Robot-Assisted Rehabilitation at New York Methodist Hospital

Aug 31, 2011

doctor helping patient

New York Methodist Hospital recently acquired a robotic-assisted rehabilitation system, known as the Lokomat, and it is already helping many patients recover from diseases and disorders like spinal cord injury, stroke, traumatic brain injury, multiple sclerosis, cerebral palsy, and Parkinson's disease. These conditions often leave patients with a decreased range of motion due to injury or abnormality of the brain. While there is currently no cure, certain treatments have been shown to greatly improve quality of life.

One of these treatments places the patient in a harness suspended slightly above a moving platform while a therapist physically moves the patient's legs. In advanced versions of treadmill training, the orthosis mechanically moves the patient's legs, training the gait more naturally and accurately. This advanced robotic-assisted machine is called the Lokomat, which, in conjunction with other kinds of physical therapy, helps patients regain mobility. The computerized robot, which is manned by one of the trained physical therapists at NYM, not only controls the speed and level of difficulty, but monitors how much effort the patient is making, providing constant feedback and personalized assessment. New York Methodist Hospital is the first Hospital in Brooklyn and one of the first in the country to acquire the Lokomat.

The premise of this robotic-assisted rehabilitation is that new movement or an improvement to an existing movement in a patient with a neurological disorder can be achieved only through a very high number of repetitions of that movement. These movements must represent the actual movement-whether walking correctly or putting on an earring-to be learned as accurately as possible. The new technology allows patients to repeat these movements at this level of accuracy. It can also focus in on specific joints and muscles, for instance, the knee or the hip, and target especially weak areas, creating an individualized therapy experience.

"The introduction of the Lokomat has proved to be a great adjunct to the therapy that NYM offers to patients," said Manuel Wilfred, P.T., chief of physical therapy. The "driven gait orthosis" of the machine automates locomotion therapy on a treadmill and improves the efficiency of treadmill training. The therapy is very individualized, based on the type of neurological disorder and phase within the disorder. "I have witnessed notable improvements with patients who have been rehabilitated on our machine, in less than three weeks," said Mr. Wilfred.

In addition to the Lokomat, used for rehabilitation involving walking and gait, New York Methodist Hospital has also acquired the Armeo, a machine for the upper body, which aims to increase mobility in the arms and fingers for patients who have experienced neurological illness. The occupational therapy exercises made possible by this machine are designed to provide patients with the specific skills needed to reach the highest level of independence in daily activities. The Armeo provides computerized games and activities to improve coordination and functional ability. An "assisted spring" in the device gives patients the boost they need to complete the tasks set for them by occupational therapists. "Patients enjoy the feeling of success in their therapy," said Norma Rossi, O.T.R., chief of occupational therapy. "They get immediate and constant feedback from the machine and from the therapists at NYM."

Acquisition of the robotic-assisted rehabilitation system was made possible by New York City Council grants sponsored by Council Member Bill de Blasio (now the Public Advocate) and Council Member Michael Nelson. "The acquisition of these two machines, in conjunction with the other equipment and excellent therapists staffing our rehabilitation unit, can only mean better care for patients who have experienced neurological distress," said Miran Salgado, M.D., chairman of neurosciences. "We are very grateful to the legislators who helped to make it possible for NYM to improve the quality of life for our patients."

For more information, please call the Department of Neurosciences' Rehabilitation Division at 718-780-3248.

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