Arizona Technology and Innovation: Robotics Rehabilitation

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Experts, students and Arizona State University faculty will meet for two days of workshops at ASU’s Tempe campus to discuss the use of robotics technology to improve physical rehabilitation treatment. Bradley Greger, an associate professor in ASU’s School of Biological and Health Systems Engineering, and Thomas Sugar, a professor in the ASU Ira A. Fulton Schools of Engineering, will discuss the use of robotics in physical therapy.

Ted Simons: In tonight's look at Arizona technology and innovation, experts, students and faculty will meet for two days of workshops at ASU's Tempe campus to discuss the use of robotics technology to improve physical rehabilitation treatment. Here to discuss the use of robotics in physical therapy is Bradley Greger, an associate professor at ASU's School of Biological and Health Systems Engineering, and Thomas Sugar, a professor at ASU's Ira A. Fulton Schools of Engineering. Good to have you both here. Thank you so much for joining us. Define terms here, robotics, what are we talking about?

Bradley Greger: Robotics are machines that move and kind of act like humans or can be used to automate and accentuate human movement. We're using them to aid movement or restore movement for people who have lost motor function and in my case in particular we're using them to replace limb. We'll build a robotic arm.

Ted Simons: It's something that is machine-ish?

Thomas Sugar: It's machine-ish but it allows you to augment or assist people so we're working in the area of prosthetic ankles, building systems that replace function so if someone has lost an ankle and a foot, we build a robotic ankle that allows them to walk, run, jump.

Ted Simons: And if let's say you do lose an ankle or a foot and you do have these robotics attach, do you control them, do the robots? Who controls what?

Thomas Sugar: The good news is you control the robots.

Bradley Greger: That is the good news.

Thomas Sugar: That's how it should be. And so we use sensors on the leg to tell how to move.

Ted Simons: Using the sensors, you do have to understand how an ankle works.

Bradley Greger: Absolutely. Well, we've done a lot of work understanding the mechanics of how the ankle works. We want to have a direct interface with the nervous system so people think about moving their foot and it will provide sensory feedback.

Ted Simons: What kind of hardware?

Bradley Greger: Well, the robot itself, tom can answer that better than I can. It's just very tiny wires, just little, tiny microwires that interface into the nerves, just to read the signals on the nerves.

Ted Simons: Would the wires interface into nerves in the brain? Do they go all the way down?

Bradley Greger: It could depend. For people who are completely paralyzed then the brain is the way to go. For someone who has an amputation or lost a foot or arm, you go into the residual nerve in the arm or foot.

Thomas Sugar: It sounds like the human-robot interaction has advanced an awful lot in a short period of time.

Thomas Sugar: It sure has and people working in the area of peripheral nerves like Bradley, they're trying to attach them to different types of robots, whether they're prosthetics or getting into the area of exoskeletons, to help people move, help people walk, assist gait and those kind of things.

Ted Simons: Let's talk about rehab specifically. Let's say that you don't necessarily need the full nine yards here but in terms of maybe pushing patients at a proper speed, I would think a machine would be much better at that.

Bradley Greger: Certainly for people who have had a stroke or something like that who are just trying to restore function from the stroke with their body pretty much intact. You could build robotics to restore the natural functions and that's something that's very much a part of this workshop.

Thomas Sugar: And also part of it is robots don't take over completely. Usually, physical therapists with the robot assist the robot, assist the person to allow the training to take over. Most of the time, the best robots are the ones that work with the therapist, work with the person and assist. So there's a lot of machines out there that are working in this arena.

Ted Simons: I would imagine if you've got a human therapist and I think I've had enough now and the machine goes not really, the machine's going to push you a little bit, isn't it?

Thomas Sugar: The machine can push you a little bit. What they try to do is assist as needed. The robot is just supposed to assist only a certain amount and then stop because if the robot does everything, then you will not learn.

Ted Simons: Right but in terms of rehab if the robot does everything to push you towards something, you should be learning there shouldn't you?

Bradley Greger: There's this trade-off. You want the robot to help but it's got to be that balance.

Ted Simons: As far as robotic body suits, I was reading about bionic limbs. This is really happening.

Thomas Sugar: This is really happening. Wearable robotics is really happening. Next year, ASU is looking to have a robotics week where we'll have wearable robotics for three days and then two days the rehab robots.

Ted Simons: As long as you've been in this field now, what have been the biggest challenges and have you managed to overtake those?

Thomas Sugar: I think some of the biggest challenges have been very cost effective sensors, very small microprocessors and good batteries and those challenges have really come about because of smart phones and the technologies. You've got great batteries, great sensors, really cost effective devices so for the last years what we've seen is you can build small, lightweight robotics systems, and now, the challenges are can you have the robot work with the person and get volitional control? Can the person tell the robot what to do, with the peripheral nerve interface.

Bradley Greger: We have to reach into the human nervous system to understand how it functions, in order to take the signals out of it to control the robot. And as you can imagine the brain and the nervous system is quite complicated.

Ted Simons: I was going to say what's more complicated getting the robotics in person or figuring out the nerves?

Bradley Greger: They're both important and both really hard. We're making progress.

Ted Simons: And as far as the progress and the impact on quality of life, tell us about that.

Bradley Greger: Well, there are so many aspects to this. The immediate things we'll see is people walking around with limbs that can provide some limited sense of touch, we're also working on restoring vision to people who have lost vision, and there will be these sorts of devices in the near term, the next decade easily, you'll see them pretty commonly that will restore lost sensory function and lost motor function.

Ted Simons: I would imagine the psychological effects even with the rehab element, as far as what you were talking about, the psychological effects on patients and families, talk to us about that.

Thomas Sugar: So we've seen people really enjoy walking with a powered ankle, a powered ankle gives you a very good function. They've told us that their back doesn't hurt anymore, that when they walk, it's easier to walk slowly, it's easier to walk longer. So in the prosthetics field, we've seen many people really enjoy these powered ankles.

Ted Simons: And the psychological aspect, this is no placebo here. This is really working.

Bradley Greger: It's amazing. Even in the limited restoration we've seen for vision and the sensory restoration for people who have lost a limb, it's amazing. They light up, it's profound. You have a patient who lost an arm decades ago control a prosthetic hand for the first time in decades, it's a wonderful thing to see.

Ted Simons: Talk about the collaboration. You've got engineering, you've got bio, medicine somewhere in the middle here. Talk about how all those disciplines are coming together on this and is that a bit of a challenge?

Thomas Sugar: That's always a challenge. We've collaborated on a grant area where you have to link engineering with bioengineering, with the medical field.

Bradley Greger: And this is what the workshop was all about to bring those sorts of talents and expertise together from all over the world to start discussing the ideas. We have to understand the clinical realities, the clinicians have to understand what we can do in terms of the engineering, it's a lot of smart people coming together to try to solve a common problem.

Ted Simons: And the medical doctors need to know what's out there, what's available, right?

Bradley Greger: Yep. And they need to guide us on what they can really do. So we have surgeons and medical specialties showing up.

Ted Simons: How fast are these advancements coming? And here's a question for you. Can you grab them when they're coming at you this fast?

Bradley Greger: Well, they're coming fast but there is also very good regulatory oversight. There's control. We have the FDA who makes sure everything is done very appropriately with great concern to safety. And the physicians, their first mandate is the care of the patient in front of them. And so I almost wish we could have them faster but it takes time and resources and that's one of the challenges.

Thomas Sugar: I was going to see there's powered prosthetic limbs out there being sold now so they're not just the passive ones. They are selling, commercializing.

Ted Simons: Are doctors realizing this? Are they informed enough?

Bradley Greger: There's powered ankles that are being sold and there's a company in town actually that works on powered prosthetics.

Ted Simons: February 13 th and 14th at the M.U. in Tempe? The workshop and can folks just wander in?

Bradley Greger: It's free. It's open to the public. Absolutely would welcome people to come.

Ted Simons: Very good. Good to have you both here. Congratulations on great work. Thank you so much.

Bradley Greger: Thomas Sugar: Thank you.

Ted Simons: Tuesday on "Arizona Horizon," hear about the upcoming Arizona sci-tech festival, which features science-based events throughout the state. And learn about a program that's using horses to help kids with low self-esteem. That's on the next "Arizona Horizon." That is it for now, I'm Ted Simons. Thank you so much for joining us. You have a great evening.

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Bradley Greger:Associate Professor, School of Biological and Health Systems Engineering at Arizona State University; Thomas Sugar:Professor, Ira A. Fulton Schools of Engineering at Arizona State University;

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