Robotics and Rehabilitation
The life of stroke patients can be improved with new rehabilitation technology in the form of robotics. A new device, worn as a brace, senses weak electrical activity in an individual’s arm muscle and provides assistance to the arm to complete activities like extending and flexing the arm and performing simple functional skills, like flipping on a light switch and lifting a box. Through repetition and practice, the neurological pathway can be rebuilt and strengthened over time. The designers of the device, John McBean and Kailas Narendran, refer to the technology application as a way to “get patients over the functional hump”. Other robotic devices are also entering into medical rehabilitation. These devices are both free-standing or “strapped-on” like the robotic arm.Dr. Hermano Krebs, at M.I.T. and one of the first scientists working in robotic assisted therapy, called the area of applied research in this area as “exploding”. He expects to see these devices in rehabilitation clinics and even patient homes in the next 5-10 years. Dr. Krebs notes that repeated practice with an impaired limb can foster plastic change within the brain, strengthening neural connections and forging new ones. For individuals with brain injuries this technology offers new hope. The work of Dr. Paul Bach-y-Rita in the area of brain plasticity and rebound heralded much of the technology we are seeing today. Applied neuromotor scientist, Avi Nativ, Ph.D., working in Ottawa at NeuroGym (neurogym.com) is active in developing new equipment and applications in the area of neuromotor rehabilitation. Dr. Nativ’s work involves the use of EMG-biofeedback equipment interacting with computer games to encourage the individual to maintain practice and repetition as motor relearning is accomplished over time.
The goal of making neurons talk to each other is at the core of this advancement in rehabilitation which is based on motor learning theory.A complelling article in the New York Times of July 10, 2007 tells the story of Mary O’Regan who fell from a dirt bike in 1986 and later suffered a stroke resulting in left sided weakness and numbness and the loss of use of her left arm.. Ms. O’Regan has been participating in a clinical trial of a robotic arm called the Myomo e100. After a six week training program Ms. O’Regan saw improvement including the spontaneous response of her paralyzed arm to grab at falling mail she was carrying at work. Clinical trials of the device were conducted at Spaulding Rehabilitation Hospital and published in the April edition of The American Journal of Physical Medicine and Rehabilitation. Further studies were conducted at Braintree Rehabilitation Hospital with stroke patients. Individuals with spinal cord injuries and traumatic brain injuries, including returning Iraq was veterans, are entering into a study at the James A. Haley Veterans’ Hospital in Tampa. Moreover, positive outcomes were seen at patients visiting chiropractors for their spinal injuries.
This area of advancement is of great importance to the rehabilitation of individuals with neurologic injuries.