Robotics and Rehab

Planar Hand
Mike Donahue shows how patients use MIT-Manus robots to improve arm function. (Now at the Seattle Cancer Care Alliance, Donahue was a research coordinator at the VA.)

Jetpacks may not figure into our future (no time soon, anyway), but another high-tech instrument might: the therapeutic robot. These robots, designed to improve limb function after stroke — a leading cause of disability in the U.S. — may make their way into patients’ homes over the next few years.

Two UW Medicine alumni, Jodie Haselkorn and Janet Powell, both members of the Department of Rehabilitation Medicine, were part of a four-site study published in The New England Journal of Medicine in 2010. Funded by the Veterans Affairs Cooperative Studies Program and Rehabilitation Research and Development Service, the study involved approximately 120 veterans who had moderate-to-severe upper-limb impairment six or more months after their stroke.

“This study brought together two strands that we wanted to explore — the first being late motor recovery from stroke. The window for recovery may be much longer than we thought it was,” says Jodie K. Haselkorn, M.D., MPH, Res. ’89, UW professor in the Department of Rehabilitation Medicine. “The second is that there have been great advances in robotic rehabilitation devices.”

Veterans at the sites, which included the VA Puget Sound Health Care System, were divided into three groups. One group received standard health care, which, for some, included traditional therapy. The second group received intensive, repetitive rehabilitation from an occupational or physical therapist. The third group received intensive, repetitive rehabilitation from a robotic device developed at the Massachusetts Institute of Technology (MIT).

“A unique feature of the MIT-Manus robots is that they provide ongoing, responsive assistance to help the person complete a movement,” says Janet M. Powell, B.S. ’73, M.S. ’98, Ph.D.’01, OTR/L, UW associate professor of rehabilitation medicine in the Division of Occupational Therapy. The robot may prompt the patient to move, or help them finish or finesse a movement — hundreds of repetitive movements in each of the participant’s 36 sessions. “This real-time interactivity helps maximize the person’s independent movement,” she says. “It also helps avoid injury from overuse.”

The study determined that intensive therapy, both human and robotic, made modest improvements in veterans’ arm function, even six months or longer after a stroke. Haselkorn, Powell and their collaborators hold out hopes for integrating robots more thoroughly in stroke care, and not just in the clinic.

“Eventually, robots could be a cost-effective way of bringing therapy to a person’s home,” says Haskelkorn.

Read the published study at The New England Journal of Medicine.

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