DR OLIVE LENNON

ASSISTANT PROFESSOR

UCD SCHOOL OF PUBLIC HEALTH, PHYSIOTHERAPY & SPORTS SCIENCE

PRO-GAIT – intelligent robots for stroke rehabilitation

Dr Olive Lennon is Principal Investigator and coordinator of the European-funded, Horizon 2020, Research and Innovation Staff Exchange (RISE) project entitled PRO-GAIT. Through an exchange programme between seven partners from academic, clinical and industry sites in the EU and US, PRO-GAIT aims to improve how robotic devices can help people after stroke to walk better by an international exchange programme to develop interdisciplinary skills in robotics and rehabilitation.  

More intelligent robots that can sense users’ intent to move, and can interpret how much help they need, can help restore movement and independence. Through this research, Dr Olive Lennon and the team will contribute to scientific knowledge and technological development of robotic devices by looking at electrical signals at brain and muscle level while walking in a robotic. 

Developments will increase human understanding of human and robot interaction and effects on brain and muscle function allowing more targeted, future interventions for people with stroke.

Dr Lennon speaks about her neurophysiotherapy research in the video below.

Problems with walking are of huge significance for stroke patients, in terms of independence, returning to normal daily activities, hobbies, social life and work. Issues with walking also limit exercise, which is important for rehabilitation, and for preventing further stroke-related events. 

Unlike current robot-assisted gait devices, the future will see intelligent robots that use brain and muscle signals to allow patients to initiate and control their own movement within the robot and provide enough of a challenge to drive changes in the brain and nervous system required to relearn skills such as walking. 

PRO-GAIT brings together a broad range of skills and expertise from rehabilitation, neurology, robotics and intelligent systems to explore the steps that are required to develop a restorative rehabilitative device. Current work in this project is focused on assessing brain and muscle signals in robotic walking in healthy people and in a small sample of individuals with acute stroke. 

Training activities include training clinicians in robotics and bioengineering, training brain computer interface engineers and neurologists in stroke rehabilitation and linking industry partners with academia and clinicians working in the area. 

Another important aspect of this research is to understand what people in the early stages after stroke think about robotic gait devices and their acceptability as a tool for rehabilitation. Pro-gait has brought together technical partners, clinical partners and academic partners to advance robotics in lower limb rehabilitation. 

Often, robot-assisted devices are developed by industry without the input of healthcare professionals and patients. This has led to a history of poor uptake of these devices for rehabilitation, and the development of robotic devices that are largely passive and do not engage the user in relearning motor skills. 

The Pro-Gait study is aimed at developing more responsive and rehabilitative robots in the future through analysis of brain and muscle signals. Exploring the impact of different robotic settings on biosignals during robotic gait will allow a better understanding of robotic walking after stroke and help develop more integrative and flexible devices to optimize motor output. 

In Ireland, approximately 10,000 people per year suffer from a stroke. This number is predicted to rise as our population ages. Three months after stroke, 20% of people remain wheelchair dependent and 70% walk with a reduced capacity. Task specific training is critical for recovery, and intensity of practice is strongly associated with improved functional gait outcome. 

Robotic gait devices allow intensive, high repetition of the gait cycle with reduced therapist input and can reduce stroke related disability. The PRO-GAIT study takes an interdisciplinary approach to tackling this problem.  

Through the Pro-Gait study, a cultural shift will occur from where robotic devices are the domain of bioenigineers to where they are used in clinical settings by rehabilitation therapists. This will help tackle the issue of poor uptake of robotic devices in the clinical sector.

Part of the issue surrounding high-intensity therapy in stroke is economic. There is significant cost associated with supplying a therapist to a patient for the amount of rehabilitation that will achieve the greatest improvements in mobility. A robotic device that can supplement traditional rehabilitation could reduce high demand for and the burden on therapists.

As Ireland gains an international reputation in research into rehabilitation robotics, through studies such as Pro-Gait, building the infrastructure and multi-skilled personnel, research and innovation investment will be attracted into the country. 

The Pro-Gait study addresses many gaps in scientific knowledge regarding robot-assisted gait devices. Limited knowledge of the effect of robotic walking at a neurophysiological level exists in healthy individuals and in stroke survivors. 

Recent research has focused on upper limb robot-assisted devices and explored brain computer interface technology. While this research has shown promising results, little has been conducted in relation to lower limb due to challenges associated with capturing clean brain signal for gait. 

The Pro-Gait study aims to develop research to advance brain–machine interface robot for gait training. This is a particularly challenging field in stroke where the pathology is at brain level and consequently brain signals may be difficult to interpret. 

Similarly, muscle activity levels are often low activity or demonstrate abnormal activation patterns (for example where spasticity is present). The Pro-Gait study is tackling these difficulties in pursuit of a truly restorative device.

Prof Lennons' RISE programme; through secondments across academia, clinical and industry domains allows fellows to gain an appreciation, understanding and working knowledge across complementary domains, broadens their knowledge base, and expands future career prospects and horizons.

About the researcher

Dr Olive Lennon graduated from UCD as a physiotherapist in 1991. She has over 20 years of clinical experience both here in Ireland and in the US with a speciality in neurorehabilitation. She held a HRB Research Fellowship post from 2007 -2011 exploring the adaptation of the cardiac rehabilitation paradigm to the stroke population and the role of lifestyle interventions in secondary prevention post stroke. This research formed the basis of a PhD thesis. Other post graduate qualifications include an MSc in Health Informatics, a PG diploma in Research Statistics, a PG diploma in Health Services Management and she has recently completed a diploma in Teaching and Learning.

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Associated References:

https://irishheart.ie/our-mission/our-policies/stroke

Mehrholz J, Thomas S, Werner C, Kugler J, Pohl M, Elsner B. Electromechanicalassisted training for walking after stroke. Cochrane Database of Systematic Reviews. 2017(5). Click here