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.