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Hand Arm Laboratory

1. Hand Arm Robot Usage Areas

The hand-arm laboratory aims to ensure that patients with stroke (paralysis), brain injury or brain tumor surgery, who developed a loss of function in their hands and arms, are able to perform basic activities such as grasping objects, dressing and eating. For hand-arm rehabilitation, the methods of robotic rehabilitation, occupational therapy – ergotherapy, compulsory treatment and traditional physical therapy are used in combination.

In cases where there is loss of hand-arm function, a serious improvement is observed in the return of the patient to the daily life, and therefore in the motivation of the recovery process, thanks to the robotic hand-arm rehabilitation.

2. Robotic Hand-Arm Rehabilitation

Among the rehabilitation methods administered for eliminating the loss of function that may occur in the hands and arms after cases such as stroke (paralysis), brain injury and brain tumor surgery, robotic rehabilitation takes the lead with the use of devices operating with virtual reality due to the developing technology.

3. Armeo Power Hand-Arm Robot

Hocoma is a Swiss company and a world-leader in robotic therapies. Armeo Power with Manova, which is the most advanced robotic device produced by Hocoma, provides physiological optimization of hand-arm functions, is also used in our clinic.

There are certain limitations of the traditional method of rehabilitation, which is performed under the supervision of a therapist in order to ensure that the patients with stroke can regain the ability to use their hand. Patients with severe paralysis may not be able to

participate sufficiently in treatment and the motivation of the patient may be low. The number of repetitions may not be as many as desired in individual exercises with a physiotherapist and occupational therapist. In this case, the additional robotic hand-arm treatment enables frequent repetitions in the correct pattern, facilitating the process of learning and encoding again in the brain. Robotic therapies also provide instant and continuously measurable feedback and records about the performance of the patient.

Robotic hand-arm rehabilitation has been developed to overcome the limitations of traditional rehabilitation, and for the patient to receive a more intense and accurate physical therapy program. With robotic hand-arm rehabilitation, the repetitive movements enable the regaining of the impaired signal flow between the spinal cord and muscles of the brain. With this treatment, the muscles are strengthened, the edema due to immobility is reduced, and restrictions of the joints are prevented. The most important and ultimate goal is to ensure that the patient regains the lost hand-arm functions by stimulating the plasticity of the brain.

With the Armeo Power with Manova robotic device, patients with stroke can be administered early intensive physical therapy. In patients, who develop a stroke due to any brain injury, the brain activates its own healing mechanisms in the first months, which means high degree of plasticity. Well-planned, targeted and intensive rehabilitation is the key to the highest level of recovery in this precious period. Armeo Power Hand-Arm Robot is a device specially designed for this purpose. The Manova part of this robotic device is particularly useful for the development of the gripping function in the hand. Although the first 3 months is golden for the rehabilitation of stroke (paralysis), it is possible to achieve functional gains with extensive and intensive rehabilitation even in cases of stroke (paralysis) with a history of months and years.

The Armeo Power device has sensors, which can detect when a patient is unable to perform a particular movement. Thus, according to the purpose of the exercise, the device helps the patient as much as required. While providing nearly full range of motion support for patients, who are not able to move their hands and arms at all, the device reduces the assistance it provides as the hand and arm functions of the patient improves. This support, which is provided upon demand, increases the motivation of the patient and participation in treatment. It stimulates the brain strongly in order to regain movement. The movement is learned again in the intact tissue found in the brain.

Armeo Power is the first commercially available robotic exoskeleton for hand-arm rehabilitation. The design of the device allows three-dimensional exercise. Therefore, besides the splicing-specific (one-dimensional) movements, it also allows the practice of three-dimensional movements that are more important to the person in daily life. The device can be used for both left and right arms and hands. Movements can be enabled for the shoulder, elbow and wrist joints. There are many game-like applications on the device integrated in the form of virtual reality. Thus, while the patient is motivated to perform the exercises, feedback can be obtained about his/her performance, and the progress can be recorded.

With the use of robotic physical therapy devices, the physical workload on the physiotherapists is reduced. Thus, they can focus their attention on the performance of the patient, evaluating their movements as well as planning and guiding therapies. This ensures a more efficient and quality rehabilitation session in general.

The device records the movements of the patient with its sensors during the treatment sessions. It provides a record of the movements that the patient can perform, the extent of the movements performed, and the amount of assistance required. Thus, the treatment offers the opportunity to focus on the direction and angles of movement required by the patient the most.

The Armeo Power robotic device optionally includes an apparatus to improve the hand gripping function. This optional part is called “Manova”. With the help of Manova, the ability of the patient to reach out and grip by hand can be improved by providing support from the shoulders and elbows as much as required. In addition, there are augmented reality applications such as computer games, which are specially designed for these exercises.

In the rehabilitation of paralyzed hand-arm, robotic devices are a part of the concept of comprehensive physical therapy. In other words, the best results are obtained for the patient when methods such as hand-arm rehabilitation, occupational therapy-ergotherapy, the treatment of spasticity with the botulinum toxin by the physiotherapy and rehabilitation specialist, orthosis and electrical stimulation are implemented in an integrated approach.

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