Stroke Rehabilitation Engineering:Robotic TherapyBy: 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