When Orfa Nitkiewicz, a 63-year-old designer and seamstress who lives in Hawthorne, saw a partially paralyzed man walking with the help of an exoskeleton walking device in a parade on television, she had no idea how important that image would be for her future.

Last October, Orfa went to work as usual in Costa Mesa. “I started feeling dizzy and nauseous throughout the day,” she remembers. “And in the afternoon, I told my manager I had to leave early because I didn’t feel well. I didn’t think anything of it. I didn’t know anything about stroke.” Orfa says other symptoms were developing—her shoe wouldn’t stay on, it was a little hard to move the steering wheel, and her face started getting numb—but she was able to drive home.

“In the driveway, I just sat for a moment and prayed,” says Orfa. “Then I banged on the front door, called my husband, and he called the ambulance.”

Orfa was lucky that she was taken to Providence Little Company of Mary Medical Center Torrance, with its designation as a Primary Stroke Center. She learned she had had a stroke. After four days in the hospital, she was transferred to the Acute Rehabcentre at Providence Little Company of Mary Medical Center San Pedro, where she spent a month on improving her functional mobility, activities of daily living and her speech. The Rehabcentre is accredited by the Commission on Accreditation of Rehabilitation Facilities (CARF). It ranked in the top 2% for patient outcomes in 2016. It offers an inpatient program with round-the-clock nursing supervision and intensive rehabilitation including physical, occupational and speech therapy. Once Orfa was ready to transition home, she went to the outpatient program.

While she was lucky she had no cognitive deficits from her stroke—“I remember everything,” she says—the right side of her face drooped and her right arm and leg were affected. She started rehab slowly and then came the exoskeleton.

“The Ekso GT robotic exoskeleton allows us to get a patient who is very weak to start putting weight on her legs and start walking again,” says Anh Long, MD, medical director of the acute rehabilitation program. “Research shows the more you use the weak limb, the faster you recover. We get patients on their feet as soon as possible while the neuroplasticity in the brain can help stimulate other parts of the brain to take over for injured areas.

“The exoskeleton is part of stroke therapy, along with parallel bars and other therapy modalities. It allows patients to be able to walk normally, without a limp,” says Dr. Long. Besides stroke rehab, the Ekso GT device is also instrumental in rehabilitation after partial spinal cord injury, brain injury and immobility due to other illnesses.

“For someone who hasn’t walked in a while, just being able to stand and look at people eye to eye is very important psychologically,” says Dr. Long. “They get really excited.”

From the start of rehab, Orfa was motivated to get better. “I had my family to think about,” she says. “My 12-year-old grandson, Clayton, said to me, ‘Grandma, don’t look at this as a sickness. Look at it as a long-term vacation without pay.’” And in that spirit, Orfa was willing to do anything to improve.

Her main physical therapist, Julia Mathews, says, “At the start of her outpatient physical therapy, Orfa was walking short distances on level ground and had gait impairments. She had to move her bedroom downstairs and couldn’t walk in the community or go to the grocery store.”

When her team of therapists brought up the idea of the exoskeleton, Orfa says she was leery at first. “Julia told me I had to sign a liability waiver, which was scary, but then I remembered seeing that man in the parade. I really trust her, so I said, ‘Okay.’”

When she started with the ekso (which it is fondly called), Orfa says she was nervous. But her leg was wiggly and she was determined to walk better. “Orfa is an ideal patient,” says Julia “She does all of her exercises here [at the rehab facility] and at home. And she is recovering with more normal movement. The quality of her walking is improving each week, she is using her affected side, and she is getting away from the compensations that she used to have to rely on.”

The device can be utilized both during inpatient rehab and, as in Orfa’s case, in outpatient physical therapy sessions. It is adjusted to custom fit each individual and operated by one of the four trained therapists at Providence Little Company of Mary San Pedro who have been certified for its use.

At first the robot can provide up to 100% of the power needed for standing and walking. During the course of several sessions, it is adjusted to put in less work as the patient learns to move on his or her own power. The device has proven to be a valuable tool in facilitating normal weight shifting and movement during the walking process. The device can also record the effort and quality of movement, giving the therapist valuable feedback on how to further tailor the walking program both in and out of the device.

Orfa, who can now negotiate stairs, walk in the community and complete tasks such as shopping for groceries, says, “I feel much more steady on my feet and my balance is improved. I am so grateful for all of the help I have gotten at Providence Little Company of Mary San Pedro. Everyone is so experienced and compassionate.”