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ICone: a novel device to scale up robotic rehabilitation and unlock the potential of motor recovery for stroke survivors.

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The rehabilitation robot finding work outside the hospital

Rehabilitation machines are effective but often restricted to healthcare centres. A portable, networked model could change that.

Nearly one fifth of the EU population is over 65 years of age, and this figure is expected to increase. Consequently, the incidence of age-related disease is growing, with incidence of stroke expected to increase 34 % between 2015 by 2035. Yet even years after a patient has suffered a neurological injury, they retain the potential for recovery. Regaining complete limb function in these patients often involves a long period of intensive, personalised neuro-rehabilitation. Delivering this treatment is a challenge for healthcare providers. The ICone project aims to address this need with the first portable rehabilitation robot. Improving access to robotic systems is a crucial factor in reducing stroke-related disability. Robotic rehabilitation has been shown to be effective, but the large, expensive machines are restricted to hospitals, and thus often limited to acute or sub-acute stroke patients. Discharged chronic patients are sometimes offered video games to play that aim to retrain the brain to gain control of their limb movements, but this is less effective. “So far, no robotic solution has meshed the usability of these games with the efficacy of robotics, to provide a technology to be used in and outside the hospital,” says ICone project coordinator Dino Accoto. “That is in short what ICone is.” Accoto is founder and director of Heaxel, the technology firm responsible for the ICone system. The robotic rehabilitation system requires patients to manipulate a lever according to instructions displayed on a screen in front of them. The physiotherapist is able to set up the haptic characteristics of the lever according to the patient’s needs. “It has a high-level user interface, developed in cooperation with clinicians, that allows the therapists to enter all the parameters to customise the therapy,” explains Accoto. “The duration, intensity, repetitions, assistance, resistance – all the parameters that normally require a programmer to be tuned are accessible from the touchscreen.” While the machine could be installed in homes, Accoto says patients are more likely to encounter it in environments such as care homes and community centres. All ICone robots are connected to the internet, allowing therapists to observe patient progress and remotely adjust the settings and therapy plans as needed. Heaxel, based in Italy, received support from the EU to carry out a feasibility study aimed at facilitating the effective and rapid commercialisation of the ICone robotic system. “Many times there is a wonderful technology which is very effective, but is not accessible because of financial reasons, or logistical reasons,” says Accoto. “The funding helped us to define a viable business model.” Tests carried out with medical staff in Italy and Spain helped to identify improvements needed in the design and function of the robot, laying the groundwork for more wide-scale trials of ICone with patients. “Stroke is one of the largest causes of disability in Europe, so that’s the societal challenge,” adds Accoto. “Our goal is to have this robot accessible to as many patients as possible.”

Keywords

ICone, Heaxel, stroke, rehabilitation, robot, patient, therapy, limb, neuro

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