‘Blue Sabino’ could be a big help

MOSCOW — On a recent morning at the University of Idaho, Ph.D. students Chris Bitikofer and Sebastian Rueda are running a robotics test.

Rueda is seated on a chair with a metal exoskeleton attached to his arm. He reaches toward brightly colored virtual blocks on a screen in front of him, and the machine follows, whirring softly.

As his hand reaches the block, a robotic voice tells Rueda, “WAIT.” There’s a brief pause, a beep, and the block disappears as another pops up.

It’s almost like a video game, though Bitikofer is quick to note the blocks are just a stand-in for more sophisticated imagery.

But unlike other games, when this technology is developed, it will help patients whose mobility has been limited by a stroke or other neurological impairment like cerebral palsy.

The device, dubbed “Blue Sabino,” is the product of more than seven years of work from faculty and students at the UI, and more recently collaborators at Whitworth University.

Funded by a grant from the National Science Foundation, the device will gather a laundry list of arm mobility measurements and provide physical therapies that engage patients.

This particular day, Bitikofer and Rueda are testing controls to try and create what’s called “transparency” — a term used to describe the device’s ability to move with the patient without resistance, despite its considerable size and weight.

That task is easier said than done — but getting as close as possible will help the device to “get out of the way” of the patient using it, said Joel Perry, a mechanical engineering professor at the UI.

“(The goal is) you don’t notice the robot being there, so that we can just do assessment,” he said.

Current mobility tests have limitations in what kinds of movements they measure, and how precisely. The team’s device could help provide more measurements with higher accuracy, said Rene Maura, a Ph.D. student at the UI.

“(Normal assessments) sort of rely a lot on the therapist’s expertise,” he said. “This device, it helps them assess that just a little bit more, giving them more measurements to assess a stroke patient.”

Those metrics include arm position, movement speed, force between the patient and the robot, and sensors to capture brain and muscle activity.

The robot currently has five joints, with a plan to expand to nine from wrist to shoulder and an additional six-jointed hand attachment.

Those measurements could not only pick up small changes current tests miss, but help providers see what therapies are helping specific patients. On a larger scale, the device’s measurements could allow better data on what therapies are best for what patients.

“What we really need to do is start building up a database that is shared globally,” Perry said. “You get consistent comparisons between subjects that have certain markers, and a database that tracks what therapy they underwent, and how they recovered.”

Doug Weeks, director of research for Providence St. Luke’s Rehabilitation Medical Center in Spokane, said having precise measurable progress is helpful for patients in recovery.

The engineering group is partnered with Providence to conduct testing. Providence is recruiting patients with impairments in the left arm to participate in trials.

“The whole focus is we want the patient to have a sense that the practice that they’re putting into recovery and arm use after a stroke is worth the effort,” Weeks said. “And this device is able to measure that.”

The interface also allows physical therapy exercises to be gamified, which can increase a patient’s motivation, he said.

“It really is something that has a look and feel of a computer game — a very expensive, technologically advanced computer game that keeps patients engaged and wanting to practice,” Weeks said.

With more development, the device will eventually allow both arms to be measured at the same time, so a patient’s impaired arm can be compared to the side with better mobility. Another work in progress for the device is creating a system to assist in specific movements.

Many common testing methods can’t accurately show progression in one area of movement when another is still limited. For instance, a patient might be able to make some motions, but need assistance lifting their arm to do them.

“Somebody can score perfectly on a Fugl-Meyer (assessment) and still have obvious impairment left,” Bitikofer said. “And you can have people that are just too impaired, (so) we won’t be able to detect anything about if they’re improving or not from therapy.”

While other motion-capture systems exist, Perry says that potential is one of the things that make Blue Sabino unique.

“There are existing motion-capture systems that have cameras around the room track movement,” he said. “But those can’t impart forces or torques onto the limb. So with this device, if someone doesn’t have the ability to do a reach and grasp movement, we can help with gravity support, and put them into an environment where they can do the activities.”

Though the engineers are still expecting years until their device is ready for FDA approval, Perry said he’s excited to see how it could improve the quality of life for people with disabilities, whether it be from stroke or other impairment. He’s also recruiting more students to work on the device.

“The thing that’s always brought me into this field, and it motivates me is wanting to make the quality of life better for people,” he said. “I grew up with a sibling with a disability, and so that really opened my eyes to that whole world. So just being able to contribute to technology that is going to help somebody is an exciting thing for me. I think all of our students that we attract here are also pretty motivated by that thought.”

Sun may be contacted at rsun@lmtribune.com or on Twitter at @Rachel_M_Sun. This report is made possible by the Lewis-Clark Valley Healthcare Foundation in partnership with Northwest Public Broadcasting, the Lewiston Tribune and the Moscow-Pullman Daily News.