Robot-assisted therapy can help stroke patients

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  • A stroke can impair a person’s movement, sensory abilities, speech, and other functions.
  • German scientists claim that a robot brain device could help a person paralyzed after a stroke regain some mobility.
  • The device was used in research in which study participants used the brain-robot interface to move their hands.

People who suffer from paralysis after stroke may have new options for controlling their hands or limbs via their brain, according to a new study published today in the Journal of Neuroscience.

Researchers, led by Fatemeh Khademi, PhD, data scientist at the Institute for Neuromodulation and Neurotechnology at University Hospital and University of Tübingen in Germany, studied a brain robot device to control the movements of a hand in stroke patients with paralysis.

Scientists measured brain and muscle activity in healthy participants as well as people with strokes using electroencephalogram (EEG) and electromyography (EMG).

At the same time, participants controlled a brain-robot interface for their hands. The researchers asked the participants to think about moving their hands to operate the device.

The researchers then observed that the electrical activity between the hand and the muscular parts of the brain increased, indicating better communication between the two regions.

“We work with patients who cannot open their hands at all. Our brain-robot interface allows them to control the robotic opening of their hand by imagining the movement. This device is a training tool,” said Dr. Alireza Gharabaghi, lead author of the study and director of the Institute for Neuromodulation and Neurotechnology at Tübingen University Hospital. “Patients are expected, after weeks or months of training, to develop the ability to open their hand again.”

Researchers placed study participants into one of two groups.

One group consisted of 27 healthy, right-handed participants, ages 19 to 37, with no history of psychiatric or neurological disorders. They were asked to perform a motor task. Fifteen participants received proprioceptive or physical feedback – the device moved. The other 12 received visual feedback – they saw a color change on a screen when they reached and maintained a predefined brain state. This group could master the motor control of the device, whether it received physical or visual feedback.

The second group included 8 right-handed participants who had previously had a stroke and had hand paralysis. They were aged 34 to 68, received 20 sessions over four weeks, and received only physical feedback.

At the end of the study, stroke participants showed a small but significant improvement in arm, wrist, and hand motor function.

The researchers concluded that motor function was possible in both groups through the brain-robotics connection. This approach could aid in neurorehabilitation in stroke patients with paralysis of the hand and possibly other limbs.

“Controlling a robotic arm by thought alone is a brain-machine interface. Essentially, the electrical activity in different regions of the brain changes with every thought, sensation, and movement,” explained Dr. Adi Iyer, a neurosurgeon at the Pacific Neuroscience Institute at Providence Saint John’s Health Center in Santa Monica, California.

“New technology (electrodes) can detect subtle fluctuations in brain waves and a computer can process that information and translate the signal into motion for a computer cursor, a mechanical arm, and even a full robotic avatar,” he said. Iyer at Healthline.

A stroke occurs when blood flow to the brain is interrupted, often due to blood clots and ruptured blood vessels.

“A stroke is when part of the brain is damaged by a lack of oxygen. The damage is often permanent and some people are severely disabled. Suppose brain-machine interfaces such as the one in the study could be used to rewire the brain after a stroke, in which case patients could recover much more quickly and completely,” Iyer said.

The effects of a stroke can be different depending on where the stroke occurs, but include decreased functioning in:

  • Movement and feeling
  • Speech and language
  • eat and swallow
  • Vision
  • Cognitive capacity (thinking, reasoning, judgment and memory)
  • Perception and orientation towards the environment
  • Self-care ability
  • Bowel and bladder control
  • emotional control
  • sexual ability

Paralysis usually occurs after a stroke, often on one side of the body, according to the Christopher & Dana Reeve Foundation. The paralysis occurs on the opposite side of the body to the stroke. For example, if the right brain stroke, the left side of the body is affected.

About one-third of stroke survivors recover with no or minor impairments. Another 40 percent have moderate to severe impairment and 10 percent will need treatment in a long-term care facility. About 15% die soon after the stroke.

A stroke can affect brain activity.

“For people who have had a stroke, parts of the brain are damaged and unable to send the signal to the muscles, causing weakness or paralysis,” said Dr. Deepak Gulati, medical director of the Telestroke program and assistant professor of neurology. at Ohio State. University College of Medicine.

“In the rehabilitation phase, several studies have shown that regions of the brain surrounding damaged tissue or regions on the normal side begin to create signals that ameliorate weakness or paralysis,” Gulati told Healthline. “These normal brain areas are trying to take over the function that the damaged tissues served before the stroke. These signals can be further enhanced by stimulation or picked up by implantable devices in the brain and then communicated to a robotic arm.

“The new brain signals and pathways generated after a stroke are called brain plasticity or brain rewiring,” he added. “Various techniques being studied stimulate these normal brain regions, which can help recover from paralysis or neurological deficits suffered during a stroke.

Stroke treatment should be given within hours of the onset of symptoms, depending on the American Stroke Foundation. Immediate treatment can minimize long-term effects and save lives. Treatment includes dissolving or removing plaque and clots from the arteries. The Centers for Disease Control and Prevention lists the signs of a stroke as follows:

  • Numbness or weakness of the face, arm, or leg, especially when it occurs on one side of the body
  • Confusion, difficulty speaking, difficulty understanding speech
  • Difficulty seeing in one or both eyes
  • Difficulty walking, dizziness, loss of balance or lack of coordination

Signs of a stroke usually come on suddenly. If someone has a stroke, you should call 9-1-1 so medical professionals can begin life-saving treatments.

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