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Rehabilitation, robots arrive in the gym

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Rehabilitation, robots arrive in the gym

The robot observes the patient with its camera. Then, after a few moments of reflection, he speaks. And he explains to the patient in rehabilitation the type of exercise he must do. If the patient then has some difficulty or does not perform the movement well, the robot intervenes by guiding the arm or leg so that the exercise is done well, but also motivating him to continue despite the pain or fatigue. “It’s the first time – he explains Loredana Zollo, dean of the Faculty of Engineering of the Campus Bio-Medico University of Rome – that we combine the ability to communicate with that of moving the limb. In this way, cognitive rehabilitation is added to physical rehabilitation, just as a physiotherapist would do during a typical rehabilitation treatment, and a more welcoming and engaging environment is created for patients during sessions.”

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A “guide” for robot-physiotherapists

The robot-physiotherapist is just one example of how complex machines, capable of carrying out elaborate tasks to manage different categories of patients, are rapidly spreading in the health sector. But the panorama is fragmented: the projects carried out in Italy are often heterogeneous, the experimental conditions in which to test the usefulness of the robots are very different from each other, the protocols are not standardized, whether they are robots for rehabilitation, exoskeletons for assistance or wearable sensors. Instead – continues Zollo – we need to gather a critical mass of patients sufficient to define how to dose the treatment, when to start it, when to intensify it and when to interrupt it, but also to understand which robot is most appropriate depending on the pathology and rehabilitation needs, whether it’s exercises for the wrist, shoulder, elbow or lower limb. In short, there is a need for rationalization to give the right indications and use the correct machine in the acute or post-acute phase.

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Il progetto Fit For Medical Robotics

To find the answers to these questions and understand which robotic technology is the most suitable for treating a pathology in a certain type of patient, “Fit For Medical Robotics” was created, a project born thanks to funding of 126 million euros from from the Complementary Plan to the PNRR, and which brings together the National Research Council, the Campus Bio-Medico University of Rome, the Scuola Superiore Sant’Anna of Pisa, the Don Gnocchi Foundation and another twenty partners between Universities, Centers clinical and research, and industrial realities.

One year after the start of the project, the numbers are comforting and allow us to reach the critical mass of necessary information: clinicians and engineers will work on 59 clinical studies distributed throughout the national territory, for over 2000 patients involved. “Obtaining efficacy data on large numbers means giving a substantial scientific foundation to the effectiveness of robotic technologies in rehabilitation,” comments Zollo. The ambition is to start a process of dialogue with institutions to facilitate the introduction of these robots in all clinical centers, from North to South.

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Robots and physiotherapists alongside patients

Physiotherapists should reassure themselves: the idea is certainly not to replace them in the daily management of patients in rehabilitation. The objective, rather, is to design robotic gyms where this professional is always present to supervise the work of the patients, maintaining human contact with them, but delegating the management of the exercises to the robots. The advantages are evident: rehabilitation with machines could involve more patients at the same time, and the one-to-one ratio (one physiotherapist for each individual patient) would be overcome, which is no longer sustainable from an economic point of view and risks generating waiting lists. “But the element that matters most to us is that of personalization, a concept that is becoming increasingly important in medicine,” explains Zollo. By equipping the robot with a series of sensors capable of measuring the patient’s data (movements, vital parameters, fatigue, attention or commitment) the machine is able to modify its behavior and therefore lighten the rehabilitation treatment, or to intensify it, or in any case to vary it based on the concrete needs of the patient at that precise moment.

Another important element concerns the standardization of rehabilitation treatments, which today are “operator-dependent”. If I have an experienced physiotherapist, with many years of training behind him, the treatment will perhaps be more effective than that carried out by a young person with little experience. With the robot, concludes Zollo, a uniformity of treatment leveled upwards and homogeneous in all centers is achieved. In this sense, declares the president of the CNR Maria Chiara Carrozza“Fit for Medical Robotics is a revolutionary project as it places the person at the center: with it, robotic technologies become the means through which to develop innovative solutions to overcome vulnerability and fragility, improve the quality of life of patients and caregivers, promote greater social inclusion”.

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