Robots could help stroke rehab

A stroke can leave a patient without the use of a limb, making even a simple task, such as reaching for a glass on a table, an…

A stroke can leave a patient without the use of a limb, making even a simple task, such as reaching for a glass on a table, an enormous physical challenge. About a third of stroke victims need intensive physical rehabilitation to regain lost movement.

Physiotherapists currently must sit with the patients and manually help them repeat lost movements over and over until the motions once again become automatic.

Researchers in Trinity College Dublin are developing an alternative method, "robot mediated therapy", which uses robotics to rehabilitate the patients.

Ms Emma Stokes, lecturer in the school of physiotherapy, TCD, the lead clinical partner in the research, said using robotics would hopefully lead to better treatment for patients, would be more cost-effective, and would allow the physio to treat more patients.

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The project's research assistant in Dublin is Ms Susan Cooke. A number of other research institutions across Europe are also involved in the project.

A stroke is a sudden loss of brain function caused by a blockage or rupture of a blood vessel to the brain. Lost blood supply causes the death of brain tissues in the area affected.

Some 30,000 people in the State have acquired a disability after a stroke.

Normally, cells in the brain fire a pattern of signals which tell the body to perform a specific task. Getting the cells to fire in the same way after a stroke but in a neighbouring part of the brain may lead to a return to normal function, Ms Stokes said.

The best way to achieve this is to repeat movements - such as reaching for a glass - so the brain can relearn the process.

After a stroke the arm does not improve as much as the leg. Research has found between 75 and 83 per cent of stroke victims recover the ability to walk. But one fifth of stroke victims have serious difficulty using their arms in the six months after a stroke.

This is because a high percentage of strokes occur in an area of the brain, the middle cerebral artery, which controls much of the upper body movement.

Rehabilitation is often needed to regain this movement. Ms Stokes uses the analogy of learning to play tennis. When trying to improve a serve, the player will repeat it again and again until the movements become automatic.

In robot-mediated therapy, the patient sits in a special chair and their arm is then placed into a support, which attaches the patient to the robot.

The patient can watch their progress in a "virtual room", where the patient sees on screen a simulation of the task they are trying to achieve - reaching for a glass, or trying to grab a ball, for example.

If the patient is completely without movement, the robot will provide all the motion. If the person has limited movement then the robot will assist the motion only as necessary.

The robotics treatment can be tailored for each patient, as the exact movement which will be beneficial to the patient is programmed by the physiotherapist.

Robots have been used previously in rehabilitation, but only as a means of assisting patients perform tasks, not as a form of treatment.

The project involving the TCD researchers is one of two currently taking place in Europe which aim to use robotics to rehabilitate stroke victims. The other, in Hungary, has received some bad publicity, said Ms Stokes.

Some physiotherapists there believed the robot would diminish their role. This will not happen with this research project, she believes.

It will be "an adjunct which will allow people more good therapy", said Ms Stokes.

She said replacing the physio "won't ever be a possibility, as you will always need a therapist to interact with the patient".

A pilot study involving the new technology received a very good response from patients, she said.

Clinical trials, which will examine whether the technology actually has therapeutic benefits, are to begin in September.