Robots Transforming Cerebral Palsy Treatment
11/1/2010
Robots are used for a variety of tasks, from the assembly line to surgical procedures, and even disabling a bomb. At one Indiana hospital, robots are an integral part of treatment for children with cerebral palsy (CP) and other movement disorders. The Robotic Rehabilitation Center at Riley Hospital in Indianapolis is the first of its kind in the state.
The interactive robots and computer games help re-program children's brains and improve their motor functions in the lower and upper extremities through repetitive, controlled motion.
Center Co-Director Pauline Flesch says Hocoma, a company in Switzerland, developed the Lokomat Gait system. "The patient is suspended in a harness over the treadmill. The harness helps reduce the weight the legs will have to bear," says Flesch. Robotic legs are strapped onto each leg to control hip, knee, ankle and foot motion.
Physical therapist Ryan Cardinal has been assisting a five year old from Greenfield, Indiana on the Lokomat. Brayden has CP and has trouble walking.
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While Brayden pushes the robotic legs toward his goal of 600 meters, his eyes are focused on a video screen.
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"Usually when I tell him we have to go somewhere for therapy, he gives me grief, but he's excited about coming to Riley," says Brayden's mother, Kristi Skinner. She says it is more engaging for her son to get up and walk with the help of the robot.
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Brayden is only able to get around using his walker, but only for a short distance. "In a perfect world, we would like to see Brayden walk independently. However, we realize that this is likely an unrealistic goal in the short time frame (8 weeks) that we will treat him," says Cardinal. "Instead, we are interested in helping Brayden become more efficient using his walker. If we are able to improve his mechanics and endurance, Brayden will be able to participate in more peer activities and have more independence without having to rely so heavily on his wheelchair."
Another robot called the Mit-Manus, assists with the upper extremities. It uses a video game and activities that encourage children to improve speed, accuracy and strength in their arms.
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The center is a collaborative effort between Riley, the Indiana University Department of Physical Therapy and Clarian Health Rehabilitation Services. Blythesdale Children's Hospital in New York and Rancho Los Amigo in Los Angeles are also participating in a study on robotic therapy for children with CP.
Physical and occupational therapies have long been considered the mainstay treatments for CP, but more patients are turning to robotic therapy for help. "We believe this will complement traditional therapy," says Flesch. "The field of robotic assisted therapy is just beginning to expand into the pediatric world."
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Doctors at Riley Hospital presented some preliminary data from their upper extremity study at the fall Midwestern Conference on Health Games in Indianapolis. "The data presented at this conference was very general, essentially describing the equipment we are using and detailing what we hope to accomplish in the study," says Cardinal. "Ultimately, data for this study will be gathered in the fall of 2011. Data from all three sites (Riley, Blythesdale Children's Hospital in New York and Rancho Los Amigo in Los Angeles) will be pooled to create a study consisting of 90 or more children with cerebral palsy."
Brayden is one of the first nine patients to take part in research being done at Riley Hospital’s robotic rehabilitation program. Flesch says 30 children will be involved in Indiana. She hopes the facility will lead the way in research to help children, like Brayden, make great strides.
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