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Using robotics in childrens' physiotherapy

Photo: Image by Suvan Chowdhury on Pexels
While health professionals in paediatric settings have extensive experience in working with children to achieve therapeutic outcomes, it can be particularly difficult to motivate this patient group to perform repetitive exercises over extended periods of time, while dealing with their own psychological and emotional trauma.

Studies have been undertaken in recent years into the use of social robots as an assistive tool within the realms of childhood education, aged care and paediatric treatment. Using such studies, the Royal Children’s Hospital in Melbourne developed a clinical trial to introduce the NAO robot as a therapeutic aid for paediatric rehabilitation.

Working with more than 30 individual children with cerebral palsy who were undergoing post-operative rehabilitation at the clinic, the physiotherapists had designed their therapy around gait correction and function, as well as decreased gross motor function as a result of the orthopaedic surgery.
The 58cm tall NAO social robot from Softbank Robotics was programmed with input from physiotherapists to be used in the independent sessions of rehabilitation during post-operative hospital stay. The robot uses vision, sensors and voice command to interact with its user. With input from the treating physiotherapists and families of patients, four roles of the NAO were identified:

Demonstrative aid – using pre-programmed voice commands, the NAO performs 15 upper-body and 7 lower-body exercises for the patient to imitate when they are required to undertake such exercises without a therapist present.
Motivational aid – the NAO provides encouraging statements and rewards for effort through interactive conversations or even as a competitive motivator (ie. competitions to hold a pose the longest).
Distractive aid – when the primary objective of an exercise is to alleviate pain or discomfort, the NAO can provide a point of focus for the patient while executing repetitive but simple exercises.
Monitoring aid – by observing and monitoring patient performance during a session, the NAO can summarise patient activity for the treating clinician to later access.

There has been some user feedback relating to short battery life and slow start up/shut down time, however therapists in the paediatric trial have anecdotally noted improvements in patient mood and therapy compliance when using the NAO as part of their therapy.

Meanwhile in the United States, Columbia University in New York is using robotics to help children with cerebral palsy develop their posture and address crouch gait through another type of robotics research.

The Tethered Pelvic Assist Device (TPAD) is harness worn on the pelvis that simulates forces on the body as subjects walk on a treadmill. Using motion-capture data from cameras, it adds a downward force of 10 per cent of body weight, without adding mass or inertia to the walking body. As a result, upright posture and muscle coordination was improved, along with walking features such as step length, range of motion of the lower limb angles, toe clearance and heel-to-toe pattern.

Team leader Professor Sunil Agrawal, noted in the study, “Currently, there is no well-established physical therapy or strengthening exercise for the treatment of crouch gait.”

The researchers involved in the clinical trial at the university are planning to increase the size and variables within the trials, adding,
“Feedback from the parents and children involved in this study was consistent. They reported improved posture, stronger legs, and faster walking speed, and our measurements bear that out. We think that our robotic TPAD training with downward pelvic pull could be a very promising intervention for these children.”

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Sharon Smith

Sharon Smith writes freelance articles as a medical, science and technology specialist. She is researching health journalism at Griffith University and lives mostly on Twitter @smsmithwriter (and would love to hear from you).