Robots come to the aid of stroke victims

An MIT professor has returned to DIT Bolton Street to explain how a robotdevice can speed up patient recovery after a stroke, …

An MIT professor has returned to DIT Bolton Street to explain how a robotdevice can speed up patient recovery after a stroke, writes Dick Ahlstrom

Robots and video games could help provide an answer to the devastating loss of movement experienced after stroke. A researcher from the Massachusetts Institute of Technology has developed an interactive robot and is getting good results in stroke patients who have lost motor function.

Prof Neville Hogan, who is professor of mechanical engineering and also professor of brain and cognitive sciences at MIT was in Dublin last week to deliver a guest lecture on his research at the Dublin Institute of Technology Bolton Street.

The talk was part of Bolton Street's celebrations to mark its 50th anniversary of engineering degree level courses in DIT. Hogan's interest in talking at Bolton Street? He comes from Dublin and is a Bolton Street grad, class of 1970.

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He ended up in Boston at MIT through a "series of accidents", but now holds two professorships and is director of the Newman Laboratory for Biomechanics and Human Rehabilitation.

Hogan has been at the forefront of the use of robotics in rehabilitation for patients with neurological injuries. This includes stroke, but also Parkinson's, multiple sclerosis and cerebral palsy. "Stroke is the big one because it is the leading cause of disability," Hogan explains.

Robots in a rehabilitation context are devices that manipulate a single limb, for example an arm. This device is in turn linked by computer to a video screen. The patient is asked to manipulate the robot arm in such a way that a simple goal is achieved on the screen, for example moving a cursor to a given point.

"It is like a very primitive form of video game," says Hogan. The robot will move the cursor if the patient doesn't have the capacity to do so, but as the patient regains control over movement, the robot does less and less.

The real trick Hogan adds is to understand what is going on inside the brain to explain the improvement in motor function experienced by these patients. "Our working hypothesis is the brain is actually re-learning connections."

The patient sees what movement must be made but the neurological injury impedes this. The robot supplies the correct movement, responding in real time to any attempt by the patient to achieve the movement himself.

"You have to give the brain the right data to connect," Hogan adds. "The main thrust of my work now is understanding how and why it works. We have been trying to develop a mathematical model of how the brain responds to movement."

He published the results of his work recently in the journal Neurology. His team is now collaborating with clinics across the US "mostly for the purpose of getting the patient count up", he says. It takes a large amount of data to confirm any benefits.

His interactive robot device delivers five times the improvement in motor response compared to conventional post stroke therapy, he says. Part of this could be because the robot makes many more movements than would be typical of regular physiotherapy, thus speeding the making of new connections in the brain.

His unusual blend of expertise also comes to the fore with his work in MIT's "Institute of Soldier Nanotechnologies". This involves finding new ways to protect soldiers in the field through the development of novel fabrics and devices.

One approach involves making fabrics that have "variable mechanical properties". Most of the time they would feel like conventional cloth but would be able on demand to become rigid and so afford protection.

While the US army is interested in anything that helped its personnel, Hogan sees endless civilian applications for such a fabric. It could be used after road accidents to restrict neck movement or to provide an instant cast to protect a broken limb, but could be put into place as simply as a bandage.