Robotics and virtual rehab: how far should we go?
Rehabilitation Rehabilitation can be a long, slow recovery process that places a burden on the health system: we look at how tech is helping to bridge the gap.
Exoskeletal devices, functional electrical stimulation, computer gaming neurotherapy, and virtual reality tools are all exciting new developments in rehabilitation.
“We have not yet had enough hard data to reflect what’s going on, but we expect data to show massive change in the next 10-20 years,” says Dr Ganesh Bavikatte, Consultant at The Walton Centre. “We are seeing more, and more various, neurological and critical patients being saved. However, quality of life afterwards and ongoing disability have to be addressed at the same pace. This is what rehab focuses on.”
One size does not fit all
Rehabilitation can be a long, slow recovery process, involving late-stage setbacks as well as social and emotional complications, placing difficulties on patients and their loved ones, says Dr Bavikatte. “It’s not about replacing, but about adding to existing long-term care provision and actual patient and family needs. Tech has a role to play, but any treatment needs to be tailored to the patient’s needs. One size does not fit all.”
Robotics can be used to replace or supplement a limb and support limb functions. Exoskeletal supports range from hand splints to lower body assistive walking devices. “It doesn’t mean everyone with severe disability, or in a wheelchair, will suddenly be walking,” says Dr Bavikatte. “There are many factors to take into account. We must always ask ourselves: what is a realistic goal for each patient? Is it helpful to get someone up and ‘walking’ with an exoskeletal device if their overall condition cannot support this technique? Potential risks such as fall and potential injury to our patients need to be considered too.”
Time to embrace tech
Virtual reality (VR) rehab is another new technology with great potential. “It can be used for stretching, strengthening, balance, walking, coordination and other tasks, and it can be as simple as a device, attached to a TV, demonstrating the exercises. The therapist assesses the best programme for the patient.”
Not yet widely available, VR rehab also increases motivation and helps mood.
“You can feel you are catching or throwing a ball,” explains Dr Bavikatte. “For the physician, the added advantage is that the patient is exercising safely. For the patient, VR stimulates the brain and psychological well-being. It’s mostly used in private charity or research environments now, but as more research comes through, that will probably pave the way for more funding, improved cost efficiency and wider use.”
Case in point
The most rewarding case Dr Bavikatte personally experienced, involved a patient who underwent months of slow but steady progress in rehab after a brain injury, with difficulties in balance and in walking straight. After many months under clinical review, she received some assistance from the a VR rehabilitation programme through the BASIC charity. “She came to my next clinic wearing high heels and told me she’d done a Sydney Harbour Bridge charity walk in them!”