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Ekso BionicsJanuary 2018
#MOVINGASONE© 2018 Ekso Bionics Holdings, Inc. All Rights Reserved.
eksobionics.com
Ekso Bionics | 2
Forward Looking Statements
© 2018 Ekso Bionics Holdings, Inc. All Rights Reserved.
Any statements contained in this presentation that do not describe historical facts may constitute forward-looking statements.
Forward-looking statements may include, without limitation, statements regarding (i) the plans and objectives of management for
future operations, including plans or objectives relating to the design, development and commercialization of human
exoskeletons, (ii) a projection of financial results, financial condition, capital expenditures, capital structure or other financial
items, (iii) the Company's future financial performance and (iv) the assumptions underlying or relating to any statement described
in points (i), (ii) or (iii) above. Such forward-looking statements are not meant to predict or guarantee actual results, performance,
events or circumstances and may not be realized because they are based upon the Company's current projections, plans,
objectives, beliefs, expectations, estimates and assumptions and are subject to a number of risks and uncertainties and other
influences, many of which the Company has no control over. Actual results and the timing of certain events and circumstances
may differ materially from those described by the forward-looking statements as a result of these risks and uncertainties. Factors
that may influence or contribute to the inaccuracy of the forward-looking statements or cause actual results to differ materially
from expected or desired results may include, without limitation, the Company's inability to obtain adequate financing to fund the
Company's operations and necessary to develop or enhance our technology, the significant length of time and resources
associated with the development of the Company's products, the Company's failure to achieve broad market acceptance of the
Company's products, the failure of our sales and marketing organization or partners to market our products effectively, adverse
results in future clinical studies of the Company's medical device products, the failure to obtain or maintain patent protection for
the Company's technology, failure to obtain or maintain regulatory approval to market the Company's medical devices, lack of
product diversification, existing or increased competition, and the Company's failure to implement the Company's business plans
or strategies. These and other factors are identified and described in more detail in the Company's public filings with the
Securities and Exchange Commission ("SEC”). You should carefully read our Cautionary Note Regarding Forward-Looking
Statements and the factors described in the "Risk Factors" section of the prospectus filed with the SEC to better understand the
risks and uncertainties inherent in our business. The Company does not undertake to update these forward-looking statements.
Ekso Bionics | 3© 2018 Ekso Bionics Holdings, Inc. All Rights Reserved.
Investment Highlights
Transformative
Technology
Compelling
Medical
Evidence
Robust
Clinical
Evidence
Growing
Commercial
Success
Industrial
Market
Proprietary wearable exoskeletons
Only exoskeleton specifically cleared by FDA for both Stroke and Spinal Cord Injury (SCI)
Multiple large current market opportunities in healthcare
o Stroke: 15 million incidences per year worldwide
o SCI: up to 500,000 incidences per year worldwide
Clinical studies showing improved patient outcomes
o Successfully improving step count and functional independence measures (FIM)
o Industry-first study to evaluate clinical and economic impact of Ekso with SCI patients
$21 billion workplace related injuries on construction sites in the US can be addressed by Ekso’s
proprietary solutions
Over 275 Ekso GT units and 325 EksoWorks products placed in the field
Preliminary Q4 2017 Revenues of $2.5M, up from $1.6M in Q3 2017
Ekso Bionics | 4© 2018 Ekso Bionics Holdings, Inc. All Rights Reserved.
Multiple Global Market Opportunities
Unique Opportunity to Address Challenges & Cost of Care in a Large Patient Population
World North America EMEA
Burden of stroke is projected to
grow from ~38M disability-
adjusted life years globally in
1990 to ~61M in 2020.1
15M people worldwide suffer a
stroke.1
Str
oke
SC
I
In Europe, stroke incidences are
projected to grow from 1.1M per year in
2000 to >1.5M per year in 2025.4
Across the European Union the total
cost of stroke was estimated to exceed
27€B.8
The cost to treat stroke is projected to
double from $72B in 2010 to $183B in
2030.9
Nearly 7.4M stroke survivors in the US
and Canada are experiencing a lifelong
recovery process.2, 3
Globally between 250,000 and
500,000 people suffer an SCI
annually.5
People with SCI are two to five
times more likely to die
prematurely.5
250,000 Americans are living with SCI
and 17,500 new cases per year6
The average LOS for SCI in acute care
is 15 days and in rehabilitation 44 days
totaling $198,000.6
In Europe, approximately 333,000
people are living with SCI.7
In Europe, there are about 11,000
new cases per year attributed to
vehicular or sports accidents
alone.7
Current Treatment Options
Current “technologies” are sub-optimal
o Labor-intensive for PTs
o Limited high dose/high intensity therapy
o Do not support early mobilization
o Limited patient engagement
o Do not restore a normal gait pattern
o 15 minutes = average time stroke inpatients currently spend on
mobility tasks PER DAY
o A severe stroke inpatient spends an average of ~95.5% of the
day in bed
Today there is no consistent standard of care
Ekso Bionics | 5© 2018 Ekso Bionics Holdings, Inc. All Rights Reserved.
Significant Unmet Need
Fastest patient to patient change-overWearable Exoskeleton
Promotes early mobility and corrects posture
Hand-Held Controller
Real-time adjustments by physical therapists
Adjustable Software
Enables personalization for unique challenges
SmartAssist Software
Prepares a patient to get back on their feet
EksoPulse Analytics
Quantifiable utilization metrics in the cloud
Ekso Bionics | 6© 2018 Ekso Bionics Holdings, Inc. All Rights Reserved.
Only FDA Cleared Exoskeleton for Stroke & SCI
Ekso Bionics | 7© 2018 Ekso Bionics Holdings, Inc. All Rights Reserved.
C1
C2
C3
C4
C5
C6
C7
C8
T1
T2
T3
T4
T5
T6
T7
T8
T9
T…
T…
T…
L1
L2
L3
L4
L5
S1
S2
S3
S4
S5
Discharge rate
by injury level
Wide SCI range
Hemiplegia
Continuum of care
(*) See website for label
Addressing Broadest Array of Patient Need
quick-fit Stand/Sit PreGait SmartAssist Free Gait beyond
Remembers
patients from
session to
session
New options offer
comfort for larger
patients
Supported squats,
balance, and
marching help build
strength to start
walking
More intuitive
forces to help
patients learn
step through
Stance assist to
help patients to
gain stance
strength
Gravity-supported
walking for high
step dosage
FES interface for
next-generation
therapy
Broad-based applicability – both by disease state and throughout patient stay - enables hospitals to
enhance ROI
Ekso Bionics | 8© 2018 Ekso Bionics Holdings, Inc. All Rights Reserved.
Improving Outcomes and Cost of Care
Administrator
“Skeptic”
Patient &
Caregivers
“Friend”
Pa
tie
nt C
ap
ab
ility
(FIM
sco
re, D
ista
nce
, B
ala
nce
, G
ait)
t = 0Average Length of Stay
(Days)
Current SOC: 2-3 PTs for acute
stroke manual therapy with risk
of readmission after discharge1
Goal: 1-2 PTs for acute stroke
robotic therapy with reduced risk
of readmission yet same length
of stay. *
(*) Actuals under clinical evaluation
Powered exoskeletons could increase early mobility improve function and reduce cost of care
Increased motor FIM scores1
Increased distances walked1
Improved balance2
Established a more natural gait3
Increased aerobic endurance, leg strength4
Promoted Neuroplasticirty5
Better Patient Outcomes
9Ekso Bionics | 9© 2018 Ekso Bionics Holdings, Inc. All Rights Reserved.
Empowering Customers to Achieve Excellence
Hospital: Rehabilitation with Ekso GT Reduces Costly Co-Morbidities
Rehab Facility: Increased Revenue and Cost Efficiencies
Early Mobilization reduces risk of complications6
Walking reduces incidences of UTI, DVT, HAP7, 8, 9
Walking leads to better discharge outcome1
Attraction of more (profitable) patients/expansion of catchment area for facility
Increased billable sessions per day
Reduction in labor costs
Possible reduction in PT injuries/turnover
Feasibility, single case
or case series,
comparative & single
arm multicenter
Ekso Bionics | 10© 2018 Ekso Bionics Holdings, Inc. All Rights Reserved.
Completed
29 Studies
o 8 SCI
o 4 stroke
o 2 multi-injury
N = ~400 patients
Ongoing
17 Studies
o 7 SCI
o 4 stroke
o 1 MS, 1CP
N = ~600 patients
Wise study
(Ekso-sponsored,
8+ centers)
Upcoming
Registry – HTA Type (RIC coordinating site)
Stroke Rehab (Kessler Foundation, Karen Nolan(1))
o Examining impact on gait function, balance, and
neuromuscular responses, as well as community
participation and overall quality of life.
Stroke, EMG, EEG – Neuro-gait project goals (EMEA)
o Developing hardware and integrate EMG/EEG data for
bio-signal processing with Ekso
o Indexing prognosis for motor recovery after stroke
SCI (Alberta Health Services; grant-funded)
o Seven Ekso sites matched with seven non-Ekso sites
o Six and 12 week training with durability assessments
SCI and Reduction in Bone Loss – Sheffield Project
SCI – EKSO, pharma, stimulation
o Determine effects of non-invasive electrical and
pharmacological neuromodulation on standing and
stepping in Ekso.
o Develop closed-loop EMG biofeedback system that
adjusts robot
Clinical Evidence Roadmap
Multi-center, larger
sample sizes in some
studies
(1) See http://www.eurekalert.org/pub_releases/2016-01/kf-kfa010716.php
(2) See March 2017 Clinical Summary on website
Research has shown training in Ekso GT is safe and
progression in the device is feasible. Early data
demonstrates training improves walking and functional
outcomes.(2)
Page 11
Early Adopters Pave Way for Broad UtilizationEarly Adopters Pave Way for Broad Utilization
© 2018 Ekso Bionics Holdings, Inc. All Rights Reserved. Ekso Bionics | 11
Ekso GT Outpatient Case Study
Ekso Bionics | 12© 2018 Ekso Bionics Holdings, Inc. All Rights Reserved.
Shifted rehabilitation program to focus on Neuroplasticity
o Repetition, practice fundamentals
o Task specificity and intensity
o Normal biomechanics with minimal compensation
Within 3-months, Ekso GT was in usage 35+ hours/week
Staff sees better outcomes and patients improving more
quickly
Within 12-months, success in the out-patient setting led to
purchase of a 2nd Ekso GT for use in-patient
Transitioned from 2 PTs to 1 PT
Expanded catchment area from a 20-mile range to six hours
and a 110% increase in locomotor training
The number of patients who used the Ekso GT during in-patient rehabilitation who required
robotic gait training when they entered the outpatient setting was reduced by 50%
Capital investment $150,000
5-Year EBITDA $513,000
Payback Period <2 years
IRR >50%
5-Year Financial Return(1)
(1) From December 2016 presentation at Ekso Bionics’ Analyst Technology Day
Direct
Distributor
Global Headquarters:
Richmond, CAEMEA Headquarters:
Germany
North America
• 5 Direct Sales People
• 6 Clinical Specialists
• National AccountEMEA
• 3 Direct Sales People
• 4 Clinical Specialists
• Distributors Manager
Focus on key in- and out-patient
centers that provide stroke and SCI
rehabilitation
Sales and support currently consist of
35+ professionals
A typical Ekso package includes:
o an Ekso GT
o two sets of batteries for continuous run-time
o training through two levels of certification
o SmartAssist software
o Ekso Care - 1- to 4-year after-sales service
Sales cycle currently averages 12
months
Ekso Bionics | 13© 2018 Ekso Bionics Holdings, Inc. All Rights Reserved.
Sales Overview
Gait training post-stroke
SCI up to C-7 (ASIA D)
Suit adjusts to fit patient (<10 minutes)
Software adjustable while walking
One size fits most patients
Multiple indications with one device
Home use
Ekso
Strong Competitive Position
ReWalk Indego
IndegoReWalk
Non FDA-cleared medical
exoskeleton companies:
Cyberdyne (Japan)
Bionik Labs (Canada)
Rex Bionics (NZ/UK)
Ekso Bionics | 15© 2018 Ekso Bionics Holdings, Inc. All Rights Reserved.
Building a Trusted Brand to Serve Growing Mobility Challenges
Minor
Moderate
Major
18,980,000 (1)
Moderate: persons reporting a lot of
difficulty with walking or climbing
stairs or standing or uses a walker
Minor: persons reporting some difficulty
with walking or climbing
stairs or standing or uses a
cane/crutches
Major: persons reporting being unable to
perform walking or climbing
stairs or standing or uses a manual or
powered wheelchair or scooter
(1) Lezzoni L et al, Mobility Difficulties Are Not Just a Problem of Old Age; Journal General Internal Medicine, Volume 16, Issue 4, pages 235–243, April 2001; N=145,000
30%
28%
42%
Potential
addressable
home
mobility
market
(US Only)
Adaptable to most
surfaces and slopes
Increased independence
More affordable
(reimbursement)
Versions of products
available to support
different levels of need
Requirements to meet
needs for home mobility
Ekso Bionics | 16© 2018 Ekso Bionics Holdings, Inc. All Rights Reserved.
Home Mobility- Products for Different Disease States
A Strategy for Success
Ekso Bionics | 17© 2018 Ekso Bionics Holdings, Inc. All Rights Reserved.
Own the rehabilitation market
o Best in class technology, key opinion leaders, multi-unit centers
Establish Ekso as standard of care
o Clinical studies providing data for early identified potential outcomes
o Support customer revenue growth and cost savings
Enable rehabilitation to serve as “Base Camp” for broader
business
o Platform for safety, efficacy and cost effective technology
Develop home mobility and wellness product$20+B Addressable Market (US only)
Home/community mobility
Chronic conditions: SCI, Stroke, TBI
Endurance impaired conditions:
oOsteoarthritis
oMultiple Sclerosis
oParkinson’s Disease
oCerebral Palsy
$1+ B Global Addressable Market
Rehabilitation facilities
Acute conditions:o SCI
o Stroke
Basecamp
Light weight
Strength augmentation
Natural range of motion
Load carriage (load bearing)
Ultra Low Power Consumption
Geometries for tool holding/load lifting
Novel Actuation strategies
Enhanced endurance
Safe and effective
Energy efficiency
Medical
Energy efficient
Load carriage
Un-actuated
exoskeleton structure
Control methods for
assisting gait
Efficient hydraulic
actuation
Methods on how medical
exoskeleton decides when to
initiate gait
Basic exoskeleton IP for
variable assist
Add-ons that complement
exoskeleton usability
Able Bodied
65 U.S. Patents
28 issued
33 in prosecution
3 provisional
214 Int’l Patents
112 issued
102 in prosecution
Ekso Bionics | 18© 2018 Ekso Bionics Holdings, Inc. All Rights Reserved.
Industry Leading, Extensive IP Portfolio
Ekso Works Mount Products
Makes tools weightless (up to 36lbs)
Works with existing tools and existing work platforms
Minimal Training Required (<5 min)
Increases Safety
Increases Productivity
Increases Quality
Reduces Fatigue
“Now one man operates safely and
precisely. They use half the manpower
and currently are producing nearly twice
the output in the same time.”
- Neil Young, VCC
Ekso Bionics | 19© 2018 Ekso Bionics Holdings, Inc. All Rights Reserved.
Able-bodied Industrial Solutions
Human Capability Augmented with Mechanical Strength and Endurance
• Offloads heavy tool weights
• Ease of adoption
• Works with existing tool and work
platforms
• Makes arms buoyant
• Provides increased agility / lower
direct tool weight on worker
• Facilitates Chest Level and
Overhead Tasks
• Offloads heavy tool weights
• Enhances worker mobility &
endurance
H2/2016 H2/2017 2018
Ekso Zero G Ekso Vest Ekso Suit
Ekso Bionics | 20© 2018 Ekso Bionics Holdings, Inc. All Rights Reserved.
Sofor Commercial Success
Trusted brand with commercial traction
Transitioning to Standard of Care to tap $1+ billion market opportunity, with
potential to expand
o Applications and target customer
o Geographic footprint to Asia
Investing further in product development for next generation suite of home
mobility and wellness products
Building Ekso Works
o Arms, vests and suits
o Leverage IP for additional financial upside
Solid Cornerstones for Commercial Success
Ekso Bionics |22© 2018 Ekso Bionics Holdings, Inc. All Rights Reserved.
Thank You
“Movement is the
essence of life”- Bernd Heinrich
Ekso Bionics | 23© 2018 Ekso Bionics Holdings, Inc. All Rights Reserved.
Unique Insight for Rehabilitation
1. Russo A et al, Utilization of a robotic exoskeleton to provide increased mass practice for gait training and its impact on discharge destination for individuals with
acute stroke. Poster presented at International Stroke Conference, 2016.
2. Arun Jayaraman, PT, PhD, et al, Evaluation of the Clinical Criteria for Safe and Efficient Use of Exoskeletons in Individuals with SCI, presented at of the at the
2013 American Spinal Injury Association (ASIA) conference, 2013
3. Salbach NM, et al, A task-orientated intervention enhances walking distance and speed in the first year post stroke: a randomized controlled trial , Clin Rehabil
May 2004; vol. 18 no. 5, 509-519.
4. Knorr S, et al, Perspective on neuromuscular factors in post-stroke fatigue, Disabil Rehabil. 2012;34(26):2291-9. doi: 10.3109/09638288.2012.683233. Epub
2012 Jun 5.
5. Good Shepherd case study
6. Cumming T et al, Very Early Mobilization After Stroke Fast-Tracks Return to Walking, Further Results From the Phase II AVERT Randomized Controlled Trial;
Stroke, 2011; 42: 153-158.
7. Rogers MAM et al, Mobility and other predictors of hospitalization for urinary tract infection: a retrospective cohort study, BMC Geriatrics2008, 8:31.
8. Bravata DM et al, Processes of care associated with acute stroke outcomes, Arch Intern Med. 2010 May 10;170(9):804-10.
9. Pashikanti L et al, Impact of Early Mobilization Protocol on the Medical-Surgical Inpatient Population: An Integrated Review of Literature, Clinical Nurse
Specialist: March/April 2012 - Volume 26 - Issue 2 - p 87–94.
Ekso Bionics | 29© 2018 Ekso Bionics Holdings, Inc. All Rights Reserved.
Sources