In recent years, along with the development of rehabilitation technologies, the robotic devices and virtual reality implementations became more and more popular in the world and in Turkey. The implementation of these technologies in the field of physiotherapy and rehabilitation is called robotic physiotherapy or robotic rehabilitation.
Robotic rehabilitation is frequently used in the following disorders: Stroke, brain injury, spinal cord injuries, Parkinson’s disease, Alzheimer’s disease, multiple sclerosis, Guillain-Barré syndrome, balance disorder due to various factors and increased risk of fall, cerebral palsy, and orthopedic loss of functions.
The goal of the robotic physiotherapy systems is the resume of the hand and arm usage, standing and gait functions.
The robotic systems can be grouped into two categories as standing upright and passive gait in the early phase and active assisted and incremental and independent gait in the late phase.
In the early phase, the preservation or quick recovery of the upright standing and gait skills are the goals of the therapy. Therefore, after the intensive care and surgical processes, the patients are cautiously trained to stand upright with the robotic gait-assisted bed under the consideration of the blood pressure and cardiovascular diseases. In the meantime, the passive gait training is initiated with the help of the robotic feet to prevent the stiffness and limitation in the joints. The robotic system called Erigo Pro developed by the Swiss company Hocoma is the pioneer in the field.
The next step of the robotic gait exercises is continued with the active-assisted and virtual-reality-augmented gait robot. The robotic gait system called Lokomat Pro with free D is the leader device in this field.
The hand-arm robot is used for the quick recovery of the lost extremity functions in the first days when the patient is able to sit. Regarding the unused tissues, the brain acts with the “USE-IT-OR-LOSE-IT” principle. Robotic rehabilitation enables the prevention of the forgetting or ignoring of the hand and arm use controlled by the damaged brain region. The hand-arm robots, which include virtual reality techniques, are used for the training of the regaining of the lost hand and arm skills near to the normal level. The robotic system Armeo Power with Manova developed by the Swiss company Hocoma is the leader in this field.
After the patient has recovered to a certain level in the robotic bed during the early phase of the disease, the active-assisted gait training with advanced robot should be continued. The robotic gait device, which is used in this phase, consists of sensor and virtual reality systems. The patient is suspended with the help of straps in order to prevent joint and spine problems caused by the excessive load. The movements of the patient and the muscle strength are loaded in the computer with the help of the robotic sensors and converted to graphics. The movements, who cannot be executed by the patient, are supported by the robotic feet. The virtual reality monitor at the front of the patient shows a graphic presenting a human body (called avatar). The movements detected by the sensors are simulated in this avatar on the monitor. The patient tries to improve his/her gait with the help of the games played on the monitor.
Robotic physical therapy systems help the patient to recover as quickly and accurately as possible.
As the movements can be repeated regularly in the most correct way thanks to the robotic rehabilitation, enables the re-learning of the correct movements at the level of the brain and spinal cord.
The reserve cells (also called stand-by cells) stimulates the brain with this method and the learning process of a task from scratch is initiated. The robotic rehabilitation enables the recovery of the mobility and strength of the muscles in the fastest and most correct way with the help of the virtual reality (VR) and sensors.
In all disorders, in which the nervous system is affected (e.g. stroke, brain damage), a comprehensive rehabilitation program should be initiated immediately after the onset of the disease in order to return to a near to normal and healthy lifestyle as quickly as possible. The robotic rehabilitation (robotic physiotherapy) increases significantly the efficacy of the treatment during this rehabilitation process. In recent years, it was confirmed that the brain contains reserve cells and these cells can learn new tasks through a remodeling period with an appropriate rehabilitation program. In the light of this information, it can be suggested that the robotic physiotherapy can be useful in all phases of the disease starting from the early phase to the middle and late phases.