Robotic Augmentation of Physical Therapists for Locomotor Rehabilitation - PROJECT SUMMARY This project seeks to transform locomotor rehabilitation with telerobotic systems that lessen the physical demands on therapists but preserve their ability to dynamically tailor therapeutic strategies using their clinical expertise and intuition. This capability could improve the quality and efficacy of robotic therapy—a significant need, given the lack of solid evidence that traditional robotic approaches surpass conventional methods in improving patient outcomes, particularly in locomotor rehabilitation. We address this need by leveraging telerobotics to augment therapists' capabilities in applying their specialized skills for manipulating movement to promote sensorimotor learning in patients. The project is structured around two aims designed to address critical gaps in understanding how physical therapists adapt their manipulative forces and provide assistance during treadmill locomotion, both during hands-on therapy and with telerobotics. In Aim 1, we enroll 40 physical therapists who manually assist a randomly assigned treadmill walker with an artificial neuromuscular impairment created by gait event-triggered electrical stimulation to the hamstrings of one leg. We measure the forces therapists exert and develop a model that describes how therapists adjust their assistance during locomotor training. Aim 2 extends this investigation to a telerobotic context, where the therapists assist the artificially impaired walkers using a small robotic manipulator that mimics the actions of a larger robot attached to the walkers, allowing therapists to remotely feel and assist the walkers in achieving different functional goals, yet with less effort because the telerobotic system amplifies the effects of the therapists' manipulative actions. We hypothesize that the manipulative strategies therapists employ will be effectively translated through the telerobotic system, demonstrating no significant difference from their hands-on approach. This research is an essential step toward determining the practicality and effectiveness of telerobotic systems in physical rehabilitation. The project will provide valuable insights into the dynamics of physical manipulation and its translation through robotic systems by directly measuring and modeling therapist manipulative strategies in both traditional and telerobotic settings. Additionally, the outcomes of this study could significantly impact clinical practices by offering a viable option for remote rehabilitation, particularly benefiting patients in rural or underserved regions who lack easy access to specialized care facilities. The integration of telerobotics into rehabilitation has the potential to transform the therapeutic landscape by reducing physical strain on therapists, enabling more precise and controlled interventions, and opening new pathways for delivering high-quality care remotely. Ultimately, this project aims to lay a foundational understanding that will guide the future design of rehabilitation robots and the development of therapeutic strategies, improving the quality of life for approximately 10 million Americans living with neurological injuries.
