RiceWrist May Facilitate Enhanced Rehabilitation for Spinal Cord Injuries

In the basement of Rice University in West Beaumont, Texas, in Professor Marcia O’Malley’s office, a new type of robotic rehabilitative device was invented. The device, called the RiceWrist, is a fully articulated exoskeleton that mimics the joints of patients’ arm from the shoulder to the hand. The RiceWrist gently re-trains the motor neuron pathways of patients with spinal cord injuries.

In April, 2010, professional motocross rider Randy Childers was injured in an accident that left him with broken ribs, a compound fracture (when the broken bone breaks through the skin) of the wrist, and crushed vertebra in his neck. After a 12 hour surgery including fusing several vertebra together and months of rehab, Childers recovered enough to walk, although very slowly.

In October of 2010, Childers contacted Professor O’Malley’s office at Rice University to participate in a single patient clinical trial of the robotic device. The RiceWrist not only markedly advanced his recovery, but with such promising results that people with spinal cord injuries around the globe were given new hope of further rehabilitation.

While the device was merely a prototype during Childers’ trial, the RiceWrist was moved to the the world renowned Memorial Hermann Hospital for further development.

The RiceWrist combines advanced computation with mechanics more sophisticated than current rehab devices. It has a fully customizable “assist as needed architecture” that allows patients to complete a task to the best of their ability, and then the robotic device takes over when the patient has reached their physical limit. Currently, the therapist dictates the degree of assistance, however future versions will automate the assistance level based on a real-time performance assessment.

The technology is based on the patients moving independently initially, and then the robot kicks in to complete the action. “Literature supports the idea that there needs to be some intentional movement to really reap the rewards of rehabilitation” made possible by the RiceWrist O’Malley said.

Research suggests spinal cords that haven’t been completely severed can, in some way, be rewired through repetitive movement.  The RiceWrist works by the brain thinking about moving with the limbs moving at the same time to begin to remap severed neuro motor pathways. The technology is based on the widely accepted theory that “neurons that fire together, wire together.”

“This is not just an exercise machine,” O’Malley explained, “This device targets more joints in a controlled way”

By using the device in rehabilitative medicine, doctors who were once limited to occasional assessments of a patient’s progress that could be months apart can now get real time feedback from the RiceWrist.  Even when powered down, a “back drivable” mode allows the patient to move all the joints and clinicians will still have real time data on the progress of the patient.

After only 2 weeks of using the RiceWrist, Childers was doing tasks with very little assistance. Fine motor skills were greatly improved on functional tasks like turning a playing card and picking up pennies.  Professor O’Malley’s research with Childers will be showcased and presented at the IEEE International Conference on Rehabilitation Robotics, a part of Rehab Week in Zurich, Switzerland June 27 – July 1, 2011.

The RiceWrist is not yet approved by the Food and Drug Administration (FDA) but is still being evaluated at TIRR for its effect on other patients with spinal cord injuries along with additional controlled studies.

Source:

http://medicalxpress.com/news/2011-04-ricewrist-robot-spinal-cord-injury-victim.html