Executive Summary / Key Takeaways

• Ekso Bionics is undergoing a strategic transformation, shifting from its legacy Enterprise Health segment to a high-growth Personal Health market, primarily driven by the Ekso Indego Personal device and critical CMS reimbursement.
• Technological innovation, particularly through a strategic partnership with NVIDIA and the development of AI-powered human motion models, is a core differentiator, leveraging a vast proprietary patient data set to enhance device capabilities and user experience.
• Despite historical operating losses and current liquidity challenges, evidenced by a "going concern" warning, management is actively pursuing financing and strategic transactions to capitalize on market opportunities and fund operations into Q1 2026.
• The Personal Health segment, projected to contribute 25% of total revenue in 2025 and potentially surpass Enterprise Health by 2027, represents a significant growth driver, supported by expanding distribution networks and a growing pipeline of qualified Medicare beneficiaries.
• While the company faces intense competition from diversified industrial and medical technology giants, its specialized focus on exoskeletons and innovative AI integration positions it uniquely within the assistive technology landscape.

A New Gait for Growth: Ekso Bionics' Strategic Evolution

Ekso Bionics Holdings, Inc. (NASDAQ:EKSO), founded in 2005, has long been at the forefront of designing, developing, and marketing exoskeleton products that augment human strength, endurance, and mobility. Initially focused on the healthcare market for physical rehabilitation, the company's journey has been marked by continuous innovation and strategic expansion. A pivotal moment arrived with the December 2022 acquisition of Parker Hannifin 's Human Motion Control (HMC) business unit, which brought the Ekso Indego Personal and Ekso Indego Therapy devices into its portfolio, signaling a strategic entry into the personal health market. This move laid the groundwork for a significant shift in Ekso's growth trajectory, aiming to unlock a broader addressable market for its life-changing technology.

The broader industry landscape for assistive technologies is experiencing robust growth, fueled by an aging population, increasing awareness of rehabilitation robotics, and advancements in medical device reimbursement. Within this dynamic environment, Ekso Bionics operates across two primary markets: Enterprise Health and Personal Health. The Enterprise Health segment, featuring devices like EksoNR and Ekso Indego Therapy for clinical neurorehabilitation, and the industrial EksoWorks EVO exoskeleton, has established Ekso Bionics as a leader, with EksoNR deployed in 9 of the top 10 rehabilitation centers in the United States, indicating its status as a standard of care for lower extremity neurorehabilitation. However, the future growth narrative is increasingly dominated by the burgeoning Personal Health market.

Technological Edge: AI as the Next Frontier in Human Motion

Ekso Bionics' core competitive advantage lies in its proprietary exoskeleton technology, which provides tangible benefits in rehabilitation and mobility. The EksoNR, for instance, is a wearable robotic suit designed to assist physical therapists in treating patients with acquired brain injury, stroke, and spinal cord injury, enabling earlier and more intensive mobilization. The Ekso Indego Personal, a lower extremity powered exoskeleton, empowers individuals with spinal cord injuries to stand and walk independently in home and community settings, a profound improvement in quality of life. For industrial applications, the EksoWorks EVO upper body exoskeleton elevates and supports workers' arms, reducing fatigue and injuries in overhead tasks.

Beyond its existing product suite, Ekso Bionics is making significant strides in technological innovation, particularly in Artificial Intelligence (AI). The company's acceptance into the NVIDIA (NVDA) Connect program in May 2025 marks a strategic initiative to build the world’s first known proprietary foundation model for human motion in physical rehabilitation. This ambitious project aims to integrate powerful new AI capabilities across its entire portfolio of Enterprise Health and Personal Health devices. Just over a month after joining the NVIDIA program, Ekso demonstrated an initial proof-of-concept for an AI voice agent designed for intelligent control of the EksoNR device. This edge AI system, developed with NVIDIA Jetson Orin Nano hardware and OpenAI tools, highlights the company's commitment to transforming human-robot interaction.

The "so what" for investors is clear: Ekso Bionics possesses a unique and growing repository of patient data, comprising approximately 350,000 patient sessions and over 15 million step-by-step data points, expanding by an additional 60,000 steps daily. This extensive dataset, combined with NVIDIA's advanced tools, uniquely positions Ekso to leverage AI to advance exoskeleton technology platforms. Management explicitly views AI as a "necessary component to enable broader adoption of exoskeletons for personal use," suggesting that these technological advancements will not only enhance existing products but also unlock new market opportunities and solidify the company's competitive moat.

Financial Performance and Strategic Pivots

Ekso Bionics' financial performance in recent periods reflects a company in transition, balancing the stability of its Enterprise Health segment with the rapid growth of Personal Health. For the three months ended September 30, 2025, revenue increased by 2% year-over-year to $4.227 million, primarily driven by a high-margin, multiple-device sale of EksoNR devices in the Americas. Gross profit for the quarter rose by 15% to $2.549 million, with gross margin expanding to 60% from 53% in the prior year, attributed to lower device costs and improved service margins. Operating expenses saw significant reductions, with sales and marketing down 25%, R&D down 29%, and G&A down 10%, largely due to Employee Retention Credit (ERC) benefits and headcount reductions.

However, the nine months ended September 30, 2025, presented a more challenging picture, with total revenue decreasing by 25% to $9.659 million compared to the same period in 2024. This decline was primarily driven by a decrease in Enterprise Health device sales in the EMEA region, partially offset by growth in the Americas. Gross profit for the nine-month period decreased by 24% to $5.174 million, though gross margin slightly improved to 54% from 53% due to cost savings and improved service margins, despite the impact of fixed costs on lower Enterprise Health sales volume. The second quarter of 2025 experienced "abnormal weakness" in revenue, reaching $2.1 million, a significant drop from $5 million in Q2 2024, mainly due to short-term delays in closing multi-device Enterprise Health sales and capital budget impacts on certain inpatient rehabilitation facilities.

Liquidity remains a critical area for Ekso Bionics. As of September 30, 2025, the company reported cash of $2.722 million and an accumulated deficit of $257.722 million. Operating activities consumed $7.470 million in cash during the nine months ended September 30, 2025.

Management has explicitly stated "substantial doubt exists about our ability to continue as a going concern for a period of at least 12 months" from the 10-Q filing date. To address this, Ekso Bionics is actively pursuing additional financing, including a $2.000 million Secured Promissory Note with B. Riley Commercial Capital, LLC (RILY), and has $3.100 million available under its At The Market (ATM) Agreement.

Management estimates current cash will fund operations into the first quarter of 2026, necessitating further external financing through various means, including potential equity offerings, debt, or even the sale of a product line or the entire business.

Competitive Landscape and Strategic Positioning

Ekso Bionics operates in a competitive landscape with both direct and indirect rivals. Direct competitors include specialized exoskeleton companies like ReWalk Robotics (RWLK) and larger, diversified medical technology and industrial firms such as Stryker Corporation (SYK) and Parker Hannifin (PH).

Compared to ReWalk Robotics, which primarily focuses on lower limb rehabilitation, Ekso Bionics offers a broader product range spanning both medical (EksoNR, Ekso Indego Therapy, Ekso Indego Personal) and industrial (EVO) applications. This diversification provides Ekso with a wider market reach and potentially greater resilience against sector-specific downturns. While ReWalk may hold a more specialized niche in certain rehabilitation aspects, Ekso's proprietary bionic suit technology, particularly its adaptability for therapists and its growing AI integration, offers a distinct advantage in user-centric innovation.

Against industrial giant Parker Hannifin, Ekso Bionics' specialized focus on wearable exoskeletons allows for faster innovation and significantly greater user-specific customization in medical and industrial settings. While Parker Hannifin benefits from extensive engineering expertise and a global distribution network, Ekso's targeted approach with devices like EVO can deliver materially better ergonomic support for repetitive tasks. However, Ekso's smaller scale can lead to higher operational costs compared to Parker Hannifin's efficient supply chain.

Stryker Corporation, a dominant player in medical robotics, presents competition through its integrated medical ecosystems. Ekso's EksoNR and Ekso Indego Personal offer more targeted rehabilitation support, potentially with greater ease of use for specific conditions. Ekso's direct sales and rental model also contrasts with Stryker's broader system focus, potentially making Ekso more accessible to smaller healthcare providers. Yet, Stryker's larger scale and robust R&D capabilities mean Ekso lags in overall financial metrics and comprehensive product ecosystems.

Overall, Ekso Bionics maintains a niche but strategically important position. Its strengths lie in product diversification, user-centric innovation, and a proactive embrace of AI. The company's partnerships, such as with National Seating & Mobility (exclusive distributor for Complex Rehabilitation Technology) and Bionic Prosthetics Orthotics Group (O&P distributor), are crucial for scaling its Personal Health market access and navigating the complex reimbursement environment. These partnerships leverage the expertise of larger organizations, providing cost efficiencies compared to building in-house capabilities.

Outlook and Growth Drivers

Management's outlook for Ekso Bionics is anchored in a dual strategy of stabilizing its Enterprise Health business while aggressively scaling its Personal Health segment. The company anticipates closing a significant portion of deferred multi-device Enterprise Health sales, including a North American IDN order in the $1 million range, by year-end 2025. Furthermore, Ekso expects a return to standard procurement cycles for large integrated delivery networks in North America in 2025, leading to more multi-unit orders. International demand, particularly in Europe, is expected to remain strong, though the exceptional growth seen in 2024 is projected to normalize.

The Personal Health market, driven by the Ekso Indego Personal device, is poised for substantial growth. Following CMS approval for Medicare reimbursement at approximately $91,000 per device, the company has established a scalable go-to-market strategy. This includes strategic partnerships with PRIA Healthcare for market access guidance and key distribution agreements. As of September 2025, Ekso Bionics had a pipeline of over 50 qualified Medicare beneficiaries, with claims expected to be submitted over the next 12 months. Management projects Personal Health products to contribute approximately 25% of total revenue in 2025, a significant increase from 10% in 2024, with the potential to surpass Enterprise Health revenue by 2027. The Nomad product is also slated for general commercialization in 2026, subject to clinical feedback.

Operationally, Ekso Bionics expects gross margins to "continue to trend up as 2025 progresses," driven by ongoing cost savings in supply chain, manufacturing efficiencies, and improved service margins. The launch of eksoUniversity, a virtual platform for continuing education for physical therapists, aims to further raise awareness and adoption of exoskeleton technology.

Risks and Challenges

Despite the promising outlook, Ekso Bionics faces significant risks. The most pressing is the "substantial doubt" regarding its ability to continue as a going concern, stemming from historical operating losses and negative cash flows. The company's reliance on external financing, with no assurance of obtaining funds on acceptable terms, poses a material threat. Future equity issuances, including those for strategic transactions or to satisfy warrants, will likely result in further dilution for existing shareholders.

Market-specific risks include the impact of federal funding policy changes on Enterprise Health customers and the uncertainty surrounding CMS reimbursement policies for the Ekso Indego Personal. While initial claims have been reimbursed, the appeals process is lengthy, and policies from regional DME Medicare Administrative Contractors are still evolving. There is no guarantee of obtaining private insurance coverage beyond CMS and VA. Furthermore, the company faces pricing pressures from managed healthcare trends and the challenge of reducing manufacturing and service costs as planned. Supply chain disruptions and risks associated with international sales, including currency fluctuations and political instability, also remain pertinent. Material impairments in intangible assets, such as the $180,000 impairment loss on the Vanderbilt Knee License Agreement in Q1 2025, could also negatively affect operating results.

Conclusion

Ekso Bionics stands at a critical juncture, poised for a transformative shift driven by its innovative exoskeleton technology and a strategic pivot towards the Personal Health market. The company's commitment to AI integration, leveraging its unique patient data, presents a compelling long-term differentiator in the rapidly evolving field of human motion robotics. While the path to sustained profitability is challenged by historical losses and immediate liquidity concerns, management's aggressive pursuit of financing and strategic partnerships, coupled with a clear roadmap for Personal Health growth, signals a determined effort to capitalize on a substantial addressable market.

Investors should closely monitor the successful execution of the Personal Health go-to-market strategy, particularly the efficiency of CMS reimbursement processes and the scaling of distribution networks. The ability to secure additional financing without excessive dilution and to realize the full potential of its AI initiatives will be paramount. Despite the inherent risks, Ekso Bionics' technological leadership and strategic focus on empowering individuals with greater mobility position it as a compelling, albeit speculative, investment opportunity for those with a long-term horizon and an appetite for growth in the innovative medical technology sector.