Increasing productivity and quality of care: Robot-aided neuro-rehabilitation

This paper presents an overview of our research in robot-aided stroke neuro -rehabilitation and recovery. At the onset of this research we had to confr ont squarely (and solve!) a critical question: If anatomy is destiny, can w e influence it? Our efforts over the last five years have been focused on a nswering this question and we will present a few of our clinical results fr om over 2,000 hours of robot-aided therapy with 76 stroke patients. To dete rmine if exercise therapy influences plasticity and recovery of the brain f ollowing a stroke, we needed the appropriate "microscope" that would allow us to concomitantly control the amount of therapy delivered to a patient, w hile objectively measuring patient's performance. Back-driveable robots are the key enabling technology. Our results to date using common clinical sca les suggest that robot-aided sensorimotor training does have a genuinely po sitive effect on reduction of impairment and the reorganization of the adul t brain. Yet while clinical scales can help us to examine the impact in the neuro-recovery process, their coarse nature requires extensive and time-co nsuming trials, and on top of that they fail to show us details important f or optimizing therapy. Alternative, robot-based scales offer the potential benefit of new finer measurements-and deeper insight into the process of re covery from neurological injury. We also plan to use present technology to establish the practicality and economic feasibility of clinician-supervised , robot-administered therapy, including classroom therapy. We feel quite op timistic that the march of progress will accelerate substantially in the ne ar future and allow us to transfer this technology from the research realm to the everyday treatment of stroke survivors.