Robotic Machine Helps Stroke Patients Recover

Each year, more than 750,000 Americans suffer a stroke. Most of them survive; but for many, it means months or years of therapy to regain movement. In Orange County, some stroke survivors are using high-tech equipment to speed their recovery. KPCC's Susan Valot saw some of that equipment at Saint Jude Centers for Rehabilitation and Wellness in Brea.

Susan Valot: Seventy-seven-year-old Willi Downey was at home in Fullerton a couple of months ago when, she says, she just didn't feel good.

Willi Downey: My legs felt wobbly. And I couldn't hold a glass of water. I said, Bob, we have to go to St. Jude.

Valot: So Downey's husband took her to the hospital for tests. She suffered a T.I.A. – a transient ischemic attack, or more commonly known as a "mini-stroke." That was on Friday.

Downey: Saturday morning I felt OK. I was walking in the hall. And Saturday night, they did another MRI, and then I noticed for the first time, I had difficulty signing my name. And Saturday night it hit me.

Valot: Downey suffered a full-blown stroke. Doctors didn't consider it devastating – but it did paralyze the right side of her body. She still can't use her right arm without help from her left. So the 77-year-old's occupational therapist decided she'd be a good candidate for robot-assisted therapy.

The machine is known as the Motorika REO. St. Jude Centers for Rehabilitation and Wellness in Brea is the first facility in Orange County, and only the third one in California, to have it.

Susan Katzmann: Are you ready, Willamena?
Downey: Sure.
Katzmann: Okay, so why don't we walk over to the machine?

Valot: The machine looks like an industrial carpet cleaner with a giant video game joystick sticking out. There's a laptop computer on top. Therapist Susan Katzmann gets Downey situated. She straps Willi's arm onto the joystick.

Katzmann: We're going to start with the guided motion, okay? So the machine will take you through those points, but you can help it.
Downey: Okay.
Katzmann: All right?

Valot: On the computer screen, there's a 3-D image of a bunch of white circles and lines. They're connected almost like Tinker Toys. One of the circles represents Downey. With the machine's help, she'll reach out her hand to touch the other circles.

Computer: Moving to the first point.

Valot: The joystick guides Downey's hand to the first circle.

[Computer beeps as it reaches the first point]

Valot: The guided series of 60 movements warms up Downey's sore shoulder. She then moves on to "initiated movement." That means Willi has to use her arm to initiate the push to the point, then the machine takes over.

Katzmann: OK, so you're going to try and push with that shoulder and elbow, straight out. That's it. Good!

Valot: Sue Potts overseas the neuro rehab program at St. Jude's. She says robot-assisted therapy isn't so much about muscle strength.

Sue Potts: You're re-establishing neural pathways. So here is my movement pattern. This is how I want my arm to go. Right now, following a stroke, that area of the brain that moves that arm has been damaged, so you either re-establish the pathway to that part of the brain, or another area of the brain can actually take over that function. And I think that's been one of the most exciting things.

Valot: You have to repeat a motion hundreds of times for the brain to figure out how to make that new connection. A therapist can get through 30 to 50 repetitions in a typical 45-minute session. Potts says the machine can get through 300 to 400 in the same time.

Potts: The difference on this is it's that high intensity, repetitive motion that re-establishes those neural pathways. And it's done at a higher frequency than what one-on-one, just passive movement, and then active-assisted movement with a therapist, will entail. And it makes us more efficient. You can do that now on the REO. I can kind of set you up and watch you while I do my hands-on with my next patient.

Valot: Motorika's studies show the REO machine leads to quicker recovery by getting through more exercises faster and more precisely. Sue Potts says machines like these won't replace therapists. They're tools therapists can put to good use.

Potts: You know, when I started this 20 years ago, we knew nothing. You know, we were really just trying to accommodate the disability. And now we're improving the disability.

[computer beeps]

Katzmann: OK, and way over toward me. There you go. Like you're going to hit me in the stomach. Right there! (Katzmann and Downey laugh)

Valot: Stroke survivor Willi Downey says the computer-based REO recovery system is more interesting and fun than regular exercises.

Downey: I think it's fantastic, yes. I really like it.

Katzmann: That's it. Nice job. I think that's your last one.

Valot: She hopes it will make her stroke recovery a speedy one.

[Computer makes noise indicating it's finished. Katzmann and Downey both say "Yay!"]

Katzmann: So tell me, how does your arm feel?