                    ROBOTICS FOR REHABILITATION
          from Epitomes-Physical Medicine and Rehabilitation
        The Western Journal of Medicine August 1988 pp 205-206

Computer-based, voice-controlled robots can enhance the quality of life for a
person with high-level quadriplegia, particularly with an injury above the 
level of C-5 to C-6.  Using robots can provide greater control over a person's
physical environment, expand avocational and vocational horizons, reduce the
expense of attendant care, and improve self-esteem.

Rehabilitation robotics began evolving in the early 1960s with Case Institute
of Technology's (Cleveland) computerized orthoses.  In the early 1970s, the 
University of Heidelberg developed an industrial manipulator and minicomputer
through which a keyboard controlled by a telephone, typewriter, or a custom 
mouth-stick could be used for vocational purposes by handicapped persons.
In 1981 the Johns Hopkins University's applied physics laboratory designed 
more advanced robotic system permitting perprogrammed manipulation sequences 
for tasks such as retrieving books and serving food.  The French Spartacus 
robotic aid made other contributions to the evolution of the field of robotics.

During the past eight years, the Stanford University and the Veterans 
Administration Rehabilitation Engineering and Research Center, in collaboration
with the Spinal Cord Injury Center, have explored through a number of projects 
the potential use of robots as assisting devices for severely disabled persons.
A wide range of users successfully commanded a robot to perform preprogrammed 
self-care tasks such as providing drinking water, grooming the hair, brushing 
teeth, and cleaning t#e face.  A third-generation desktop robotic assistant 
has already been developed and clinically evaluated for persons with high 
level quadriplegia.  Advances in speech-recognition technology and commercial 
computer hardware and software have significantly augmented the uses of the 
system PUMA-260 robot manipulator.  Efforts are currently being directed to 
develop a desktop system that would be useful for a skilled computer scientist
in an office setting.  The most recent developments in progress include a 
controlled mobile manipulator consisting of a commercial robotic arm equipped
with sensors and mounted on an omnidirectional vehicle, useful to a handi-
capped person confined to a bed or wheelchair.

Ordinarily no knowledge of computer programming in required to operate the 
robotic arm; the on-board microprocessor is preprogrammed by a therapist to
perform complex tasks in response to one or two commands from the user.

                                            Inder Perkash, M.D.
                                            Palo Alto, California
                               REFERENCES
Awad RE, Engelhardt KG, Leifer LJ: 1983 Development of Training Procedures
for an Interactive Voice-Controlled Robotic Aid.  Proceedings of the Rehab-
ilitation Engineering Society of North America's 6th Annual Conference, San
Diego, 1983, pp 276-278

Seamone W, Schmeisser G:  Early clinical evaluation of a robot arm/worktable
system for spinal-cord injured persons. J Rehabil Res Dev 1985;22:38-57.
