Dr. Andrew Butler, Research Scientist at the Center for Visual and Neurocognitive Rehabilitation at the Atlanta VA Medical Center www.varrd.emory.edu is working with other VA medical centers to develop new ways to rehabilitate the limbs of stroke patients. “We believe by using robots to do therapy at home, neurons can be remapped allowing stroke survivors to move their arms better”, reports Dr. Butler.
Voluntary hand movement is often affected by stroke, and the neurons in the brain that control the hand may be able to remap through a process called neuroplasticity. Although neurons can’t regenerate in the brain, existing neurons can reorganize based upon the stimulus received.
The brain is capable of massive reorganization subsequent to stroke. When people lose the neurons representing portions of the hand, neighboring areas invade brain areas that were formerly occupied by the hand.
The Department of Veterans Affairs Office of Rural Health’s www.ruralhealth.va.gov funding has provided a specially designed robotic exoskeleton to help strengthen arm muscles and improve brain connections as part of the rehabilitation for rural veterans.
Rural veterans in Georgia and Alabama successfully used the robotic device to improve functional outcomes and eliminate travelling to centralized therapy services. So far, the robotic device has shown to significantly increase the number of veterans taking part in physical rehabilitation.
To use the device, the veteran operates either a hand or foot peripheral component connected to the central computer to play video games onscreen. The veteran can move the hand or foot up and down to play games such as ping pong or to navigate a balloon through obstacles. The device records information such as the range of motion achieved while playing the games, time spent using the device, and provides scores for each game.
The veteran keeps the device for three months and is instructed to engage in up to two one hour sessions of daily therapy. The therapist remotely monitors the use of the device and the progress being made to achieve greater wrist or ankle range of motion angles via a secure database. So far, veterans who consistently used the device on a daily basis improved their ability to perform functional tasks and were able to increase independence in their daily living.