Background of the ExoSym (formerly IDEO)
Prosthetist Ryan Blanck designed the Intrepid Dynamic Exoskeletal Orthosis (IDEO*) at the Center for the Intrepid, Brooke Army Medical Center in 2009. His goals were to reduce pain and restore mobility to active-duty and retired service members with limb salvage conditions as a way to avoid amputation.
The IDEO provided increased dynamics and energy return to give patients more agility and enable high impact activities like running, jumping, skydiving and redeployment, sometimes carrying up to a 120‐pound ruck sack. Of the 500+ service members who received custom IDEO devices, many have returned to active duty and deployment.
Hanger Clinic continues to support the military in these goals, while bringing this Department of Defense-proven technology to civilians. Ryan joined Hanger Clinic in 2013 and now provides the highest possible level care with the ExoSym program to restore high‐level activity and function to patients with severe lower-extremity conditions or injuries.
Candidates for the ExoSym Kinetic Orthosis
The ExoSym device has helped patients across the United States, Canada and abroad with limb salvage injuries as well as ankle fusions, partial-foot amputations, fractures, tarsal coalitions and other lower extremity dysfunctions.
"I've been able to do so many things since I got [my ExoSym devices] for [the first time in] ten years, and what a joy it is. But what I haven't done is even more important—I haven't fallen down, and I haven't looked at my future as one slow slide into being in a wheelchair again. And I don't hurt anymore—the relief is amazing. It's hard to believe that being pain-free is going to be my new normal."
– Nancy G. from Massachusetts
The ExoSym device is an evolution of the IDEO that is lighter, thinner and stronger than the original version. It is more like a hybrid prosthetic‐orthotic design than a conventional orthosis. The upper section incorporates many socket design concepts used in prosthetic limbs. Each patient is evaluated for the right degree of alignment and off‐loading for the specific injury and dysfunction. The ExoSym incorporates a specialized dynamic energy‐storing strut system often used in prosthetic running limbs for amputees. This adaptation provides injury‐specific deflection, energy storage and power, all while maintaining control and minimizing pain.
Alignment and positioning is critical to success. Even with similar injuries, each case must be carefully evaluated to determine the exact characteristics of strut resistance, ankle positioning and triplanar control. Each patient is evaluated utilizing a variety of tests and measures to make sure he or she is a good candidate. This allows the ExoSym to be custom-made for each individual's needs with optimal alignment, positioning, off‐loading and control.
The ExoSym Care Program
The ExoSym care program takes place at a specially designed facility in Gig Harbor, WA, which ensures the best possible outcome for each patient's individual condition and needs. It starts with a clinical evaluation and fitting process. An intense training regimen with ongoing adjustments ensures optimal device fit, and each individual is trained to properly use it for everyday and intense physical activities.
ExoSym is a tool to maximize each patient's functional potential and restore your abilities. As you progress through rehabilitation, the ExoSym system may be required permanently (much like a prosthesis), or you may progress to part-time usage for task-specific activities such as specific employment needs. You will develop an understanding of how your ExoSym device will best meet your personal goals to get back to work, a life of comfort, greater stability and the physical activities that are most affected. This may mean caring for your children, returning to employment, coaching a soccer team or running a 5K race.
Insurance coverage for medical devices such as ExoSym can vary by state and by individual insurance plan. The Hanger Clinic staff and your prescribing physician may be required to provide justification of the medical necessity of the ExoSym system for your individual needs. Your voice also counts! Stay in close touch with the claims adjuster to understand the process and to advocate for yourself. We know it can be frustrating if you have to wait for payment approval when a solution is in sight, but try to be patient, persistent and positive.
If your insurance provider does not cover the device, there are several funding alternatives to consider.
Crowdsourcing enables individuals to personally contribute funds to help people in need through online communities such as
Financing is available through
CareCredit, a GE Money company that offers no-interest and low-interest payment plans based on your needs and budget.
Other resources that may be available in your local community include private foundations, places of worship, charities, volunteer groups and civic organizations. For example, Knights of Columbus, Rotary, Kiwanis and Lions Clubs often respond to requests to help provide assistive devices.
Empowering Patient Stories
People who wear the ExoSym device tend to be a passionate group. We are proud to feature a few stories from these amazing individuals who have overcome incredible odds and, with the ExoSym, have returned to their active, productive lives.
Philip Stevens (Barre, MA) ran the largest dairy farm in Massachusetts until he fell off the roof of his barn and landed on concrete, breaking both of his heel bones. Unable to manage his farm, he lived with significant pain for years and was considering amputation after being inspired by veterans running the Boston Marathon wearing advanced prostheses. Through his daughter, Nellie Zarif, who is a Hanger Clinic prosthetist, he found Ryan Blanck and the ExoSym (then called IDEO). Phil has had incredible success with the program and is now back at work on his farm – cutting wood, running a chainsaw, walking and milking the cows.
View Phil's Empowering Story
Beth Shaver (Austin, TX) was injured in a soccer game at the age of 23, resulting in a broken foot and torn tendons in her right ankle. She endured multiple surgeries and complications resulting in severe nerve pain and reduced mobility for two years, limiting her ability to be functional. Beth was faced with the possibility of never running again, let alone walking & living without pain, until she found the ExoSym (then called IDEO), which changed her life. Beth is back to working full-time, running races (recently completing a half-marathon), competing in endurance adventure races, playing dodgeball and doing Crossfit. She has also been a great resource for other ExoSym patients and even started a blog to share wisdom, provide inspiration and share others’ stories. It’s called the
ExoSymplyAmazing blog – take a look!
View Beth's Empowering Story
Matt Runte (Seattle, WA) is a firefighter, a U.S. Army veteran and an avid runner. He was hit by a car while stopped at a red light on his motorcycle. He had severe injuries to his foot and eventually had two toes amputated. Facing the prospect of no longer being able to return to his career or to run again, Matt didn’t lose hope. His wife discovered the ExoSym (then called IDEO) device while he was in the hospital. With the ExoSym, Matt is not only back fighting fires, he also recently completed a half marathon (and promptly set his sights on a full marathon) and climbed 69 flights of stairs in full gear during the annual Scott Firefighter Stairclimb.
TIME Magazine, May 2012
WOAI NBC News 4 San Antonio TX, February 2014
NPR, May 2014
Q13FOX News Seattle WA, October 2014
WCAX3 News Burlington VT, September 2014
The Worcester Telegram & Gazette Worcester MA, January 2015
SOFREP News March 2016
120 Sports (ref. 06:25-09:10) May 2016
While there are a number of peer support resources for amputees, you may not yet have found a strong community for those with injured or salvaged limb(s). We recommend connecting with the
Trauma Survivors Network to find someone who has successfully overcome injuries similar to yours.
IDEO is a U.S. Army medical facility product.
The ExoSym™ could be the perfect solution to fit your needs. Call 1-877-4HANGER (1-877-442-6437) option 1 to schedule a free evaluation.