Robot technology is offering incapacitated stroke patients some help.
According to the scientists from at the University of California, Irvine, a robotic hand is helping patients get strength and movement back so they are able to perform simple acts such as grasping and releasing objects.
"Robots may help patients decrease disability after experiencing stroke," informed lead scientist, Dr Steven C. Cramer, an associate professor of neurology, anatomy and neurobiology. "People who had weakness months to years after stroke were able to have improved movement in their arm and hand as a consequence of the robot therapy."
Cramer was scheduled to describe the new device, known as the Hand-Wrist Assisting Robotic Device (HOWARD), on Wednesday at the American Stroke Association’s annual meeting, in San Francisco.
How the research was carried out
In the research, Cramer and the team cooperated with seven women and six men, at the average age of 63, who had experienced a stroke.
Over three months after experiencing stroke, all the patients had moderate weakness and decreased function in their right hand, even though the hand was not completely paralyzed or unable to feel.
At first, the scientists tested the remaining strength in the right hand and how well patients were able to squeeze. "We also observed things that people would care about - things like picking up a cup and holding it without spilling it," Cramer said.
In the course of the sessions, the patient’s hand was strapped to the robot. "When they moved their hand, these metal brackets, Velcro-ed to the back of the hand, measured how well they were moving," Cramer explained. "If they were not able to finish the movement, the robot would finish the movement for them," he added.
According to Cramer, the movement coupled squeezing the hand and extending the wrist. "The participants practiced both grasping and releasing everyday objects," he added.
Each patient was offered training using HOWARD in 15 two-hour therapy sessions spread within three weeks.
Improvements across the board
According to the investigators, after three weeks, all patients had improved their ability to grasp and release objects.
All the patients demonstrated significant improvement in the ability to perform real-world tasks, like grasping a block, gripping a drinking glass, pinching to pick up a small marble or ball bearing, and putting their hand on their head. What’s more, they demonstrated considerable improvement on tests of dexterity.
Additionally, after three weeks, patients developed a radically wider range of motion in their hands and wrists and were rated as less disabled on a typical occupational therapy test.
Within the next month of follow-up, much of the improvement in movement was maintained, however others deteriorated, Cramer explained. But he informed that it was probable that more work with the robot would further improve movement.
Cramer is convinced that the robot is able to become a valuable part of rehabilitation after stroke.
"Robots provide several advantages for therapy after stroke," Cramer informed. "There is consistency, accuracy, durability and the potential for tele-rehab," he said. "You could treat ten patients in their homes from a single location."
Could be of real help
One of the specialists agreed that the technique could offer bona fide help to patients.
"The implementation of robotics coupled with virtual reality training holds promise for motor recovery and, optimistically, functional recovery for chronic stroke patients," informed Dr Ira G. Rashbaum, chief of stroke rehabilitation at New York University Medical Centre in New York City. "I’m delighted to see the scientists combined these modalities with the potential for synergy."
Stroke patients and their partners have to realize, though, that there must be adequate residual motor power in their arm and hand in order to set off some movement for this therapy to be effective, explained Rashbaum, who is also clinical associate professor of rehabilitation medicine at New York University School of Medicine.
"As is the case with constrained-movement therapy, one size does not fit all for stroke rehabilitation patients," he added.
"The other point to take into account is that motor recovery, whilst exciting to obtain, does not necessarily translate into functional recovery," Rashbaum explained. "The question arises, whether these patients improved many of their upper extremity activities of daily living, like grooming, hygiene, dressing, undressing and toileting?"
