Robot helps stroke patients with their rehabilitation at home

Principal occupational therapist Christopher Kuah guiding Madam Seet Jeu Luang in the use of the H-Man. ST PHOTO: ONG WEE JIN

SINGAPORE - A portable robotic device that can help stroke patients with their recovery at home was unveiled at a media event at Tan Tock Seng Hospital (TTSH) on Wednesday (Oct 28).

With help from the robot, patients can do the repetitive exercises needed to regain control in their arms and build up their strength once more, without always having to visit a clinic or hospital to attend sessions with an occupational therapist.

The portable arm rehabilitation robot weighs 14kg and has been named "H-man".

Rather than resembling a man, however, the device sits on a table, its joystick-shaped handle attached to a computer screen and a resting pad.

It may look simple enough but H-Man is an intelligent device.

It can sense the condition of the patient's arm in terms of strength and agility and automatically adjust assistance or resistance according to the patient's needs, when he or she performs the exercises.

In this manner, the patient relearns sensorimotor control so that he can resume daily activities.

Furthermore, H-Man will provide feedback on the patient's progress to his therapist, who can monitor recovery remotely. This is particularly convenient amid the Covid-19 pandemic.

During the media launch at TTSH, Dr Asif Hussain, the chief executive and co-founder of Articares, the company that is developing H-Man, said that the robotic device is used in some hospitals and nursing homes here and overseas but not at TTSH, though the hospital has plans to incorporate it in one of its post-stroke therapy programmes sometime next year.

He said that most robots currently used for rehabilitation purposes weigh up to 70kg, require special reinforced housing and are located at hospitals where their operation is managed by occupational therapists.

These robots are also costly, which makes widespread implementation a challenge.

Rehabilitation robotics was pioneered by the Massachusetts Institute of Technology in the United States in the late 1980s.

Associate Professor Domenico Campolo, co-founder of Articares, said the portability of the H-Man can make a difference in the use of such technology for post-stroke therapy.

"When we started, we really wanted to build something for the home... Our definition of portable was anything that fits in a taxi," he said.

The Articares founders said the H-Man can be rented or purchased but they declined to share the cost.

"The traditional way is to bring the patient to the clinic where you have maybe one hour for the therapy. Anything longer than an hour is difficult, as the patient will be fatigued," said Assoc Prof Campolo, who is also director of the NTU Robotics Research Centre.

"But if you have something closer to home, maybe you can have 15 minutes in the morning, 15 minutes in the afternoon. It opens up possibilities to try new therapies as well."

Madam Seet Jeu Luang, 60, who had a stroke in July last year and has weakness in her dominant right arm, was happy using the H-Man to complement the daily hand and arm exercises she did at home. She was one of 10 patients who experienced the H-Man that was on loan from Articares at TTSH's Centre for Advanced Rehabilitation Therapeutics (Cart) early this year.

It has since been returned to Articares.

H-Man is the result of more than eight years of work by scientists from Nanyang Technological University (NTU) Singapore, in collaboration with rehabilitation physicians and occupational therapists from Cart.

Adjunct Associate Professor Karen Chua, a senior consultant at TTSH's department of Rehabilitation Medicine and at NTU's Lee Kong Chian School of Medicine, led the clinical trials for the H-Man from 2014 to 2018. She said it has demonstrated its efficacy in helping patients improve their upper-limb mobility in combination with conventional occupational therapy, during a clinical trial involving 60 stroke patients undergoing rehabilitation.

"Furthermore, lasting gains up to 19 weeks were observed after training, implying sustainability of the training and this was associated with high levels of patient safety and self-reported satisfaction in trained subjects," she said, adding that the therapist will set the training goal for the patient and that the exercises must be prescribed.

When the H-Man trial was completed, the technology was commercialised and spun off into Articares, which is incubated by NTUitive, NTU's enterprise and innovation company.

TTSH principal occupational therapist Christopher Kuah said the H-Man, which can also be used in hospitals, makes repetitive exercises less boring for the patients, as they play a game while doing their therapy.

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