The 'robot' method gives new hope to the 110,000 British stroke victims
Many patients have difficulty moving arms and shoulders after strokes
Robot-assisted rehab helps by ‘reading’ what the patient can and can’t do
Gradual approach encourages the muscle and nerve connections to regrow
By Mratyn Halle For The Mail On Sunday
Movement is being restored to the arms of patients paralysed by stroke – thanks to a robot physiotherapist and a retro ‘bat- and-ball’ computer game. The method gives new hope to the 110,000 British victims who are left with difficulty moving hands, arms and shoulders due to brain damage after a stroke. Robot-assisted rehab is a growing field of medical treatment. Usually the ‘robot’ takes the form of a kind of support that is worn in some way by the patient. The robot helps by ‘reading’ what the patient can and can’t do, and learns how and when to give support.
This gradual approach can encourage the muscle and nerve connections lost after a stroke to regrow. Improvements have been seen in patients treated up to five years after their initial stroke. Patients taking part in trials of the method sit at a table facing a computer screen and place their arm on to a specially designed support. Their arm moves a robot arm connected to the computer which in turn controls a spot or cursor that appears on the screen, enabling them to play games. In one game, designed to strengthen the wrist, patients play a ‘bat-and-ball’ computer game. If the rehab-robot senses the user is struggling, it steps in and helps to move their arm to complete the task.
In another game, which helps condition shoulder movement, they are asked to manoeuvre the spot to hit points on a clock, moving from a number and back to the centre repeatedly. Patients receive therapy for one hour, three times a week for 12 weeks. Stroke consultant Dr Helen Rodgers at Northumbria NHS Trust, one of four trial centres, says: ‘It’s fun, and patients get immediate visual feedback that their arm is doing something, which is a huge motivator.
But therapy like this means people regain the ability to dress themselves, eat with a knife and fork, and do ordinary things that stroke can rob people of the ability to do.’ Dr Rodgers, who is leading the trial, says that while stroke services in the UK are improving in terms of rapid treatment of strokes, rehabilitation still lags behind. And there is generally less attention paid to upper-body mobility, with most stroke rehabilitation focused on helping sufferers to walk again. Between 30 and 66 per cent of stroke victims regain their ability to walk, but only one in five recovers movement in the arms and shoulders. The arm robot was developed at the Massachusetts Institute of Technology in the US. Researchers there have established that the technology is highly effective at recovering movement in the arm, taking over the work that would normally be performed by physiotherapists. The robot is being put through its paces at Glasgow Royal Infirmary, Addenbrooke’s in Cambridge, Queen’s Hospital in London and Northumbria NHS Trust, Tyneside. The trial, involving 700 patients, is split into three equal groups with one group on the robot, a second having intensive therapy from a physio and the third getting standard physiotherapy.
One benefit of using the robot is that it frees up physiotherapists to help more patients. The robot also collects data in its computer of how well the patient has done, allowing accurate charting of progress.
Dr Rodgers believes the robot will boost recovery rates for arms and shoulders to those achieved for walking recovery. A bonus is that it can help people who have had strokes many years ago. She said: ‘We are enrolling people who had strokes as far back as five years.
‘It’s best to start physiotherapy soon after a stroke but we know that movement can be improved even if there has been a delay.’ Tom Means, 61, has already taken part in the robot trial. The electrician from Newcastle had a stroke last year and spent about two months in hospital. Now back at home, he continues to receive physiotherapy twice a week.
Immediately after his stroke, Tom attended North Tyneside General Hospital for sessions with rehab robot as part of the trial. He said: ‘After the stroke, my left arm was pretty useless – I couldn’t even feel it. Playing the old-fashioned computer games was actually quite fun and did get you moving. ‘After only a few sessions I really felt the difference. I haven’t recovered my arm mobility completely – I never will – but it’s vastly improved.’
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