Mr. Roboto Dr. Jules Dewald and his team look to change how physical therapists approach the treatment of movement disorders through an innovative use of robotics. By Devon McPhee 14 ward rounds summer 2010
If you were a study participant in the lab of Jules Dewald, PT, PhD, chair of the Department of Physical Therapy and Human Movement Sciences (NUPTHMS), you might find yourself with an arm floating in virtual anti-gravity, or pushing through simulated viscose matter, or repeating an exercise that replicates the action of lifting a gallon of milk, all while attached to a high-definition electroencephalograph (EEG) recorder. By studying these movements and mapping the accompanying brain patterns, Dewald and his team hope to unlock the basic science behind movement disorders — specifically those found in stroke and cerebral palsy patients — and develop more targeted therapies to treat them. Reaching this goal, Dewald says, requires an innovative use of robotics in human movement science. “Robotics has been used in research since the early ’90s, but we are among the first to use it to study the science behind movement disorders,” explains Dewald, associate professor of physical therapy and human movement sciences, biomedical engineering, and physical medicine and rehabilitation at <strong>Northwestern</strong> <strong>University</strong>. “Once we understand the science, we can use these robots for therapy.” Dewald’s science-based approach to developing therapies for movement disorders diverges from the way rehabilitative treatments have traditionally been developed. “The way physical therapy currently works is through qualitative evaluation — trial and error,” he says. “Usually, therapies are developed before we understand the underlying mechanisms of the movement disorder. Our approach is to first understand the mechanisms, and then develop therapies based on that under - standing.” Getting from point A (figuring out the science) to point B (more targeted therapies) requires a hefty investment of time, since researchers must break a movement into distinct pieces and understand each one to get at the whole. “It’s literally like taking Humpty Dumpty apart and putting him back together again,” he explains. The slow pace of understanding the mechanisms underlying movement impairment following brain injury is likely one of the main reasons this approach to rehabilitation science remains novel, Dewald says, but he has faith that once clinicians see the results from science-based therapies, they will become converts. “The best way to convince rehabilitation clinicians about the merits of reductionist scientific inquiry is to demonstrate the results you can obtain,” he says. A team of researchers aids Dewald in his pursuits, including two assistant research professors of physical therapy and human movement sciences, Ana Maria Acosta, PhD, and Jun Yao, PhD; an instructor in physical therapy and human movement sciences, Michael Ellis, MPT, DPT; a research associate in biomechatronical engineering from the Netherlands, Arno Stienen, PhD; five DPT/PhD in biomedical engineering students, Theresa Sukal Moulton, DPT, Christa Nelson, Laura Miller, Rachel Hawe, and Lindsay Garmirian; three PhD students, Daniel Krainak, MS, Jacob McPherson, MS, and Natalia Sanchez; and three research physical therapists, Carolina Carmona, DPT, Donna Hurley, DPT, and Justin Drogos, DPT. Taking a peek inside the Dewald lab, one could easily draw comparisons to a strength training room at the gym — except the machines here build knowledge instead of muscle. Three large machines have customized robotic arms that measure movement or create “haptic” or virtual environments for study subjects to operate in, and serve as important tools for the research being conducted. In May, Dewald added a fourth robot to his collection, which he calls the “Rolls Royce” of upper extremity robotics. The new device, developed and built with a quarter-million dollar grant from the National Institutes of Health (NIH), will allow for a much larger work space on which to conduct studies and has the added ability to perturb the arm — mimicking the action of an arm getting pushed out of the way or the jerking of a steering wheel — to add to the complexity and realworld application of the lab’s studies. The device also gives participants the ability not only to move The ACT-2D measures the effect of abnormal shoulder/elbow joint torque coupling on the expression of spasticity in stroke survivors. their arms forward but also up and down. wardroundsonline.com 15
- Page 1 and 2: summer 2010, volume 27, number 2 Ed
- Page 3 and 4: Contents Ward Rounds Summer 2010 Vo
- Page 5 and 6: Ward RounDS nEWS Maggie Daley Cente
- Page 7 and 8: To view more graduation photos, vis
- Page 9 and 10: Batjer Co-chairs NFL Head, Neck and
- Page 11 and 12: Donna Woods, EdM, PhD, had the idea
- Page 13 and 14: Using 22 different pens, President
- Page 15: enefit from the perspective of thei
- Page 19 and 20: study explores reaching movements i
- Page 21 and 22: 1. Bruce Henschen, a second-year me
- Page 23 and 24: 9. Bruce Scharschmidt, MD ’70, re
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