VA Watchdog Stuff
cups, hats, shirts
click here to
support the site





Be sure to get all five
VA Watchdog dot Org
RSS feeds --
Daily VA
News Flashes
House CVA
Veterans' News
Senate CVA
Veterans' News
VA Press
Releases
VSO Press
Releases

Download your
free copy of the
2007 VA benefits
handbook here...

Printer-Friendly Version

ROBOTS HELP REHABILITATE STROKE VICTIMS AT THE VA --

The study into the effectiveness of robotics in rehabilitating

upper extremities in stroke victims has implications

beyond veterans and stroke victims.

Stroke victim Becky Schrader, left, works with occupational therapist Randee Frost on a robotic device at Seattle's VA Puget Sound Health Care System. (photo: Paul Joseph Brown / P-I)

For more about the use of robots in veterans' rehab, use the VA Watchdog search engine...click here...
http://www.yourvabenefits.org/sessearch.php?q=robots&op=and

Story here... http://seattlepi.nwsource.com/health/349981_robot05.html

Story below:

-------------------------

Robots help rehabilitate stroke victims at VA

Seattle hospital taking part in national study

By MIKE BARBER
P-I REPORTER

After 16 years in the Navy, Petty Officer 1st Class Becky Schrader was medically retired when a stroke blindsided her at age 37.

Schrader, who as a Navy cryptologist gathered, guarded and provided critical military information, was left first paralyzed after the stroke five years ago, then quite weak on her left side. The cause was as mysterious as the ciphers she once helped to devise and unravel. Doctors told her husband she might never walk again.

Today, after five years of traditional rehabilitative therapy at Seattle's VA Puget Sound Health Care System on Beacon Hill, Schrader has regained some use of her left arm.

She now walks and does so at least twice a week to enter the local VA medical center's research center. There she calls upon the same determination with which she once served her country to volunteer in the service of medical research.

"I'm a walking miracle. I am fighter, not a give-up person," said Schrader, of Lake Stevens.

In her corner are not only hospital staff who continue to use conventional therapies, but also three new robots that are the focal points of a national research project in which the Puget Sound VA system is participating.

The $4.8 million study into the effectiveness of robotics in rehabilitating upper extremities in stroke victims has implications beyond veterans and stroke victims, research officials say. Veterans suffering from multiple sclerosis and society at large stand to benefit from what Schrader and other veterans do here, they say.

The study here is being conducted with VA medical centers in Baltimore, West Haven, Conn., and Gainesville, Fla. The robots being used to help rehabilitate hands, wrists and shoulders were developed at the Massachusetts Institute of Technology. They are considered a vanguard of the serious inroads being made by 21st-century rehabilitative robotics into physical and occupational therapy.

Schrader says she has experienced improvement beyond her usual therapies.

"I'm gaining strength in my shoulder and elbow," Schrader said recently during one of her sessions. She is now in her second month working with the robots.

The implications are especially important to individuals as insurance coverage can be pegged to an assessment of a person's level of recovery from stroke, she said.

The robots "will help the insurance companies and the community to see that gains can still be made, that if there is a stroke, you don't need to be left in a corner to die away or to be left in paralysis," Schrader said.

Dr. Jodie Haselkorn, director of the Seattle VA hospital's Multiple Sclerosis Center of Excellence overseeing the study, said there has been a shift in thought about stroke damage that veterans such as Schrader are helping to explore.

Brain cells are not necessarily obliterated by strokes; some go to sleep. "Even if they are obliterated, there is some repair; not all of them die," Haselkorn said. Damage can be repaired with the right input; other redundant pathways can pick up functions through repetitive therapy.

With more than 700,000 cases reported each year, strokes are a leading cause of disability in the United States. Haselkorn said rehabilitative robotics have implications for multiple sclerosis patients, but a decision was made to study stroke patients among veterans because strokes offer a more stable benchmark for research compared with the progressive nature of multiple sclerosis.

The local study, however, is sorely in need of more veterans who have suffered strokes affecting their arms in the past six months, said Mike Donahue, the Seattle study coordinator.

The Seattle study began in August 2006 and has had 17 participants but wants to reach 40 before the final deadline at the end of November. Nationwide, at least 160 veterans are expected to participate. Study results ought to be known by the end of 2009 or early 2010.

Donahue said veterans who want to volunteer don't have to have a service-connected stroke, nor do they have to be in the VA system.

Those accepted will be placed into one of three groups:

One for robotic therapy; a second to undergo similar treatment but through intensive conventional therapy; and a third titled "usual use" therapy as a more casual control group.

Those in the latter group, as Schrader was when she volunteered last year, have the option after completing the study of choosing to enter either robotic rehabilitation therapy or intensive conventional therapy. Schrader chose to try the robotics. Those selected for the intensive conventional therapy group cannot choose to also try robots afterward.

Haselkorn said the study includes an assessment of the potential costs of robotic rehabilitation. An adjunct involves neuroimaging and electrophysiology testing volunteers through the University of Washington to understand what is happening in the brain.

"In some studies, we see multiple pathways (in the brain) trying to do the task. Over time, with more perfect (rehabilitation) practice, we see the multiple pathways go away and a more central area appear. It appears the brain is working more efficiently," she said.

Randee Frost, a VA occupational therapist helping Schrader, compared the traditional therapy room she uses, where therapists provide the intense human touch to help patients, with the robotic research room, with its three main characters each devoted to either hand, wrist or arm rehabilitation.

In the traditional therapy room, stroke patients with arm limitations can strap their forearms into a skateboard and try to move it from point to point or in a figure eight. Or they might use an upper-arm bicycle.

For five years, Schrader labored on such devices to restore mobility to do tasks once taken for granted -- opening a door or brushing her hair.

A drawback, however, is that the traditional exercises are timed and their accuracy determined subjectively.

"A robot is entirely objective," Frost said.

Schrader and other users at least twice a week perform two sets of 320 movements on each machine.

"They eliminates therapist fatigue," Frost said. "I couldn't duplicate that pattern 320 times, the repetitive movements to wake up those nerves."

Each computerized robot can read how much effort a patient is putting into each movement, remember it and help to guide him. If a patient can't take his or her arm farther in the movement, the robot gently takes over to move them the rest of the way, recording progress and shifting levels accordingly, even making recommendations to Frost.

Rehabilitative robots exist for lower extremities but are not part of the study.

TO VOLUNTEER

The VA Puget Sound Health Care System's study of rehabilitative robots needs veterans who had a stroke at least six months ago and have moderate to severe arm weakness. Once selected for the study, volunteers will be divided into three groups. The first will use the robots for training, the second will use intensive physical therapy using exercises, and the third will receive standard medical care. All volunteers will be asked to commit nine months to the study. Researchers are accepting volunteers through November. To volunteer or to learn more about the study, call Michael Donahue, Robotics Study Coordinator, at 206-277-3460.

-------------------------

posted by Larry Scott
Founder and Editor
VA Watchdog dot Org

Don't forget to read all of today's VA News Flashes (click here)

Click here to make VA Watchdog dot Org your homepage

email Larry

(go back to VA Watchdog dot Org Home Page)

VA Watchdog Stuff
cups, hats, shirts
click here to
support the site