Paediatric Robotic Rehabilitation

Original Editor - Syeda Bushra Zehra Zaidi

Top Contributors - Syeda Bushra Zehra Zaidi, Lucinda hampton and Rishika Babburu

Introduction

Children with physical disabilities often face challenges in daily activities, which can hinder their physical, social, and mental development. Rehabilitation is essential to mitigate the adverse effects of various physical disabilities and improve independence and quality of life. In recent years, robotic rehabilitation has shown potential in enhancing traditional physical therapy. However, most existing robotic rehabilitation devices are designed for adult patients, limiting their potential for pediatric patients.

Rehabilitation and Robotic Devices

Rehabilitation plays a vital role in improving functionality and maintaining physical abilities for children with physical disabilities. Traditional therapies, including passive orthoses, surgery, and physiotherapy, have been employed to manage musculoskeletal deterioration and enhance physical function. In contrast, robotic rehabilitation, a type of robot-assisted therapy, offers several advantages over conventional methods. These benefits include quantitative assessments, repetitive task-specific movements, and reduced therapist effort.

Paediatric Robotic Rehabilitation Design Requirements

To develop optimal robotic rehabilitation devices for children, several design requirements must be considered. These include operability, weight, safety, and motivation factors. Operability is crucial as children are continuously developing, and the device must adapt to their changing abilities. Minimising the weight of the robot is essential to avoid hindering the child's movement and increasing energy consumption. Safety mechanisms must be incorporated to minimize risky situations, considering that children may not assess hazards adequately. Additionally, motivation is essential to engage children in the rehabilitation process, and strategies like aesthetic designs and virtual environments can help achieve this goal.

Types of Robots Used in Pediatric Rehabilitation

The review identified 58 robotic devices used for pediatric rehabilitation, with prototypes in action. These devices were categorized based on their mechanical structure (end-effectors or exoskeletons) and the anatomical part of the body they targeted (upper limb or lower limb).

The two main categories of robots used in pediatric rehabilitation are:

1. End-effectors: End-effector robots work by applying forces to the distal segments of limbs, creating a mechanical chain that prompts movements of other parts of the limb, generating a pattern of specific activity across different joints. They are often used for both upper and lower limb rehabilitation. These robots are generally simpler in structure and can be adapted to the needs of different pediatric patients. However, it can be challenging to isolate specific joints since they produce complex movements involving the whole limb.
2. Exoskeletons: Exoskeleton robots are wearable machines that mirror the patient's skeletal structure. They are designed to move specific joints of the limb where the exoskeleton is worn, allowing for independent and concurrent control of those segments. Exoskeletons provide more targeted therapy and can be used for both upper and lower limb rehabilitation. However, they require precise customization to match the length of the patient's segments, and increasing the number of degrees of freedom in the robot can increase its complexity and weight.

Both end-effectors and exoskeletons have their advantages and limitations, and the choice of the robot depends on the child's condition, functional goals, and specific therapy requirements. As technology advances, researchers and developers continue to explore and refine these robotic devices to enhance their effectiveness and cater to the unique needs of pediatric patients of cerebral palsy, stroke, or any physical diasablility.

Role of Medical Doctors (M.D.s) in Robotic Rehabilitation for Children with Physical Disabilities

1. Diagnosis and Evaluation: Doctors are responsible for diagnosing medical conditions and determining the extent of a patient's health issue. They use their medical knowledge, clinical expertise, and diagnostic tools to identify the underlying cause of the patient's symptoms.
2. Treatment Planning: Once a diagnosis is established, doctors develop treatment plans tailored to the patient's specific needs. They consider the patient's medical history, overall health, and any other existing conditions to ensure a comprehensive approach to treatment.
3. Prescribing Medications: Doctors have the authority to prescribe medications to manage symptoms, treat diseases, and improve overall health. They carefully consider potential side effects and interactions with other medications to ensure patient safety.
4. Surgical Interventions: When necessary, doctors may recommend and perform surgical procedures to address certain medical conditions or injuries.
5. Monitoring Progress: Doctors regularly monitor a patient's progress through follow-up appointments and further evaluations. They may adjust treatment plans based on how the patient responds to interventions.
6. Coordination of Care: Doctors often serve as the central point of contact for a patient's healthcare team. They coordinate care among specialists, therapists, and other healthcare professionals to ensure a unified approach to the patient's well-being.
7. Patient Education: Doctors educate patients and their families about their medical conditions, treatment options, and lifestyle modifications needed for optimal health.

Role of Physical Therapists (PT) in Robotic Rehabilitation for Children with Physical Disabilities

As a pediatric Physical Therapist (PT), your role in robotic rehabilitation for children with physical disabilities is of utmost importance. Here are some key aspects of your role as a pediatric PT in robotic rehabilitation:

1. Comprehensive Evaluation: You are responsible for conducting a thorough evaluation of each child to assess their specific impairments, functional limitations, and overall physical abilities. This evaluation helps determine whether robotic rehabilitation is suitable for the child and aids in setting appropriate goals.
2. Device Selection and Customization: Working closely with engineers and developers, you provide valuable input in selecting the most suitable robotic device for each child. Your expertise in understanding the child's motor function and physical capabilities helps in customizing the device settings to optimize therapy outcomes.
3. Therapeutic Planning: Based on the evaluation results, you design personalized treatment plans that incorporate robotic rehabilitation as part of the overall therapy regimen. Your expertise in pediatric rehabilitation enables you to create exercises that are developmentally appropriate and address specific functional goals.
4. Progress Monitoring and Adaptation: You regularly monitor the child's progress during robotic rehabilitation and make necessary adjustments to the treatment plan based on their evolving needs and improvements. Your keen observation skills enable you to identify any challenges or limitations the child may be facing.

Conclusion

In conclusion, pediatric robotic rehabilitation holds significant promise in enhancing the functional outcomes and quality of life for children with physical disabilities. By offering advantages such as quantitative assessments, repetitive task-specific movements, and reduced therapist effort, robotic rehabilitation complements traditional therapies and provides a more engaging and effective approach to rehabilitation. The use of end-effectors and exoskeletons caters to the diverse needs of pediatric patients, with each type offering specific benefits. The collaboration between physical therapists, engineers, caregivers, and healthcare professionals is essential in tailoring these robotic devices to meet individual needs and ensure a patient-centered approach. By embracing and integrating robotic rehabilitation into pediatric care, we can significantly improve the functional abilities and independence of children with physical disabilities, fostering a brighter future for their overall well-being.