Two groundbreaking robotic devices are now available at the Rehabilitation Research Center at Kernan to assist patients who meet the criteria for use. These devices include the InMotion 2.0 Shoulder-elbow robot and the Anklebot.
The Anklebot is designed to help restore range of motion, passive stiffness, strength and motor control of the neurologically impaired ankle. During Anklebot training sessions the patient sits in a comfortable chair with the legs resting on a padded support.
The Anklebot is attached to the affected leg with a knee brace that is connected to a mounting plate on the chair. The patient also wears a special shoe that connects to the Anklebot's lower end at the foot.
The anklebot can rotate the foot at the ankle in two directions: "up and down," and "in-and-out." During use the patient plays a simple video game that requires movements of the affected ankle to hit targets that move slowly across the computer screen.
The amount and speed of movement can be set to match the patient's ability, and usually the Anklebot will only provide a gentle push toward the target when the patient is unable to complete the movement. As game scores and movement ability improve the game can be adjusted to increase challenge levels.
The benefits of the Anklebot are not fully understood at this time, as it is a relatively new device. In pilot studies we have found that patients who have had a stroke many years prior can improve the control of affected ankle movements and also improve how fast they are able to walk.
We do not have information on how this robot may be useful in the early stages after stroke, which is why we now are now conducting research during the inpatient stays at Kernan Hospital.
When provided as an added treatment along with usual inpatient physical therapy, we hypothesize that there may be more rapid gains in regaining walking and balance functions. If this proves successful, we envision offering Anklebot training as part of ongoing outpatient therapy after discharge from the inpatient service. As with the shoulder-elbow robots, the Anklebot can provide immediate quantifiable feedback on progress and performance.
Currently we only are working with people who have incurred a stroke, however in the future we expect it may be useful for those who have sustained brain injury, multiple sclerosis, spinal cord injury and other neurological injuries that affect walking and balance.
People who are not appropriate include patients with unhealed fractures or orthopedic weight bearing restrictions and those without any ability to activate the lower leg muscles.