Robot-assisted physical therapy proved beneficial to stroke patients (Photo courtesy of Wan-wen Liao)




By Jeannine Stein, Los Angeles Times / August 11, 2011

Robots are our friends, right? Maybe more than you think–a study finds that robot-assisted physical therapy may improve stroke patients’ mobility more than regular therapy.

Researchers assigned 10 stroke patients to robot-assisted therapy, and 10 to a more traditional physical therapy program that included occupational therapy techniques (this served as the control group). Both groups had sessions lasting 90 to 105 minutes a day, five days a week for four weeks. The patients’ arm activity was measured using an accelerometer, which tracks the body’s acceleration, allowing researchers to record dynamic movement.

Stroke patients can have weakness on one side or area of their body, limiting movement and making daily tasks difficult.

Working with the Bi-Manu-Track robotic arm trainer, participants did repetitive bilateral arm movements. The device was able to adjust its settings to encourage patients to engage in more active movements with their weaker arm and offered immediate visual feedback of the participants’ efforts.

Overall, the robot-assisted group fared better than those who had more traditional therapy. Among the discoveries, researchers found that those using robot-assisted therapy were able to do more daily tasks with their weaker arm compared with the control group. Arm movements also improved compared with the controls, as did bimanual ability.

The study authors noted the device’s ability to do so many repetitions could be beneficial in helping patients continue to improve and get stronger, ultimately regaining more motor function.

The study was released Wednesday in the journal Clinical Rehabilitation.
, August 11, 2011, by Kevin Murphy – A Kansas college hopes young doctors will be more willing to practice in small towns if they go to a medical school in a rural area.

The University of Kansas will have what it says is the smallest four-year medical education site in the country when eight students begin taking classes on Monday on a satellite campus in Salina, Kansas. The move is in response to a shortage of rural doctors in the United States.

“By training physicians in a nonmetropolitan area, we are showing young medical students that life can be good, and practice can be stimulating, outside of the big city,” said Dr. William Cathcart-Rake, the physician who directs the University of Kansas School of Medicine-Salina.

Students will get some course work via tele-video and podcasts from the school’s other campuses, but they will also train through visits to doctors’ offices in small communities and at the hospital in Salina, school officials said.

“It’s a bold and innovative move,” said Dr. Roland Goertz, president of the American Academy of Family Physicians. He said students at rural clinics will be exposed to a potential medical career they wouldn’t see in urban hospital settings.

Dr. Cathcart-Rake said six of the eight students being taught at Salina, as part of their scholarships, have committed to practicing in a rural area. Seven of the eight students are from rural areas to begin with, he said.

“They see the value of living in wide open spaces and going back to where their friends are,” Dr. Cathcart-Rake said. Attending medical school in a place such as Salina reduces chances they will change their minds, which could happen if they went to a big-city school, he said.

Salina, with 46,000 residents, is about 175 miles west of the Kansas City metropolitan region where the university’s main medical school is located.

Small-town America has become increasingly under-served by doctors. About 21% of U.S. residents live in rural regions but only about 10% of physicians practice there, according to data cited by the family physicians group.

In Kansas, 12 counties don’t have a full-time doctor at all, said Barbara Atkinson, executive dean of the University of Kansas School of Medicine.

Several factors are often cited for a shortage of rural doctors.

Rural doctors tend to be paid less, partly because they are more likely to treat patients on Medicare and Medicaid, which reimburses at rates below standard insurance. General practitioners make up the largest share of rural doctors, but until recent years fewer medical students were going into general medicine, putting a strain on rural care.

Recent changes in federal healthcare laws are intended to make rural practice more acceptable to doctors. Doctors who practice in certain underserved areas will get bonuses beyond the 10% boost in Medicare reimbursements they were already receiving, Dr. Goertz said.

He said another reason why there are fewer rural doctors is that the large majority of medical students come from urban areas, where medical schools are usually located, making them less like to consider rural medicine.

“You tend to gravitate to where you grew up,” Dr. Goertz said.

Dr. Cathcart-Rake is optimistic that the Salina medical school will be a success and that in future years’ admissions may grow from eight to 12 students.