Maybe Robots Are on Our Side

-

 



At one point in time, life after a paralysing stroke meant having to come to terms with and learning to cope with significantly diminished motor capacity. Routine tasks would begin to seem nearly impossible, with very limited scope for improvement. Recent breakthroughs resulting from extensive research in neuroscience and mechanical engineering have made possible what once sounded like science fiction—Robot-Assisted Rehabilitation. This technology can be seen as one that essentially serves the same purpose as physiotherapists do, but with increased precision and greater consistency. The success of a rehabilitation plan depends on its intensity, frequency, and suitability. Robot-Assisted Rehabilitation is able to measure progress in real-time, allow for repetitive movements, and function independently while catering to one’s specific needs, ultimately reducing recovery periods.

Robot-Assisted Rehabilitation has been found to help combat a phenomenon called ‘learned nonuse’ (Saebo, 2024), where individuals having undergone paralysis stop making attempts to engage affected areas, such as a limb. With prior efforts being met with discomfort, pain, and failure, individuals avoid trying altogether, which only reinforces the disuse of the area in question. This leads into the broader psychological concept of ‘learned helplessness’, where individuals who are persistently met with negative experiences in which they feel no control, resort to passivity. Both concepts stem from a place of perceived lack of control. Restoring a degree of this control is exactly what Robot-Assisted Rehabilitation successfully achieves. Its greatest psychological benefit is the sense of autonomy that it provides to patients, making them feel in control of their movements again and allowing them to depend less and less on external assistance. Additionally, in traditional physiotherapy programs, patients often feel as though their progress must be attributed to their physiotherapists. In this case, without the presence of another entity, patients are more likely to attribute their improvements to their own relentless efforts, fostering a greater sense of personal achievement.

Types of Robotic Mechanisms 

Robotic Rehabilitation Devices (RRDs) seek to improve impaired motor functions by engaging or targeting certain muscles. These are generally used in clinical settings as part of treatment plans that are overseen by therapists. Robotic Assistive Devices (RADs), on the other hand, specifically aid functional movements—ones required to carry out personal care and routine activities (Khalid et al., 2021). Essentially, these devices assist daily life without the need for a therapist. 

Robotic mechanisms serve as interactive tools that operate on algorithms based on performance, wherein the devices provide only as much assistance as the patients need. A drawback of these devices, however, is that when patients receive all the assistance that they require, they remain within their comfort zone, not attempting to break out of it. It might also lead them to minimise their efforts, which compromises experience-dependent plasticity (Duret et al., 2015).

Comparing Effectiveness 

While it seems intuitive that Robot-Assisted Rehabilitation has certain advantages over traditional physiotherapy, there is also plenty of evidence to support it, one being a study conducted by Sale et al. (2014) wherein 53 patients who having recently suffered strokes were divided into two groups: one group assigned to traditional physiotherapy and the other one to Robot-Assisted Rehabilitation. Both groups showed improvement in motor functions, but the latter showed more overt results, with significant improvement in certain shoulder and elbow movements. It suggests, therefore, that Robot-Assisted Rehabilitation can enhance and speeden the overall recovery period from a stroke with a greater degree of restoration to original motor functioning.

Another comparative study (Lo, Stephenson & Lockwood, 2019), this time assessing economic costs of both treatment plans (borne by hospitals), concluded that Robot-Assisted Rehabilitation provides more cost-effectiveness and economy of scales, compared to traditional physiotherapy. This conclusion was arrived at by analysing data from five different studies and a total of 213 stroke patients. The costs borne by individual patients, on the other hand, is understandably significantly higher for Robot-Assisted Rehabilitation, making it less accessible to certain economic classes.

Patients’ Perspectives

Based on a large scale analysis (Oña et al., 2019) of patients’ feedback of Robot-Assisted Rehabilitation, these are the potential areas for improvement for this technology: 

Daily life- While RADs are able to produce outstanding results in performing movements, this ability is lost when applied to daily tasks. Integrating perceptual and cognitive aspects with motor functioning would allow for more practical applications of these devices.

Virtual reality- A promising potential that has not yet been tapped into is the use of virtual reality in order to fabricate real-life settings, once again allowing for the translation of robotic device-induced motor learning into practical activities.

Adaptability and safety- Robotic technologies must be developed in adaptability in terms of both hardware and software. Additionally, the standards for safety must be laid down more concretely, as current ones are still evolving. The greater the assurance of safety, the greater the reliability and general acceptance of robotic systems.

In essence, Robot-Assisted Rehabilitation is on the road to transform the field of motor function recovery. Researchers in this field are continually developing and improving existing models. With a few tweaks here and there, this evolving field will contribute significantly to the physical and psychological well-being of stroke patients, ultimately providing a better quality of life. Countless developments are on the horizon, and undoubtedly, exciting times are ahead!




References

Duret, C., Courtial, O., Grosmaire, A., & Hutin, E. (2015). Use of a robotic device for the rehabilitation of severe upper limb paresis in subacute stroke: Exploration of Patient/Robot interactions and the motor recovery process. BioMed Research International, 2015, 1–7. https://doi.org/10.1155/2015/482389

Khalid, S., Alnajjar, F., Gochoo, M., Renawi, A., & Shimoda, S. (2021). Robotic assistive and rehabilitation devices leading to motor recovery in upper limb: a systematic review. Disability and Rehabilitation Assistive Technology, 18(5), 658–672. https://doi.org/10.1080/17483107.2021.1906960

Bressi, F., Campagnola, B., Cricenti, L., Santacaterina, F., Miccinilli, S., Di Pino, G., Fiori, F., D’Alonzo, M., Di Lazzaro, V., Ricci, L., Capone, F., Pacilli, A., Sterzi, S., & Bravi, M. (2023). Upper limb home-based robotic rehabilitation in chronic stroke patients: A pilot study. Frontiers in Neurorobotics, 17. https://doi.org/10.3389/fnbot.2023.1130770

Chang, W. H., & Kim, Y. H. (2013). Robot-assisted therapy in stroke rehabilitation. Journal of stroke, 15(3), 174. https://doi.org/10.5853/jos.2013.15.3.174

Utilizing Robotics in Stroke Rehabilitation: A Deep Dive. (2024, May 2). Saebo. https://www.saebo.com/blogs/clinical-article/utilizing-robotics-in-stroke-rehabilitation-a-deep-dive

Lo, K., Stephenson, M., & Lockwood, C. (2019). The economic cost of robotic rehabilitation for adult stroke patients. The JBI Database of Systematic Reviews and Implementation Reports, 17(4), 520–547. https://doi.org/10.11124/jbisrir-2017-003896

Sale, P., Franceschini, M., Mazzoleni, S., Palma, E., Agosti, M., & Posteraro, F. (2014). Effects of upper limb robot-assisted therapy on motor recovery in subacute stroke patients. Journal of NeuroEngineering and Rehabilitation, 11(1), 104. https://doi.org/10.1186/1743-0003-11-104

Oña, E. D., Garcia-Haro, J. M., Jardón, A., & Balaguer, C. (2019). Robotics in Health Care: Perspectives of Robot-Aided Interventions in Clinical Practice for Rehabilitation of Upper Limbs. Applied Sciences, 9(13), 2586. https://doi.org/10.3390/app9132586

About The Author

Saniya Kolwalkar, Head of PsyCreative Column

Psychology Committee, JDSOLA, NMIMS Mumbai.

Saniya, a second-year student currently pursuing a Bachelor of Science degree in Applied Psychology, lives by the principle of romanticising the mundane. She embraces the “jack of all, master of none” philosophy, valuing the idea of throwing in random facts about various fields into everyday conversations. A lover of all things literature and psychology, Saniya gets a thrill out of analysing just about any piece of media from both lenses. A self-proclaimed Rory Gilmore wannabe with a soft spot for gothic literature, she firmly believes that there’s nothing that a good playlist and a cup of tea can’t fix!

Comments

Post a Comment

Popular posts from this blog

THE PSYCHOLOGY BEHIND THE “FAKE IT TILL YOU MAKE IT” PHENOMENON

-
Image
-by Unnati Sahni (FY, MSc. Applied Psychology) Have you ever found yourself stepping into a situation where you didn’t feel ready, telling yourself, "I'll act like I belong here?” Maybe it was speaking up in a meeting giving a presentation, or even asking someone out. That’s the essence of “fake it till you make it.” At its heart, this concept isn’t about being deceptive—it’s about leveraging the mind-body connection to grow into the person you want to be. From a psychological point of view, this is effective because the human brain is amazingly adaptable. One theoretical framework that supports this notion is the self-perception theory, which argues that people often come to know their emotions through their behaviors. For instance, when a person smiles, even when in pain, the brain interprets the smile and starts to associate it with good feelings. The same principle applies to confidence—when you act confident, your brain interprets your actions as evidence that you are con...
Read more

The Diasporic Disconnect Amidst Urban Setting in Students

-
Image
 The Diasporic Disconnect Amidst Urban Setting in Students  - By Drishti Haldia (MSc. Applied Psychology, Sem II) Automat by Edward Hopper (1927): The painting depicts isolation and urban loneliness.  “ Imagine standing by a window at night, on the sixth or seventeenth or forty-third floor of a building. The city reveals itself as a set of cells, a hundred thousand windows, some darkened and some flooded with green or white or golden light. Inside, strangers swim to and fro, attending to the business of their private hours. You can see them, but you can‘t reach them, and so this commonplace urban phenomenon, available in any city of the world on any night, conveys to even the most social a tremor of loneliness, its uneasy combination of separation and exposure .” -Olivia Lang What is Diaspora?  Diaspora refers to a population or group of people who originated from a specific geographic location but currently reside in different regions or countries. It is very re...
Read more

Myths Being Debunked and Facts about Suicide

-
Image
Aarya Patil MSc. FY Applied Psychology  “Help! Help! It was someone screaming, I looked behind and saw no one was there. I heard the same scream again but this time I did not look back, because I knew, I was familiar with this voice, it was the voice within me, suffocating but it wanted to speak.” Let’s understand the myths about suicide and debunk them instead of feeling suffocated. 1) “ Individuals who have a mental health condition are the only ones affected by suicidal ideations and attempts ”, that’s not true - anyone out there without a mental health condition can be affected by suicidal thoughts - so keep checking in on your loved one’s or anyone you know of displaying signs.   2) “ People who talk about suicide are attention seekers” , When we are physically hurt, like if we have scrapped our knee or bleeding through our lips, don’t we ask for help readily? Just because suicidal thoughts are not physically present, people often assume it’s just for attention seeking, ...
Read more