Stroke Rehabilitation Engineering: Robotic Therapy By: Dana Demers

1. Stroke Rehabilitation Engineering:Robotic TherapyBy: Dana Demers

2. 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

3. 2 Types of Stroke Ischemic Stroke Hemorrhagic Stroke More harmful When a blood vessel in the brain leaks blood into the brain 13% of strokes, yet over 30% of deaths • Arteries are blocked by blood clots or gradual buildups of plaque and fatty deposits • 87% of strokes

5. 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

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

7. 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

8. 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

9. MIT Anklebot

10. 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

11. 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

12. 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

13. The HWARD Experiment

14. 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