BCI-Robot-Therapy

News Article
Move my arm, robot
Wednesday, 24 l 03 l 2010 ; Source: The StraitsTimes
By Chan Chi-Loong
Thought-based robot therapy helps stroke patients recover. Chan Chi-Loong reports DOCTORS at Tan Tock Seng Hospital (TTSH) have quietly scored a world first for using thought-based robot therapy to help stroke patients recover. Their work on 26 stroke patients during a pilot trial from April 2008 to October last year showed that patients recovered faster with this treatment than with traditional physiotherapy regimens. Known as Brain Computer Interface or BCI-robot therapy, it involves placing electrodes on a recovering stroke patient’s head, explained Dr Karen Chua, one of theproject’s researchers. The patient’s thoughts – for example, “move my arm” – will prompt a robotic arm, which she is grabbing in her stroke-affected hand, to move. The doctors were researching the link between thought and action in stroke patients, which they believed would help patients regain limb movement such as moving their arms and gripping things. For Madam Pakiam Thangaveloo, whose speech became slurred and who needed crutches to walk after her stroke, the difference between pre and post-robot therapy was stark. The 60-year-old was hospitalised in TTSH after suffering a stroke in January 2008, but found herself making little improvement after five months of physiotherapy. In July, her doctor, Karen, suggested that she go for the BCI-robot therapy. Her regimen involved hour-long sessions three times a week over six weeks. “Before the treatment, I couldn’t move my right arm at all,” said the grandmother of two. Post-treatment, she could move her arm and she has put away her crutches. The power of thought Apart from TTSH, two other agencies are also involved in the trial. They are the National Neuroscience Institute and the Agency for Science, Technology and Research (AStar). Dr Guan Cuntai, AStar’s lead researcher, pointed out that BCI therapies, which grew in the mid-1990s, have been used to assist patients to adapt to their environment – for example, an amputee controlling a prosthetic robot hand. But Cuntai, who set up AStar’s BCI research lab in 2003, is confident that the Singapore trial is the first in using BCI to help stroke patients recover. Of the 26 patients in the study, 11 went on the BCI-robot therapy, 14 were put on pure robot therapy and one dropped out of the programme. Evaluations showed that those on the BCI-robot treatment experienced an average of 16.5 per cent improvement after four weeks. Patients had more range of movement in their arm and shoulder. Improvements rose to 19.2 per cent after 12 weeks. Compared to this group, those on pure robot-therapy – where the robot moved a patient’s arm automatically without her thought input – improved by 13.9 per cent after four weeks and 17.4 per cent after 12 weeks. So, the BCI-robot treatment had done “surprisingly well”, said Karen, who is also a senior consultant at the hospital’s department of rehabilitation medicine. In BCI-robot therapy, the arm moves an average of about 140 times an hour while in pure robot-therapy, the arm moves about 1,000 times an hour. Unaided by a robot, the patient can do only about 40 to 50 repetitions an hour. In theory, more repetitions should bring about better results. But not so. “We learned something in this process,” Karen said. “It is not just what you do but how you do it.” She added: “In this case, thinking about moving your arm is more effective than actually moving your arm many more times. It’s a startling finding.” Spurred on by the results of BCI-robot therapy, the doctors have embarked on Phase 2 – a three-year study which began late last year and will run till early 2012. Part of the funding will come from a $36 million pool that AStar will spend in the next few years to drive medical technology. The sector, worth $2.9 billion in 2008, should hit $5 billion in 2015, according to statistics from the Jurong Town Corporation biomedical and chemicals cluster. The doctors want to extend the study to other functions like finger and wrist movements and swallowing, and perhaps even come up with a portable BCI device which patients can use at home. Cuntai is already talking to interested parties about commercialising the BCI-robot therapy and making it available to other hospitals. Pakiam is all for the idea. “They should have more of this,” she said.
What is BCI-robot therapy? It looks like a scene straight out of a science fiction movie: You focus on an object and it moves. No, this has nothing to do with psychic powers or magic: Witness the power of Brain Computer Interface (BCI) at work. Coupled with robotics, BCI-robot therapy holds promise in that it could help post-stroke patients recover faster – a world first. It is pioneered by the Agency for Science Technology and Research (AStar), Tan Tock Seng Hospital and the National Neuroscience Institute. In the therapy, electrodes are attached to the patient’s skull while she holds a rod attached to a robotic arm. When the patient thinks of moving her arm, neurons are fired within the brain. This produces bursts of electrical activity, which is measured in an electroencephalography (EEG). The BCI senses these EEG inputs and causes the robotic arm to move, pulling the patient’s arm with it. Not all patients are suitable for BCI-robot therapy. Only patients recovering from a mild to moderate stroke qualify. That is because patients must be able to sit up for an hour – in a specially built chair – and focus. Of the hospital’s 150-odd stroke patients seen during the trial period, 55 were eligible and 26 agreed to undergo the study. Two engineers, an occupational therapist and a standby doctor attend to patients during the hour-long sessions. Singapore’s AStar researchers are some of the best in the world when it comes to EEG-based BCI. At the most recent BCI Competition held in Vancouver, Canada, in December 2008, Singapore swept the first prize in all three EEG-based BCI categories among 35 submissions globally.