Stroke rehabilitation: Human therapists vs Robots

Two groups of stroke survivors. One group had robotic devices to assist them in walking again. The other group had physical therapists in attendance. Which group do you think performed better?

According to a study conducted by the University of Illinois in Chicago, stroke survivors seem to benefit more from therapist-assisted walking rehabilitation compared to those who underwent robotic devices-assisted therapy.

“The study included 48 people who’d suffered strokes at least six months earlier and still had moderate to severe trouble walking due to weakness on one side of the body. The patients were randomly assigned to receive physical therapist-assisted or robotic-assisted locomotor therapy. All the patients received a dozen 30-minute therapy sessions during the four to five weeks of the study.”

Although both groups showed progress in walking, the improvement is significantly higher among patients of the therapy-assisted group. Specifically, better improvements were observed in the speed of walking and the length of time spent using the weaker limb. The patients also felt a significant improvement in their over all quality of life.

So why the difference?

The researchers attributed it to the fact that

“therapist-assisted training allows for patient error, while the robotic device controls movement and minimizes errors…When learning to walk again, if people can make mistakes and realize their errors and change their behavior based on those errors, they may learn better.”

Stroke patients were also observed to work harder and exert more effort when training with physical therapists because the latter only help them when necessary.

According to the National Institute of Neurological Disorders and Stroke (NINDS), successful rehabilitation of stroke victims depends on:

Amount of damage to the brain

Skill on the part of the rehabilitation team

Cooperation of family and friends. Caring family/friends can be one of the most important factors in rehabilitation

Timing of rehabilitation – the earlier it begins the more likely survivors are to regain lost abilities and skills

The main goal of rehabilitation is for the stroke survivor to achieve the highest possible level of independence and restore as much productivity as possible. Each patient is unique with unique rehabilitation needs. Human therapists are therefore better equipped in customizing a therapy or a training program to the patient’s condition and need. In the end, no piece of equipment, no matter how sophisticated, can be substitute for the human touch.

The researchers conclude that

“…robotic-assisted therapy may be best for stroke patients who have no ability to walk on their own, while therapist-assisted training is best for those who can walk independently, even at very slow speeds.”

Sources:

Hornby et al. Enhanced Gait-Related Improvements After Therapist- Versus Robotic-Assisted Locomotor Training in Subjects With Chronic Stroke. A Randomized Controlled Study. Stroke, 8 May 2008

HealthDay News, 8 May 2008

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