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Cynthia Kelleher (Kernan)
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Kernan Uses New Robot-Assisted Therapy to Help Stroke and Brain Injury Patients

 

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The Rehabilitation Research Center at Kernan is a collaborative effort to bring state of the art research to clinical rehabilitation care for the patients we serve.

 

Baltimore, MD (May 3, 2010) - Kernan Hospital’s rehabilitation physicians and occupational therapists are now using robotic therapy to help improve motor skills for some of the hospital’s stroke rehabilitation and brain injury patients. Kernan is the largest provider of rehabilitation care in Maryland and is a part of the University of Maryland Medical System, an 11-hospital system.

A state-of-the-art therapy tool, the InMotion 2 robot is included in treatment plans for patients with neurological conditions such as stroke, spinal cord injury and brain injury.

At Kernan Hospital, the robot is used by patients who need rehabilitation to help restore range of motion and strengthen the muscles of their shoulders and elbows. Designed specifically for this purpose, the robot interacts with humans gently and safety, while continuing to challenge the patient.

"Robot assisted therapy provides an opportunity for motor recovery beyond that of traditional therapy alone,” says George F. Wittenberg, M.D., PhD, Associate professor of Neurology at the University of Maryland School of Medicine, and a member of the Rehabilitation Division at Kernan Orthopaedics and Rehabilitation. "Improvements are long-lasting and are seen in patients who begin using robot assisted therapy months, even years post-injury.”

Kernan is using an interactive-motion robot that provides computer-guided exercises for patients. These exercises are similar to video games that promote eye-hand coordination and are designed to help the brain recover using repetition. For patients who are too weak, robots assume the labor-intensive function of physically manipulating the impaired limbs through a range of repetitive-motion exercises intended to rehabilitate affected muscles and restore limb function.

The InMotion 2 robot consists of a two-foot-long computer-driven arm and a computer monitor. During a robot-assisted therapy session, the patient sits at a table and the arm is supported in a trough, connected to the robot. The patient is prompted to try to move the robot arm through an exercise pattern displayed on the video screen, designed to help restore range of motion, strength and motor coordination of the shoulder and elbow.

The robot imitates exercises which would traditionally be accomplished with an occupational therapist. However, the robot is able to provide the patient with many more repetitions than traditional therapy, which has been shown to rehabilitate damaged nerve pathways, caused by a neurological injury. The robot is able to assess the patient’s movement and responds to a patient’s continually changing ability.

Similarly as an experienced clinician would do, the robot guides the exercise treatment accordingly. If the patient is unable to move, the robot gently assists the patient to initiate movement towards the target. If coordination is a problem, the robot guides the movement, allowing the patient to move towards the target and making certain that the patient is practicing the movement the correct way. As the patient gains movement control, the robot provides less assistance and continually challenges the patient.

If the patient does not move the afflicted area, the robot does it for the patient – still exercising the muscle. If the patient moves on his or her own, the robot provides adjustable levels of assistance and resistance. The robot provides quantifiable feedback on patient progress and performance through recording information on each patient’s therapy session. Rehabilitation therapists think this repetitive motion can rebuild nerve pathways from the brain to the injured limb. "This cortical reorganization appears to continue even years after the initial injury,” says Dr. Wittenberg.

About Kernan Orthopaedics and Rehabilitation:

A 138-bed rehabilitation and orthopaedic specialty hospital, Kernan specializes in joint replacements and treatment of sports injuries; neck, back, upper and lower extremity injuries; scoliosis; trauma reconstruction; plastic surgery; and dental surgery for adults and children. Kernan's William Donald Schaefer Rehabilitation Center provides the most technologically advanced therapy for orthopaedic injuries, brain and spinal cord injuries, stroke, multiple sclerosis and other neurologic disorders. Kernan is also the home of the University of Maryland Center for Integrative Medicine.