April 1, 2008 Using a technology called haptics, mechanical engineers can design physical therapies that reestablish motor pathways broken down by strokes. A motorized joystick guides patients to move their hands in the direction dictated by graphics on a television screen. This feedback helps the patients regain motion that had been previously lost.
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There are more than four million stroke survivors living in the United States. It's been a standard prognosis for almost all of them -- whatever motor skills you didn't get back right away may be lost forever; but now, new technology is proving that even stroke rehab is better late than never.
Judy Walsh is proud grandmother and a stroke survivor. "I just couldn't believe it," Walsh recalls. "Here I am, 54. I never thought I would have this problem."
But now at age 64, ten years post stroke, Walsh is still feeling the effects. "My left side of my leg, my left arm, my speech and my swallowing," Walsh describes.
For many stroke patients, functions that aren't relearned in the first few months after their stroke are nearly impossible to get back. Regaining motor skills is a frustrating process that makes even the simple things in life difficult.
"Getting dressed, putting socks on … that's a two-handed deal too," Walsh says.
But mechanical engineer Marcia O'Malley is determined to help stroke patients continue on their road to recovery, no matter how far out they are. "If we continue to deliver therapy, they're going to see continued improvement," Marcia O'Malley, of Rice University in Houston, told Ivanhoe.
Using the same technology found in video game controllers, she's using a technology called haptics, which relies on the perception of touch, allowing patients to feel their environment while being guided through correct movements.
"We know that repetitive practice -- high intensity practice -- can improve outcomes for rehabilitation, and robots are really well suited to that," O'Malley explains.
By repeating exercises over and over, patients regain motion. Mike Dixon was able to get the results he was looking for, four years after his stroke. "Things show that I'm improving on a regular basis," Dixon says.
This joystick therapy could be in high demand, but that's something O'Malley and her team has already thought about. "A robotic device might enable one therapist to oversee numerous patients at the same time," O'Malley explains. Giving more patients like Walsh the freedom to move as they please.
This joystick technology can also potentially be used by patients at home, allowing them to continue rehab on their own schedule.
ABOUT STROKES: Stroke is a type of cardiovascular disease that affects the arteries leading to and from the brain. When one of these becomes blocked, or bursts, blood and oxygen can't get to that part of the brain and it begins to die. Strokes can cause paralysis, affect language and vision, and lead to memory loss. Stroke kills nearly 163,000 people every year; it is the third leading cause of death, behind heart disease and cancer.
ABOUT MOTOR FUNCTION: Even a simple motor movement involves many different regions of the body, but the primary motor cortex of the brain is one of the most important. It sends out electrical impulses through nerve cells called neurons that control the execution of movement. Every part of the body is represented in the primary motor cortex; the left side of the brain controls the right side of the body, and vice versa.
Certain diseases or brain damage can disrupt these basic functions. For instance, cerebral palsy is a disorder that affects body movement and muscle coordination because of brain damage, which interferes with messages from the brain the body, and vice versa.
WHAT IS VIRTUAL REALITY: The term "virtual reality" is often used to describe interactive software programs in which the user responds to visual and hearing cues as he or she navigates a 3D environment on a graphics monitor. But originally, it referred to total virtual environments, in which the user would be immersed in an artificial, three-dimensional computer-generated world, involving not just sight and sound, but touch as well.
Devices that simulate the touch experience are called haptic devices. Touch is vital to direct and guide human movement, and the use of haptics in virtual environments simulates how objects and actions feel to the user. The user has a variety of input devices to navigate that world and interact with virtual objects, all of which must be linked together with the rest of the system to produce a fully immersive experience.
Editor's Note: This article is not intended to provide medical advice, diagnosis or treatment.

