Clinical Trials News: Using Robots to Regain Ground After a Stroke
Albert Lo believes that the brains of stroke victims are more resilient than most neurologists think. And he's betting that four $180,000 robots will help him prove it.
Lo, a staff neurologist at Connecticut's Veterans Affairs Healthcare System, is now looking for 150 volunteers so he can study whether computerized devices strapped to disabled limbs can help people practice and regain upper-body functions lost to a stroke—even well after the usual rehabilitation efforts are over. The robotic system dictates the appropriate movements, which are designed to rehabilitate the weakened or deadened limb. If the person can't complete the motion unassisted, the robot helps out, theoretically building "muscle memory" in the process. The volunteers' progress will be compared with that made by patients using conventional rehab. According to the American Heart Association, 700,000 adults have a stroke each year in the United States.
Lo's hunch is that the precision and consistency of motion created by the robots will capitalize on what he calls the brain's "latent ability" to recover lost functioning more effectively than physical therapists—who eventually get tired—can. Sharon Turner, a Navy veteran who participated in a study several years ago to help engineers at the Massachusetts Institute of Technology develop the robots, is hopeful that Lo is right. "You never get over the loss of that extremity. You always hold out hope and prayer that you're going to be restored to the person you were before your stroke," says Turner, who still has dreams that she's in "able-bodied form," though she lost function in her left leg and arm after a stroke 16 years ago at age 35—five days after giving birth to her daughter.
Currently, standard practice may call for only three to six weeks of physical therapy, encouragement to exercise, and perhaps advice to take a daily low-dose aspirin to prevent stroke recurrence. It's generally believed that the "window of opportunity" shuts after the first three months. Lo will test his theory on people who are at least six months past their strokes. "If this works, it's going to be a huge paradigm shift in the restoration of function," he says. His team thinks the robots could also potentially work for patients with Parkinson's disease, multiple sclerosis, and traumatic injury to the brain or spine.
The trial, which is expected to run through 2009, will compare the effectiveness of rehab using the robots with one physical therapy regimen as intense as that provided by the robots, and also with the standard regimen. (Volunteers placed in the "typical care" group will be offered their choice of the other two rehab regimens at completion.) Lo seeks veterans who have lost function in their upper body, including the shoulder, elbow, wrist, or hand. The research will be conducted at the Veterans Affairs hospitals in Seattle; Baltimore; Gainesville, Fla; and West Haven, Conn. Further information is at ClinicalTrials.gov.
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