The role of robotic neurorehabilitation in treating spinal-cord injuries
A number of hospitals have incorporated service robots and robotized systems into rehabilitation schedules of many patients. So far, such a practice proves that rehabilitation and recovery of patients with integrated service robots and robotized systems do not last as long as conventional rehabilitation. The robotics technologies also assist the disabled in a way that improves the quality of their living and enables fuller stress-free lives.
Based on their use, rehabilitation robots are generally classified into two groups: therapy and aid. Furthermore, rehabilitation robots also cover prosthetic, neurostimulation and devices for assisting people in their daily activities. The following are the categories of robotics technologies based on their use:
- Robotic therapy for mobility (walking)
- Personal rehabilitation robots
- Robotic therapies for upper extremities
- Smart prosthetic
- Social service robots for personal care, autism and elderly care.
Lokomat* is one example of these devices. The results of the integration of this device into rehabilitation programs of disabled persons are promising. One outstanding feature of Lokomat is that its functions can be adapted to individual needs of primary users, even where children are concerned. This adaptability minimizes injury occurrences and enables an optimal 45-minute exercising regimen. Conventional exercising regimens do not stimulate the brain as much as Lokomat. Consequently, after finishing the conventional therapy, the condition of a person can worsen. This is not the case with Lokomat. On the contrary, the accomplished progress and the improvement are permanent.
When exercising with these robotic devices, a monitor is stationed in front of them. Their task is to overcome "obstacles" in video games by activating a target muscle group of upper or lower extremities and in that way to facilitate the recovery. A definite advantage of such an approach to physical therapy is that the brain sends the command for the movement of an arm or a leg which is not the case with the conventional physiotherapy. A dynamic weight relief is another important factor that enables a quicker recovery and longer and more intense workouts.
Other similar devices are Erigo – a modern table for a verticalization of patients that were bedridden for a longer period of time due to an injury they suffered or an illness. Armeo is the only device that is not automated. Tyromotion and PerPedes are also worth mentioning.
The mobility rehabilitation (walking) is the most important step that grants the highest level of independence in everyday life. The more profoundly improvised natural movements, the better. Thanks to the brain's plasticity they are permanently memorised.
Every year there are around 1 000 service robots installed for medical purposes – in the area of neurosurgery, orthopedics, endoscopy, mini-incision, ionizing radiation, colonoscopy, rehabilitation, patient care etc. Thanks to the development of information and sensor technologies, the integration of service robots in medicine is gaining more momentum on daily basis.
Since the process of recovery of mobility is especially strenuous and demanding for therapists, the integration of robotic technologies is seen as a primary goal. Rehabilitation hospitals throughout the world have already integrated dozens of robotic rehabilitation systems.
Key factors of successful neurorehabilitation and recovery are:
- The principles of motor learning should support the neuroplasticity and the recovery of the brain.
- The therapy should be intense. It should include frequent repetitions and an appropriate ratio of exercises.
- The patient should experience the therapy as something challenging and motivating.
- The feedback relating to the progress evaluation is highly motivating for patients.
As a consequence of an increasing loss of interest in health-care career opportunities, in 10 to 15 years robotics technologies and service robots will be in high demand. This is why we should encourage scientific institutions to develop prototypes of service robots to use them in areas of elderly care and rehabilitation.
*Lokomat is a robotic device that assists patients in the process of their recovery of the lost or weakened function of mobility (walking). The conventional approach to recovering the walking function is usually manual and demands up to five therapists per patient. Hocoma, a company located in Zürich, introduced Lokomat in 2004.