Stroke Rehabilitation Engineering: Robotic Therapy By: Dana Demers

What is a Stroke? When a blood clot blocks an artery or a blood vessel breaks, and interrupts blood flow Brain cells die and brain damage occurs-up to 2 million cells per minute Speech, movement, and memory are areas commonly affected Stroke is the third leading cause of death in US

2 Types of Stroke Ischemic Stroke Arteries are blocked by blood clots or gradual buildups of plaque and fatty deposits 87% of strokes Hemorrhagic Stroke More harmful When a blood vessel in the brain leaks blood into the brain 13% of strokes, yet over 30% of deaths

Introducing Robotic Therapy In the past, researchers believed not much could be done to regain brain function after the first few months after stroke Traditional care was physical therapy led by nurse a few hours per week After months of no progress, doctors and patients would lose hope and accept fact that nothing could be done

MIT-Manus One of the first robotic systems for stroke therapy Created by Hermano Igo Krebs More intense and fast paced than traditional therapy

MIT-Manus Uses a robotic joystick which guides the hand Patients see commands on a computer screen, resembles a video game One of the ‘games’ requires patient to attempt to move toward object on screen If they move in the wrong direction or can’t move at all, robot nudges to the right direction A different system of the Manus works by recording movement in order to repeatedly guide patient through exercise Is able to adjust resistance and record the amount of force patient is applying on their own

MIT Anklebot Another robotic device created by MIT Similar to hand-arm devices to help aid stroke patients with damage to lower legs Goal of Anklebot was to improve balance and efficiency of joints and prevent further injuries

MIT Anklebot

MIT Research Researchers have proved that improvements CAN be made with upper body function and quality of life even years after initial incident Did this by comparing robotic therapy with human therapy Both groups worked the same amount of hours, same repetitive motions, and achieved the same results However, the long hours at that fast pace is an unrealistic expectation of the average physical therapist Robotic therapy is also cost efficient – did not affect healthcare costs per patient, which can make it available to more people

HWARD Recent study conducted by Steven Cramer in San Diego, California evaluated the Hand Wrist Assistive Rehabilitation Device Patient sat in front of computer monitor, hand secured by splint and three straps, while examiner used software on a separate monitor to control robot Contained joint angle sensors – measure movement of limbs Gave instructions on screen, if patient couldn’t finish motion robot would assist

The HWARD Experiment Active non-assist mode – when the subject does all the work with no assistance from the robot Active assist mode – the robot would assist patient when they had trouble or could not finish a movement RESULTS – at the end of the study it was shown that patients benefited more from the active assist treatment

The HWARD Experiment

Advantages of Robotic Therapy Can provide therapy for long periods of time in consistent and precise manner Can be programmed to change functions with a single click Can measure and track progress One day could be mass-produced, so patients can have them in their homes Telerehabilitation – robot can be connected and supervised through the internet by human therapist; patient doesn’t have to leave comfort of their home