A Bionic Leg That Rewires Stroke Victims' Brains

waderoush writes "A startup called Tibion in Sunnyvale, CA, has begun selling battery-powered robotic exoskeletons that help stroke victims with one-sided weakness relearn how to stand, sit, walk, and negotiate stairs. The leg isn't a permanent attachment; the company says patients who use the device for 45 minutes a week for four weeks experience significant gains in walking speed that persist and even improve months after the treatment. They believe that the $40,000 device — which includes sensors that respond to subtle signs of user intentions, such a shift in weight — provides feedback that triggers neuroplasticity, the brain's ability to rewire itself to repair damage."

Re:Are there any studies?

[trb]

I agree, show me the research. I work in the field of rehabilitation robotics for stroke, and I am not aware of science that says that simply assisting someone's movement will improve their neural/muscular function.

I've been working on this problem for 10 years (as a software designer, not a neuroscience researcher) and researchers who use our robots have many studies that show patient improvement, but this comes from providing controlled rehabilitation exercises, not just by driving their limbs with an exoskeleton. I think research indicates that the rehab benefit comes from having the patients work to control their own limbs (with assistance and guidance if necessary from a robot or therapist) rather than by just driving the limbs without the patient working the neural paths.

refs:
N Engl J Med 2010; 362:1772-1783 May 13, 2010
http://www.nejm.org/doi/full/10.1056/NEJMoa0911341 [nejm.org]
http://www.interactive-motion.com/clinical_research.htm [interactive-motion.com]

Re:Are there any studies?

[MozeeToby]

The, at this point anecdotal, evidence is based on people who are beyond the generally accepted 12 month window of improvement. They showed an increase in walking speed of .2 m/s while using the device, and an additional .1-.2 m/s improvement in the months following the device's use.

So, if their results hold up in larger studies, I would say that this is either a new effect, or the conventional wisdom is dead wrong and we're giving up on rehabilitation too soon. Either way it's fantastic news for stroke victims. Some of the people they talked about were able to double their comfortable walking speed, that's a pretty big deal for a stroke victim who was told by their doctor "this is the best you will ever be able to walk".

Re:So there is a market for this stuff ?

[trb]

Problems of an aging and stroke-prone population cross international boundaries. "Who can afford this?" and "Will insurance pay for this?" are good questions, and the answers are different from country to country, and from year to year. Note also that hospitals and insurance companies are slow-moving organizations. If robotic science was a clearly safe magic pill that cured strokes, I assume we would find someone to pay for that cure. But with cures that provide only some degree of improvement, the treatments go through the normal course of medical research, and if the treatments are found to have sufficient and lasting efficacy, the medical and insurance fields eventually adjust to incorporate the new treatments.

As it is, I've seen research that shows repeatable quality-of-life improvements from our robotic therapy, and I've been at clinics and hospitals where patients and their families have given me heartfelt thanks for my work, which, while very gratifying, does not count as a controlled repeatable verifiable research result.