Spend even a short period of time with Amanda Boxtel and you will quickly realize that she is someone far more inclined to look forward rather than back. Yet, even with her effervescent personality, can-do attitude and constant smile, she can’t help but occasionally look over her shoulder and ask “What if?”
She would surely be forgiven if her hindsight focused on that day, 27 years ago, when an accident on the slopes of Snowmass left her paralyzed from the waist down and therefore wheelchair bound. She is far more likely, however, to wonder “what if” the technology and therapeutic knowhow that now exists — much of which she herself helped pioneer — was around when she lost the use of her legs. She firmly feels that she would have been much better off.
All she can do now is take advantage of recent innovations and through the non-profit foundation — Bridging Bionics — she founded not quite three years ago, help others achieve the ability to stand tall and walk.
Boxtel is a native of the Land Down Under. She came to the Roaring Fork Valley in 1988 because she had fallen in love. She soon fell in love with the mountains. She had been a fourth-grade school teacher in her native country and had established a pen-pal relationship with a local teacher.
An accident such as hers would be hard on anyone. It was especially so with Boxtel because she had always considered herself an athlete. Once she completed the basic therapy following her paralysis, she decided that she would continue to be an athlete.
“After I was paralyzed, I had to figure out life,” she said. “There weren’t many options at that time, so I had to figure out a lot on my own. I established a four- or five-day-a-week fitness regimen consisting of cardio, stretching, range of motion, sitting, standing, everything I could think of to keep my body flexible and fit.”
She decided early on that she would get back on the ski slopes.
“I broke my back” Boxtel said. “I did not break my spirit. I became a better skier than I ever was before my accident. I became a ski instructor. There were dark hours, sure, but destiny waits for no one.”
A great attitude is critically important to any recovery process, of course, but physiological reality bats last. Boxtel was spending her life in a wheelchair. Which sucked on numerous levels.
“When you sit, you begin to die,” she said. “I needed a way to prepare my body to walk again.”
That opportunity presented itself when, in 2010, she was contacted by a company now called Ekso Bionics, which made an offer that changed her life and, by eventual extension, the lives in many other people in the Roaring Fork Valley.
“They heard about me through a friend of a friend,” Boxtel said. “I became the first paralyzed woman test pilot for their new exoskeleton prototype. The only catch was that I had to commit to using the device on National Geographic television, and I only had four days to practice. They hired me and I became an ambassador for the company and introduced their product to the world. I flew all over the world.”
In 2012, the Ekso Bionics Exoskelton was, after substantial testing and approval by the FDA, brought to the market. Boxtel raised enough cash to become one of the first private individuals to own one of these futuristic devices which, first, cost about $150,000 and, second, look for all the world like something straight out of a “Star Trek” episode.
The exoskeleton is an engineering marvel. It boasts integrated artificial intelligence, two motors and sensors that allow the machine to pick up on neural impulses. It does not just “take steps” of its own volition that the user then follows; it actually reads neural impulses and reacts accordingly. The user instigates the action.
Over the course of the next couple years, Boxtel took more than 130,000 steps around a parking lot in Basalt in her new exoskeleton.
During that time, her health improved.
“It allowed me to stand upright,” she said. “We are meant to stand upright and walk.”
Also, during that time, she began wondering how to expand the reach of the robotic technology that was helping her once more become a card-carrying biped.
She decided to found a nonprofit entity, which eventually became Bridging Bionics, and donate her exoskeleton to the community. It was not as easy as it might sound.
It took a year to get the necessary bureaucratic approvals for what was still then considered experimental technology. She had to jump through a series of hurdles in order for those who would use the exoskeleton to be reimbursed by insurance companies and for the facilities that would offer use of the suit to be properly indemnified in a tort-filled world. She also had to convince the manufacturer that it would be appropriate to allow their product, which weighs more than 50 pounds, to be taken from a purely therapeutic setting — like a rehabilitation hospital — to a health club used by the teeming masses.
“We had to figure out all the liability issues,” Boxtel said. “It was very complicated.”
In 2013, she filed the nonprofit incorporation paperwork for Bridging Bionics. In 2014, she received tax-exempt status from the IRS. After another year of organizational, fundraising and training work, Bridging Bionics opened for business with a stated goal, according to its official website, of “providing access to bionic rehabilitation technology for all individuals challenged with neurological mobility impairments. We serve individuals with neurological mobility impairments resulting from injury or disease, including: spinal cord injuries (paraplegia, quadriplegia), multiple sclerosis, Parkinson’s disease, ALS, Cerebral Palsy and stroke. We work every day to be a bridge between advanced technology and those in need.”
At first, Bridging Bionics worked out of the Aspen Club, which gifted use of the space. When that closed in 2016, she moved shop to the Snowmass Club.
The Snowmass Club has embraced Bridging Bionics and its clients.
“They established the first-ever corporate membership for us,” Boxtel said. “We pay $5,400 a year for the corporate membership.”
Bridging Bionics’ clients pay a $500 annual fee, which allows them full use of the Snowmass Club’s extensive — and top-shelf — facilities.
The latter is important.
According to Boxtel, Bridging Bionics clients don’t just walk around the Snowmass Club in the exoskeleton. They participate in a wide range of activities, which helps to address the sense of isolation many people with mobility issues experience. It is also more healthful.
“Bill Fabrocini, a personal trainer, serves as advisor to our program and is mentoring our team to round out our program using the full gymnasium,” Boxtel said. “Clients are gifted individual sessions to get back to being as athletic as they can.”
About 30 percent of Boxtel’s clients are unable to pay the $500 annual fee. Those clients are gifted their sessions, which run about $300 an hour. A trained therapist is always on duty, and their take-home pay is about $75 an hour.
This is not an inexpensive enterprise. All told, the annual budget for Bridging Bionics runs about $465,000 a year.
Last June, Bridging Bionics purchased a $170,000 Indego Exoskelton, which is lighter than the Ekso Bionics Exoskelton. Having the Indego, which only weighs about 26 pounds, allows Boxtel to easily offer her services at Midland Fitness in Glenwood Springs.
“That allows us access to the I-70 corridor,” Boxtel said. “We have clients coming from Grand Junction, Paonia, New Castle, Rifle and Gypsum. What’s so great about that is that the owner, Steve Wells, works with our clients on a pro-bono basis.”
All told, Bridging Bionics has provided almost 2,300 sessions, which last an hour to an hour-and-a-half, to a total of 61 clients, 33 of whom are currently active, with three more getting ready to sign up.
“It fluctuates,” Boxtel said. “Some are here year-round, while others are seasonal, while others are here for the winter ski team.”
The impact on the community has been overwhelmingly positive.
“Our clients have improved,” Boxtel said. “To be able to leave the wheelchair behind — look, I can’t be perceived as cocky, but through accessing technology, Bridging Bionics has contributed to the process of increasing our clients’ mobility. There are certainly other therapies that are very important as well, like pool therapy, acupuncture and massage. But we have played a big role in helping people who cannot walk to stand upright and once again become walkers, which we were meant to be.”