Robotics and technology has a crucial role to play in helping individuals regain lost function after neurological injury. However, we also recognize that technology, no matter how advanced, is just one piece of the puzzle. Effective neurorecovery hinges on a fundamental principle: dosage and intensity. Robotics should serve as a powerful tool to supplement these crucial elements, not replace them.
This concept was recently reinforced in a fascinating conversation on the "Synapse" podcast, featuring Dr. John Krakauer, a renowned neurologist and neuroscientist. Dr. Krakauer, a leading voice in the field of neurorehabilitation, emphasized that dosage and intensity are paramount to neurorecovery. He explained that while technology can be helpful, it's the sheer volume of targeted, challenging practice that drives neuroplasticity and functional improvement. You can listen to the full podcast episode by clicking on the picture below:
Dr. Krakauer's insights align perfectly with our philosophy at NextStep Robotics. In the podcast, Dr. Krakauer explains that neurorecovery is a complex process influenced by three key factors:
- Dosage and Intensity: The amount and challenge of the rehabilitation exercises.
- Residual Amount: The extent of remaining neural tissue capable of repair.
- Plasticity Level: The brain's capacity to reorganize itself and form new neural connections.
While rehab and rehab robotics can influence the first factor – dosage and intensity – it's crucial to understand that they are not a magic bullet. Simply using a robot doesn't guarantee recovery. The way the technology is used, and the emphasis on high-dose, high-intensity training, is what makes the difference.
Consider this: if a patient performs a repetitive movement with robotic assistance, but the movement is passive and requires minimal effort, the potential for neuroplastic change is limited. Conversely, if the robot is used to facilitate active, challenging movements, providing assistance only when needed, the brain is forced to engage, adapt, and rewire itself. This active engagement, driven by appropriate dosage and intensity, is what stimulates meaningful recovery.
Emerging research further underscores the importance of high-intensity rehabilitation. Studies, such as those by Nick Ward and his colleagues, suggest that significantly higher levels of therapy – potentially up to 5 hours per day – may be necessary to induce substantial neuroplastic changes, far exceeding the traditional 3 hours per week often provided. This highlights the challenge of delivering sufficient therapy within conventional settings.
This is where robotics can truly shine. Robotic devices can enable therapists to deliver high-intensity, repetitive training with greater efficiency and precision. They can assist with challenging movements, provide real-time feedback, and track progress objectively. In essence, robotics can act as a force multiplier, allowing therapists to maximize the dosage and intensity of therapy and potentially achieve better outcomes for their patients.
At NextStep Robotics, we're committed to developing and utilizing robotic technologies that empower therapists to deliver the high-dose, high-intensity rehabilitation necessary for meaningful neurorecovery. We believe that by focusing on these fundamental principles, and by using technology as a supplement, we can unlock the full potential for recovery after neurological injury. We encourage you to listen to our podcast with Dr. Krakauer for a deeper dive into this important topic. And as always, we welcome your thoughts and comments.
Rehab Robotics: Amplifying Dosage and Intensity, Not Replacing Them