoeuvre indoors, but the user does not need additional transfers as this product is their main tool for moving and standing.

Outdoor use

The Tek RMD can now be provided with an optional outdoor wheel kit that changes the front wheels and tailpiece. This arrangement extends the base of support and, via the use of pneumatic tyres, allows operation on grass and gravel-type surfaces. Some standing wheelchairs will be excellent for outdoor use, and some will be more limited. Exoskeleton designs may require flat and even terrain and may become unstable on uneven surfaces.

Battery Life/Range

Battery life and range can vary depending on the design. Batteries are typically heavy and require proper maintenance to perform optimally. Regular recharging is essential; users must carefully follow the manufacturer’s instructions to ensure longevity. Deeply discharging a battery can lead to the need for replacement, a process that can be both expensive and inconvenient—particularly for devices like exoskeletons.

Cost

As noted above, exoskeletons are likely to represent the highest cost in terms of the upfront product cost, plus the training and maintenance costs. This tends to restrict the use of exoskeletons to therapy centres operating them on a commercial basis or to individuals with settled medico-legal claims following a catastrophic injury. Unlike some other countries like the USA, the State in the UK will not provide these products to individuals.

Powered standing wheelchairs and the Tek RMD are likely to represent prices in the range £19 - £25k in the UK. Where an individual can use these products to return to work, it might be possible to apply for state funding which can offset some fo the cost.

Unique advantages of the Tek RMD?

As we have seen, each product type has strengths and weaknesses. So, how do we choose the best option for an individual?

The first step is to carefully review each product's list of indications and contraindications. If a product demands physical abilities, the user does not have, no further considerations are necessary. Safety must always remain the top priority.

If a product is likely to be safe to use then we can consider whether it might be effective. Effectiveness requires consideration of what you desire to achieve by using a product. It is also necessary to consider where the product would be used and whether the environment is suitable.

A trusted advisor can be important here to help establish realistic criteria for product comparison. Without doing this costly errors can result.

We do feel that the Tek RMD has some unique advantages as a product. We would say that as we know the product intimately and have worked with it for years. However, we also understand it's limitations and that it cannot be the best choice for everyone.

Perhaps the best feature of the Tek RMD in my view is the fact that it allows users to spend more time in an effective, balanced standing posture that is good for health whist being able to move around in varied environments.

The ideal use case for these products in my view is as follows

• Tek RMD: Daily living tasks (cooking, socialising), navigating narrow spaces whilst standing, and outdoor mobility with minimal home modifications.

• Exoskeletons: Clinical gait therapy or users prioritising the act of walking over standing.

• Standing Wheelchairs: Static standing for short durations without active mobility. The convenience and comfort of a wheelchair is prized more than standing.

In summary, the Tek RMD M1 fills a niche for paraplegics seeking active, upright mobility with practical daily utility, while exoskeletons cater to gait rehabilitation and standing wheelchairs offer limited static support. Its compact design and insurance coverage make it a compelling option for enhancing independence without extensive infrastructure changes.

Some Links

[1] https://www.matiamobility.com/tek-rmd/

[2] https://www.anatomicalconcepts.com/articles/2019/08/07/2019-8-7-comparing-the-indego-and-tek-rmd

[3] https://hspersunite.org.au/innovative-mobility-device/

[4] https://www.anatomicalconcepts.com/articles/2019/11/12/2019-11-12-who-would-use-a-tek-rmd

[5] https://www.anatomicalconcepts.com/articles/tek-rmd-and-standing

[6] https://bestpowerwheelchair.com/products/matia-robotics-tek-rmd

[7] https://exoskeletonreport.com/2016/09/comparing-indego-vs-ekso-gt-vs-rewalk-researched-vapahcs/

[8] https://livingspinal.com/products/the-tek-rmd-by-matia-robotics.html

[9] https://newmobility.com/tek-rmd-moving-standing-frame/

[10] https://www.youtube.com/watch?v=AKOYizVWo6Q

[11] https://www.anatomicalconcepts.com/articles/living-with-the-tek-rmd

[12] https://hspersunite.org.au/innovative-mobility-device/

[13] https://www.matiamobility.com/faq/

[14] https://www.youtube.com/watch?v=NQUAxAY6NrM

[15] https://livingspinal.com/products/the-tek-rmd-by-matia-robotics.html

[16] https://www.anatomicalconcepts.com/articles/2019/11/12/2019-11-12-who-would-use-a-tek-rmd

[17] https://www.matiamobility.com

[18] https://wateamobility.com/en/collection/tek-rmd-2/

[19] https://www.anatomicalconcepts.com/tekrmd-standing-mobilisation-device

[20] https://www.matiamobility.com/tek-rmd/

[21] https://www.anatomicalconcepts.com/articles/living-with-the-tek-rmd

[22] https://www.youtube.com/watch?v=YTyW4V_iBXQ