Robots that cause paralysed muscles to move and aids that replace the wheelchair: assistive technologies are on the rise, and expectations for pioneering inventions are high. Objective: The technology is aimed at providing the best possible support to people with a disability, making their lives easier.
The Swiss Paraplegic Centre (SPZ) supports the ETH in the form of collaboration in the development of the robotic “VariLeg” walking aid.
Useful in therapy
The theme of robotics is already part of everyday therapeutic practice at the SPC: assistive technology is a fixed component in the rehabilitation of individuals with spinal cord injuries. Robotics support the patients in re-establishing motor skills. We also use robotics in the therapeutic sector, such as for alleviating spasticity or pain. In principle, a device helps the patient to perform a movement that they would not be capable of without technical support.
Robotics is particularly helpful where there is still residual function in nerves and muscles. The objective is to reawaken and train them. The nerve system can be activated using a high number of repetitions. “It learns through the patient performing the same movement thousands of times.”
Robotics can support the patient in re-establishing skills.
Making everyday life easier
Robotics can’t work miracles. In almost all cases, the prospect of a patient completely relearning how to run using a Lokomat or Motionmaker is neither possible nor the objective. Instead, the intention is for each patient to achieve the objectives we have set. For one patient this may be that they are able to turn themselves over in bed, or are able to slightly lift their legs when being transferred from the wheelchair to the car. Or, that a tetraplegic patient relearns how to bring a fork to their mouth. These are all important skills that make the day-to-day lives of people with spinal cord injuries significantly easier.
Various robotic devices are used at the SPC:
On the Lokomat, patients are suspended on a piece of equipment in such a way that they are able to walk on a treadmill with a small amount of body weight – supported by a robotic mechanism that is attached to their legs. The robot makes the stepping movement, while the individual with spinal cord injury tries to support the movement to the best of their ability.
An exoskeleton enables the patient to walk slowly, together with sticks and two people helping. The machine stipulates the movement, and the person with spinal cord injury moves their legs with the aid of the robot. The objective may not simply be to learn to walk again. The device has a wide range of benefits: walking upright is good for blood circulation and the circulatory system, as well as giving the individual with spinal cord injury a better feeling of balance and alleviating cramp in paralysed muscles. It reduces spasticity and cramps. It can even help to improve sitting upright in the wheelchair. The exoskeleton also enables nerve pain to be alleviated.
Robotic arms are available for tetraplegic patients who are not able to move their upper extremities or can only do so with restrictions. The robotic arms take away the weight of the arm itself, meaning that various movements are as easy as possible for the patient to execute. The devices are connected to a computer, and the patient uses movements to operate a game on the screen. This strengthens the arm and improves coordination. The robot arm helps to reactivate residual function in muscles.
The Motionmaker is a piece of equipment with which the patient performs bending, stretching and bike riding movements with their legs. The special feature of this piece of equipment is that the movements are initiated using electrical stimulation. Electrodes are attached to the legs of the individual with spinal cord injury. Electrical stimulation is used to stimulate the nerves, and small current pulses cause the muscle to contract. When electrical stimulation stops, the muscle slackens, triggering the movement. The device stimulates and strengthens even paralysed muscles. This can be useful for gluteal muscles, as it creates “padding” that helps to avoid pressure sores.
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