Robot-aided Therapy Post-stroke
May, 2002

From: Peninsula Stroke Association, Strike Out Stroke Volume 2, Issue 1 - May 2002 - page 2

Following a stroke, recovery of lost arm function is often more difficult and less successful than regaining the ability to walk. While significant independence can be gained by learning to do things with one arm or with adaptive devices, many daily activities require the use of both hands.

East and West Coast scientists are using robotic technology to help stroke survivors improve arm function. Robots are commonly used in manufacturing when very precise or highly repetitive movements are required. The motivation to use robots for stroke rehabilitation comes from trials of new therapy methods that appear more effective, but require a degree of repetition that would be too labor-intensive for human therapists.

There is evidence that improved recovery can result ftom intensive therapy, by using highly repetitive movements during training, and by practicing simultaneous movements with both arms. Semi-automated, computer-controlled devices that help a therapist apply these techniques have recently demonstrated encouraging results.

Scientists at the Palo Alto VA Rehab Research & Development Center have developed a robot capable of providing sophisticated exercise patterns. MIME is a robot that can move the stroke-affected arm in straight lines or in complex patterns, along a table top surface or in 3-dimensional space. It can also assist or resist movements as subjects recover more arm control. A unique feature of MIME is its ability to take commands ftom the stronger arm and to continuously help move the stroke-affected arm in a mirror-image pattern. This permits practice of bimanual movements to aid in recovery of muscle control. In a recent study, subjects who averaged 2 years since their strokes practiced 1 hour, 3 days per week for 8 weeks, either with MIME or one-on-one with a therapist. Both groups improved their ability to move the stroke-affected arm but the robot-assisted group showed faster recovery. Two studies using MIME are currently in progress, aimed at making robot-assisted therapy even more effective and determining which patients benefit most from its use.

Until significant advances are made in prevention of stroke and hemiplegia, more effective methods are needed to restore arm and hand control necessary for daily activities. However, before insurers will pay for new therapies, the effectiveness and efficiency must be proven with rigorous clinical trials. If you (or someone you know) had a stroke within the past 5 months and would like to be a subject in one of the MIME studies, you can get more information by contacting Peggy Shor, OT.

Charles Burgar, MD