Interactive Robotic Therapy Helps Stroke Victims Regain Limb Function

Stroke patients can regain some ability to use their arms using a robot that delivers high-intensity response-controlled physical therapy, even if the stroke had occurred years earlier.

Researchers at the Massachusetts Institute of Technology (MIT, Cambridge, USA) developed the MIT-Manus system, which is based on the principal that it is important for stroke patients to make a conscious effort during physical therapy. Patients using the system grasp a joystick-like handle connected to a computer monitor that displays tasks similar to those in simple video games. In a typical task, the subject attempts to move the robot handle toward a moving or stationary target shown on the computer monitor. If the person starts moving in the wrong direction or does not move, the robotic arm gently nudges the patient's arm, wrist, or hand as he or she tries to make specific movements, helping the brain form new connections that will eventually help them "relearn” how to move the limb on their own.


A study with the system conducted at four U.S. Veterans Affairs (VA) hospitals found that patients who used the MIT robotic devices for 12 weeks experienced a small but significant gain in arm function, demonstrated again at 36 weeks. A control group of patients who received high-intensity therapy from a physical therapist, which matched the number and intensity of the robot movements--developed specifically for comparison purposes for this study--showed similar improvements. However, this high-intensity, interactive physical therapy exacts physical demands on the therapist that make it unlikely that it will ever be widely used. The researchers are also studying whether the MIT-Manus system could help patients with cerebral palsy, multiple sclerosis (MS), and spinal cord injury. The study comparing the two therapies was published in the April 16, 2010, online issue of the New England Journal of Medicine (NEJM).

"If you can get a therapist to work at that pace with a patient, certainly the benefits are roughly the same, and we showed this benefit when we designed this intensive comparison group, but it's not practical,” said MIT-Manus system principal developer Hermano Igo Krebs, Ph.D., of MIT's department of mechanical engineering. "Robotics and automation technology are ideal for this kind of highly repetitive tasks. We're using robotic technology to create a tool for the therapist to afford this kind of high-intensity therapy while maintaining the therapist supervisory role, deciding what is right for a particular patient.”

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Massachusetts Institute of Technology