- In the early adopters of automation and artificial intelligence (AI), recruiters and hiring managers found the technologies handy. Human touch is required in certain vocations despite fears that this technology may ultimately replace them. While it may be amusing to see one of your relatives do the dreaded “robot move” at your wedding, it is understandable that robots lack the dexterity necessary to deliver a human-like physical or massage therapy experience.
- It’s important to be able to identify even the tiniest signs of a client’s body’s reaction while working in this field, adds Lee. As a result, “these basic elements of therapy render this profession essentially humanistic, and not suited for AI.”
- Robotic neurosurgery became possible in 1985 because to the PUMA 200 robot, which was the first to successfully execute a neurosurgical biopsy using a robot at the time. Almost forty years later, advances in robots in medicine have altered medical practice, methodology, and the patient experience. A significant stride forward in contemporary health and therapy is being made possible by the advent of robots, which are capable of anything from conducting very accurate operations to providing psychological and mental stimulation for the elderly.
- Automated machines are often used to do repetitive and high-volume activities without human involvement. Robotics has several advantages, and healthcare robotics in particular is always being investigated and improved. Medical practitioners may free up more time to focus on diagnosing, treating, and curing patients in need of urgent attention by using robots to do routine activities. Technology has advanced to the point that robots can engage with and aid patients, rather than just monitoring or completing routine activities. An exoskeleton may be fitted to the entire or particular limbs, and sensors track and react to the movement and placement of patients undergoing physical therapy rehabilitation using these robots, as an example.
- The World Health Organization estimates that about 15% of the world’s population has some form of disability. Rehabilitation has a key role in decreasing the level of disability. Application of advanced technologies in rehabilitation is a promising opportunity to attain this goal.
- The development of rehabilitation robots started in the late 1980s. The following decade was a pioneering phase. After the year 2000, the first representatives of commercially available robots appeared. These devices can assist in practicing upper or lower limb movements and motor relearning, and in developing proprioception, cognitive functions, and attention. There is equipment that patients can use to practice the same movements as with the robots, but it does not provide mechanical assistance; so, patients have to rely on their own strength. The emphasis is on high repetition, interactive and personalized therapy. The aim is to attain a higher level of function in a shorter time frame. The philosophy of the application of robots in rehabilitation is not to replace the therapist, but to widen treatment options.
- In rehabilitation robot treatment, the primary aims are to improve function in the upper limbs and aid in gait re-education. Rehabilitation robots are most often utilised in patients who have suffered damage to the central nervous system, such as a stroke. There have been several clinical studies and meta-analyses on these robots. According to Mehrholz et al., the effectiveness of electromechanical arm training was examined in 45 randomized controlled studies including 1619 people. Arm function and muscular strength, as well as daily living tasks, were observed to improve with this kind of treatment. In spite of this, the research methods utilised in the various investigations were fairly diverse, and a total of 24 distinct devices were used.
- Most of the gadgets allow you to work out in a virtual world. The Reharob system is one of the few robots that allows users to experiment with actual things in a real environment. However, can virtual reality have the same impact as actual practice, or is it just simpler to implement? The purpose of rehabilitation is not merely to enhance upper limb function in any sector, but to reduce the patient’s degree of reliance in everyday tasks. However, it is not a guarantee that the patient would be able to dress, eat, and wash more on their own if they get greater points in video games. Furthermore, video games leverage an essential but small range of motion in the upper limbs, which is why they are so popular.
- In other words, the brain’s structure is not fixed. It’s dynamic and malleable, and that’s what makes it tick. Plastic changes in the body must be taken into consideration by any patient-therapist working to help them re-learn how to do something. These are the reasons why learning about the most effective ways to stimulate the plasticity of the brain using robots is very important
- There are now various clinical studies being conducted to address the issues at hand. Research with more than 700 patients in three randomized groups, Robot Assisted Training for the Upper Limb after Stroke (RATULS), is likely to have the largest number of participants. An important part of this massive study is to assess the efficacy of conventional, improved traditional, and robot-mediated treatments, as well as to do an economic analysis. End-of-year findings from RATULS are scheduled to be released in 2019.
- In the future, robots with artificial intelligence (AI) will have more possibilities. It’s not good enough for robots to serve as therapy extenders and save humans’ time and energy by doing tedious exercises. An further benefit of robots might be their ability to constantly evaluate the patient’s condition and choose the next workout appropriately.
- Human therapists have the unique ability to address the physical and mental needs of the patient as a whole. Multiple levels of communication are constantly occurring between the therapist and the patient. Only a small portion of the body can be moved by current rehabilitation robots; sensory input is limited, and decision-making abilities are limited to the simplest of tasks. For real-world applications to be valid, it’s best if you include at the very least the whole upper limb from the shoulder to the fingertips. There is a good chance that moving the whole upper limb is required to restore proper joint synchronization. But in the early phases, if there is more acute palsy, it may be enough to include one or two joints. As the patient’s condition improves, so does the need for more parts of the team. Two robots are now required to concurrently exercise both the proximal and distal parts of the limb. It should be feasible to do this with a single device.
- Doctors and patients may benefit from more study into artificial intelligence, which might be used to healthcare robotics. Human-to-human treatment and interaction will never be totally replaced by robots, but medical technology’s future is bright. The future of patient care and treatment may be influenced by interdisciplinary teams that include robots and healthcare workers.
Types of robotic devices for rehabilitation
Rehabilitation devices can be passive, limiting the affected limb’s range of motion while providing no assistance or resistance, active, using actuators to direct the affected limb along a trajectory, or interactive, using forces applied in response to the affected limb’s movement to provide the best possible assistive strategy. Active or interactive gadgets are the most common, although passive ones may be utilised as well. Furthermore, the devices may be classed as either end-effector devices or exoskeletal devices depending on how they interact with the user.
End-effector robotic devices
End-effector devices for upper limb therapy and gait training communicate with the user through a manipulandum that is held in the user’s hand. An arm attached to the manipulandum delivers the user’s force and the sensors that monitor performance. Users of varied body types may simply utilise this system since the forces and measurements all take place at the same location. To take advantage of this, rehabilitation of the upper limb and gait training are popular with end-effector systems because of this. However, since there is only one point of contact between the robot and the user, each joint’s movement cannot be individually controlled. The MIT-Manus is an end-effector robot designed to assist in the rehabilitation of the upper limb after a stroke. Spring-loaded restraints limit the manipulandum’s vertical mobility, but allow it to move in the horizontal plane. Simple video games are used for sensory-motor training, and the input is delivered by manipulating the device. As the user interacts with the manipulandum, a point is moved on the screen and the user may create shapes or go along a route. The manipulandum provides assistance to the user if they are unable to complete the job on their own. Robotics can aid and augment conventional therapy and increase rehabilitation results, according to a number of studies. Kinematic data gathered by the MIT-Manus as a consequence of manipulandum motion may be beneficial in assessing post-stroke motor recovery, as proved by studies on the robot. By using robot-collected kinematic data instead of human-assessed measures, more trustworthy and objective data may be obtained to guide training. Robots of this sort have also been used to teach both arms at the same time, either independently or in a mirror-symmetrical fashion. Due to the lesser amount of complexity connected with these motions compared to those of the upper limb, end-effector robots are being employed to enhance lower limb function. As a consequence, there has been a lot of interest in the development of devices for gait rehabilitation. End-effector robots, like the Haptic Walker, are capable of mimicking walking and ascending stairs. An interactive control method using force and torque sensors is possible, as is the collecting of data to assess the user’s progress and walking performance. For gait training, the G-EO System has a comparable end-effector robot. Compared to the control group, users evaluated this device well and reported improved walking and stair-climbing abilities. Repetitive gait training is possible with minimum effort from a physical therapist without increasing the danger of falling, thanks to gait training robots.
Exoskeletal Devices
The exoskeleton-type robots are more complicated to design and manufacture than the end-effector robots because they must follow the design of the limb that is targeted, be customizable to suit users of varying anthropometric measurements, and connect to the limb at many locations. Robotic joints may be controlled by motors; however, the joints are often linked via rigid links attached to the arm or leg (e.g., Ankle Bot and LOPES). Bimanual training robots have also been put to the test. Because current upper-limb exoskeleton designs employ stiff connections to increase the arm’s weight by 4–6 times, users must adopt compensating non-physiological muscle methods while moving. Exoskeleton inertia may be reduced by separating the joints from the motors and driving the joints via cables and pulleys (e.g., L-exos, CADEN-7, and MEDARM). The CAREX upper arm exoskeleton is a revolutionary robot that uses a robot-controlled cable system to suspend the arm, making it ten times lighter. There has been some preliminary research showing that CAREX promotes muscle patterns that are almost identical to those seen in movements without it. It is possible to use the upper limb exoskeleton robots to improve motor learning after a stroke by providing: (1) assist-as-needed force fields to keep the upper limb within the desired path of motion, referred to as path-assistance; and (2) adjustable weight support to eliminate the effect of gravity. Partial weight support has been proven to minimize aberrant upper-limb motor synergies after stroke and enhance range of motion and function by removing gravity from the equation. With assist-as-needed force fields, individuals display better movement accuracy along their intended route. What isn’t obvious is how the therapy regimens should be changed for various degrees of impairment and which features of robotic function should be applied to a certain user. Using a two-degree of freedom exoskeleton robot, the Ankle Bot directly actuates the ankle and is able to identify gait defects and actively apply correction forces to train a paretic ankle and improve both balance and walking after stroke. Additionally, the ankle joint stiffness may be employed as a clinical assessment instrument, which can be used to track rehabilitation success. As an eight-degree-of-freedom exoskeleton for the lower limbs, LOPES may be used for gait training or as a passive measuring instrument.
