Robotics and Physical Therapy: Closer Than You May Think

Robotic technology is slowly making its way into the field of physical therapy. Two recent advancements exhibit the vast potential of robotics in therapy applications. The remarkable technology is offering hope to many patients suffering from spinal injuries and partial nervous system impairment, especially those who are recovering from a recent stroke. Stroke is the number one cause of adult disability; many stroke survivors are left with movement disabilities including weakness in limbs and muscles, partial or full paralysis, and the inability to move or walk. One of the more common disabilities is the loss of movement or the ability to grasp of the hands. A robotic therapy device was developed by a research team at the University of California, Irvine to treat these hand impairments. The device is named HOWARD, which stands for “Hand-Wrist Assisting Robotic Device” (pictured to the left and right). According to a press released just a few weeks ago, the device is designed to “help people regain strength and normal use of affected hands.” The robotic device is designed to wrap around the patients’ hands while they attempt to grasp and release various objects. The device works with a computer program that guides the patients through a physical therapy program. The device does not perform the whole motion for the patient; patients must first initiate the movement and the robot just assists and monitors. As Steven Cramer, a professor at UCI who was involved with this project, stated. “The HOWARD therapy isn’t passive; the patient has to jumpstart the program and initiate the motor command… but if the hand is weak and can only budge one-tenth of an inch, the robot helps to complete the task so the brain relearns what its like to make the full movement.” The studies that have been performed on this robotic device have had positive results. The study was performed on a number of people who recently suffered from a stroke that left their right hand functionally impaired. All patients, after a three week treatment program, improved their abilities to grasp and release objects. Their scores on the Action Research Arm Test (which measures the ability to perform real world tasks) rose by almost ten percent, and their scores on the Box-and-Blocks Test (which assesses skill as the patients move blocks in a given time) improved by twenty percent. The patients also developed a seventeen percent increase in the range of motion of their hands. The research showed that this brilliant application of robotics into physical therapy can be very effective. The device is currently being reworked and is going to be continuously tested, and it may one day become a regular in physical therapy clinics.

Another advance in robotic technology focuses on lower body rehabilitation. Researchers at the University of Michigan have developed a robotic exoskeleton that targets lower body motor disabilities. The “exoskeleton” is a robotic device that is attached to patients’ lower limbs to aid them in their motor function (pictured to the left and right). An amazing attribute of this device is that it is controlled by the user’s nervous system. Muscles from patients who suffer from various neurological disorders or spinal injuries do not receive proper signals from the brain that stimulate movement, which causes the motor disabilities. Through the use of electrodes attached to the patient’s leg, the device is able to receive these signals transferred from the brain and translate them into movement by the exoskeleton. The exoskeleton is designed to function like an exterior muscle; when the signals reach the robotic device, it contracts along with the patient’s muscles. Daniel Ferris, a professor in movement science at the University of Michigan, described how the device works; “The artificial muscles are pneumatic. When the computer gets the electrical signal from the wearer’s muscle, it increases the air pressure into the artificial muscle on the brace… the artificial muscle contracts with the person’s muscle.” So far, the device has been tested on healthy subjects to analyze how it affected the movement and function of the lower limbs. Although the researchers do not plan to commercialize the device, their research provides a tiny glimpse to the vast potential of this device in physical therapy applications. The robotic brace can be used directly in physical therapy treatment sessions or indirectly by simply helping patients walk and move more effectively. It is exciting to imagine that this is just the start of advanced technology being applied into the medical field. Due to their proven effectiveness, it would not be much of a surprise to see robotic devices like the two mentioned earlier in physical therapy clinics all across the world within a few years.