Organiser: Step by Step Foundation.

Collaborating organisation: Ramon Molinas Foundation.

Implementation dates: 01/09/2021 – 30/08/2022.


An initiative to provide quality physiotherapy treatment to people with neurological disorders from vulnerable socioeconomic groups

The Ramon Molinas Foundation is collaborating with the Step by Step Foundation to upgrade the robotic exoskeleton used by the clinic to improve quality of life and promote the personal autonomy of adults with neurological disorders from vulnerable socioeconomic groups. The cooperation between both foundations will upgrade the Step by Step Foundation’s exoskeleton to the Ekso NR model. The device is made up of long supports that are adjusted and fitted to the legs and torso of the user. In the joints, a series of motors imitate the movements of the human muscle that helps patients with injuries that have affected the nervous system to develop the necessary strength to stand and walk.

The use of the exoskeleton in the treatment of people with neurological disorders helps with gait training. The objective is not to teach patients how to walk but to show the movements and patterns necessary to achieve the most functional gait possible. The device, which can be used standing on two feet or sitting, supports the user in an active, safe way to achieve a functional gait. The exoskeleton is also an excellent device to improve aerobic capacity and work with the force of gravity. It can also be used to relieve urinary infections, respiratory and cardiovascular complications, digestive disorders, pressure ulcers and osteoporosis among others.

In comparison to the previous model the Ekso NR moves more softly, is more adaptable, and offers better assistance for posture and balance support. The physiotherapist can modify patient objectives and levels of assistance and receive information, feedback, and analysis in real time. The Step by Step Foundation acquired its first robotic exoskeleton in 2012. Four years later the organisation purchased two new ones. One of these will be upgraded thanks to the support of the Ramon Molinas Foundation.


The initiative provides treatment once the acute phase of the injury has passed

When someone suffers a spine or brain injury, the public health service provides excellent care in the acute phase, which can involve surgery and a comprehensive rehabilitation programme of between two and three months in specialised clinics. Once the acute phase has passed however, people with spine or brain injuries no longer have access to specialised centres that offer personalised care and treatment at an affordable price. This can lead to a loss of personal autonomy due to physical deterioration, and the onset of early, secondary complications, which in the long term, may cause difficulties when the person tries to reintegrate into society.

The Step by Step Foundation provides treatment to patients with spinal cord injuries, traumatic brain injuries, cerebrovascular injuries, neuromuscular disorders, multiple sclerosis, and other disorders of the central nervous system that have passed the acute phase of the rehabilitation process. Patients are referred by their hospital or from other organisations. The Step by Step Foundation then makes a diagnosis, identifies the person’s physical, psychological and social needs, develops a personalised treatment programme, and monitors their progress.

The organisation offers personalised treatment which is divided into unique zones and stages based on the objectives set in the assessment of each patient. Exercises are split into floor, working on the floor to activate motor activity patterns and strengthen the parts of the body above and below the injury; load-weight bearing, in which patients exercise with weights and weight distribution to stimulate the neuromuscular system, working with the force of gravity; stimulation zone, in which vibrations are used to counteract the loss of muscle mass; standing exercises, which exercises patient coordination and balance to improve posture in both sitting and standing positions; and step training, which makes use of the robotic exoskeleton.


The Step by Step Foundation, an organisation that seeks to improve the quality of life of adults with neurological injuries that have affected the central nervous system

The Step by Step Foundation was created in 2007 to offer personalised and quality physiotherapy to people with neurological injuries that have affected the central nervous system, improving the quality of life of patients.

The organisation believes in physiotherapy and in physical activity as tools to recuperate and stay healthy. Pending scientific advances that will allow for complete recovery of these patients, the Step by Step Foundation believes that it is essential to improve and strengthen the maximum residual capacity after the injury and keep the body in good physical health.

The Step by Step Foundation has two rehabilitation centres located in Barcelona and in Tenerife. The headquarters located in Barcelona helps more than 200 users every year, providing almost 16,000 hours of treatment.


Links of interest:

Step by Step Foundation website.