A stroke is the death of cells in a part of the brain due to a loss of oxygenated blood. There are two main types. An ischemic stroke occurs when a clot blocks the flow of blood to the brain. The clot may form in a blood vessel feeding the brain (called a thrombosis) or it may develop elsewhere and travel through the circulatory system, becoming lodged in a narrower artery in the brain (called an embolism). Ischemic strokes are the most common kind, accounting for about 87 percent of all strokes.

A hemorrhagic stroke occurs when a blood vessel feeding the brain bursts. Depending on the location of the rupture, the blood may seep into the brain tissue or into the space surrounding the brain. This has two main effects. First, the tissues in the area of the brain beyond the rupture are deprived of oxygenated blood. Second, contact with blood damages nerve cells and can impair their ability to function. Although they are less common than strokes caused by a clot, hemorrhagic strokes are far more deadly. Roughly 38 percent of those with an ischemic stroke die within 30 days.

The American Heart Association estimates stroke effects 780,000 Americans annually. It’s the third leading cause of death (after heart disease and cancer), killing more than 150,000 in 2004. The condition is also the leading cause of serious, long-term disability in the U.S. This year, the cost of stroke to the U.S. is estimated to be $65.5 billion.

After a Stroke

The effects of stroke vary, depending on the part of the brain that has been affected and the amount of damage. One of the most common problems after a stroke is weakness or paralysis. It can affect a part of the limb or an entire side of the body. Researchers estimate about 25 percent of stroke survivors have severe arm weakness and loss of movement in the hand.

After a stroke, therapists begin rehabilitation to help a patient regain as much function as possible and increase his/her ability to maintain independence. Some brain cells may only be temporarily impaired. In other cases, the brain can sometimes learn to adapt by re-wiring control to undamaged areas.

ReoGo for Stroke Rehabilitation

Stroke rehabilitation may be provided by a number of different professionals, like physical therapists, occupational therapists and speech therapists. Some rehab programs are also using robots to aid in recovery.

There are many different robots used in stroke rehabilitation. One of them is called ReoGo (from Motorika Ltd.). ReoGo is used for patients who have acquired motor weakness in an upper limb from stroke or other type of neuromuscular condition (like spinal cord injury or traumatic brain injury).

The goal of ReoGo is to improve muscle strength, range of motion, control and coordination of the affected arm. After an initial assessment, the therapist programs the robot for the appropriate levels of exercise. For example, the therapy can be used to improve hand grip or arm control and strength. For patients who initially have no voluntary movement, the ReoGo guides the arm through a series of repetitive exercises as the motions are displayed on a monitor. This visually guided movement sends a message to the brain about the position of the hand and arm, helping the brain make new connections for motor pathway signals. As the therapy progresses, the patient initiates a little bit of movement, then the robot continues moving the arm in the movement pattern. Gradually the patient gains more control over the prescribed movements, eventually reaching a point where the movements are controlled entirely by the patient.

Maryann Vanya is an Occupational Therapist with Good Shepherd Rehabilitation Hospital in Allentown, PA. She says ReoGo monitors a patient during therapy. All exercises need to be performed in a free-flowing pattern. If ReoGo senses the patient is using too much force during the therapy session, the robot temporarily halts the exercise. That enables the patient to learn normal patterns of movement.

Experts say robots can’t replace the interaction between therapists and patients. But the machines do have some advantages over humans. A robot can continually reproduce the exact same exercises without variation or becoming tired. It can provide more precise control over muscle movement. And a robot can be programmed to change movement patterns as a patient progresses through rehab.

ReoGo is used in conjunction with other types of rehabilitation therapies. It is covered by many insurance plans. For information on ReoGo.

For information on stroke:

American Stroke Association

National Institute of Neurological Disorders and Stroke

National Stroke Association