Rehab Cell

Physical Medicine and Rehabilitation

Robotic revolution in healthcare: Michał Mikulski at TEDxWarsaw

Robotic revolution in healthcare: Michał Mikulski at TEDxWarsaw


Translator: lisa thompson
Reviewer: Peter van de Ven I’d like to tell you a story,
a story about Robert. Robert is 51. He is a lawyer,
a successful one from Gliwice. He has an amazing wife,
three wonderful children, and actually gives back to the community. What I didn’t tell you
about Robert – in this picture – is that, actually, he was diagnosed
with a rare genetic disease at the age of eight, called FSH, and by the age of 30,
Robert was unable to move using his legs and required a wheelchair to move around. The problem with Robert is, actually,
that he needs rehabilitation to move, to gain muscle strength, and to function
and have good quality of his life. Can you imagine – and I dare you to – what would you do if the next time
you went to see a doctor, you would get a diagnosis that in five years’ time,
you would not be able to walk? Do you think about it? And think about it,
when walking down the street, what would happen if you got hit by a car
and were not able to move tomorrow? This is actually a worthy question
to comprehend and to think about because the problems with disabilities
actually are pretty common, and we do get them a lot. In Poland, there are 7.6 million
kinesiotherapy procedures done annually. It’s actually rehabilitation by movement. And this is a problem. And it’s a huge number done
in Europe as well and in the U.S. There is a deficit
in the U.S. of physiotherapists – about 20,000 this year. And it’s estimated
to rise up to 60,000 by 2020. This is a huge problem with healthcare. And this is not a problem
of people with disabilities; this is our problem. There is no they, and there is no us;
there is only us as a society, and we have our problems with healthcare,
and those are ours to deal with. What we tried to do and what we
tried to understand with disabilities is what really drives those people. Those people are actually heroes,
struggling day by day. And we wanted to understand
them a little bit more. We actually rented a wheelchair
a couple of months ago and wanted to understand how it is
to ride a wheelchair every day. And as you can imagine, being given
a toy for the office for 20-year-olds, we took a lot of fun with it. We drove all around. We even did wheelies, like standing
on two wheels with a wheelchair, which we’re all going to hell for. But what’s most important is that
even though we had fun, there was a little thing that bothered us. We wanted to leave the office, and we do have
self-locking doors in our offices – those little brakes at the door
that keep them shut. It took us 15 minutes
to leave the room in a wheelchair. 15 minutes. This is an important problem
for all people riding wheelchairs and for people with
physiotherapy in general. So we wanted to address the problem then. With Robert and other people
with severe neurological diseases [the problem] is that they need
specialists to help them – specialists: physiotherapists and doctors – and that they are hard to come by. There aren’t really
that many great experts in the field, so you have to wait in queues
to get to them. If you’ve ever been to a doctor in Poland,
that’s the way it goes: you go register and you stand in the queue for a months or even years,
depending on what’s wrong with you. So the problem with experts and specialists
in the field of physiotherapy and doctors is something to be dealt with
by us in our society. So what we tried to do
is actually have something to help them, and we started with exoskeletons. You can see the first exoskeleton
on your left, the upper limb exoskeleton, and the exoskeleton
for the lower limb on your right. Of course, well, we thought of Iron Man because duh – if you’re going to do robots,
do Iron Man, and we do encourage that. But although I love the technology myself, I think exoskeletons
are really the future; they’re not really
the solution for our problems because if you have exoskeletons, you still do need
one physiotherapist and one patient because you have to have a physiotherapist
to handle the patient with exoskeletons, and it has to be a specialist. So, still nothing going on there. You still need specialists. So we thought, “What else can we do and how can we
help people get the best care possible?” So what we did is –
here, actually, before you. This is exo-EMG. This is our first
commercially available robot. This is something –
a tool for the physiotherapist. So it’s not, let’s say, exoskeleton, but it’s a tool to make
any physiotherapist great with both neurological patients
and orthopedic ones. This actually has a technology called
electromyogram active rehabilitation. Okay? Let’s say – and I hope you do know this. I hope I can explain it well. Our bodies actually work
kind of like a computer. We have a brain; it fires electrical signals
to our muscles, which then contract and generate
a lot more electricity on them. With multiple sclerosis,
muscle atrophies, Duchenne and Becker – as much as a muscle atrophy
like with Jacob here in this picture, a student of 21 – those kinds of diseases attack the muscles
and make them atrophied. So Jacob here actually
cannot move his arms or legs and drives a wheelchair
and needs professional care every day. So what we wanted to do is make Jacob
move his arms and legs himself. So we strap electrodes to his muscles and detect the slightest
electrical signals from inside them, massively amplify them,
and use them to control the robot. And I’d definitely like to show you
how this actually works with Paweł here. Paweł is already strapped
to exo-EMG with his bicep, so he has two electrodes on his body – actually three – and this is the robot
that moves with Paweł. We want to calibrate the robot
so the robot understands what kind of muscle strength
does Paweł have. So we’ll run the calibration, and Paweł
will flex and release his muscle, and we’ll stop the calibration
to let the robot move. Right now, the robot
actually works with EMG, so where Paweł will flex his arm, the robot will move
by those signals themselves. Why is this important? It’s important because
if Paweł was having muscle atrophy, he couldn’t move his arms. But if he stands
near the robot in the front, he can actually
have the robot move his arms and have an active form
of rehab with the robot. So this is how exo-EMG
with electromyogram works itself. We, of course, wanted something more,
well, let’s say broader for the patient, so not only neurological patients; we wanted also to have the availability
to work with orthopedic patients and a larger spectrum. So we did get something called
continuous active movement. And Paweł will set it up right now. We wanted the robot
to feel what the patient is doing. If we’re recovering after a surgery
or something like that, it’s something we get back from, so we wanted the robot
to feel what we’re doing. So if you actually touch the robot – there are no electrodes now – it can be light as a feather, and it can help you move
with little resistance – it’s called dynamic resistance – but it can be really hard to move
if you’re recovering. So if Paweł tries to move it hard,
it will make it efficient for him; it will require him
to have better muscles. So this is how, actually, the two programs
we’d like to show you work, and this is how exo-EMG does it. But we were thinking,
actually, “What more to do? How can we help and change
what we think about rehab and healthcare?” Because if you think about people
going to rehab, you think, “Okay. This is pain. This is suffering. This is personal drama
for all those patients.” And we want to have
a revolution in healthcare. We want to make physiotherapy
great but also fun and enhance the experience of
physical training to enrich what we do, to change the meaning
of what rehab actually is. And we thought – and this has been said all over TED, and not just TEDx here, but over
TED conferences all around the world – how to have the people
engaged in a process. So we thought, “Okay. Let’s do games.” Gamification sounds nice. We’ll develop a game that
when you move with the robot, you can actually control
an airship collecting stars. You can move through different maps, up and down, flexing,
doing physical training, but in the same time,
your brain doesn’t feel or doesn’t think about, pain, suffering – This hurts. Why am I here?
What am I doing? Am I getting better? – I’m collecting stars,
and I can even fly a dragon if I want to. So I’m not thinking about
that I need to do this; I want to do this. And we actually had some
pretty amazing people play this game because we’ve presented it
all around Poland and in the U.S. So, this is former ambassador
of the United States for Poland, Lee Feinstein, playing in Chicago. He actually scored,
in one of our games, 35 points. We had the Google director
from Kraków, Wojtek Burkot, play this game as well. He scored 33, so a little less. But we had multiple people playing this, but what struck me most
and what found us interested in the topic was two little girls in Chicago as well – 7-year-olds, first time seeing the robot,
first time seeing the game, first time seeing us –
never before. They also played the same game
that Wojtek played and scored 33; they played the same game
that Lee played and scored 35. They both scored 45 points in our game. 7-year-old girls. It’s a game-changer for them because they need something
to keep their minds off physical training. This is a new generation
that we’ve all experienced here at TEDx. We heard some amazing speakers talk
about how kids are changing what we know and how we must attune to them. So this is natural for them. This is something
to keep us interested in rehab and to redefine – to have a revolution – what rehabilitation
and healthcare actually mean. In the end, I’d like
to leave you with two things. Well, I ask of you two things, actually. First of all, I want you
not to fear robots. A lot of people do,
and I think that’s a mistake because robots, actually,
are a tool for you to get better. If you understand that, if you go to your physiotherapist,
your doctor: demand best possible care; don’t settle for anything less. Demand robots. Demand getting better as fast as you can. And with it comes responsibility
for your healthcare provider, for rehabilitation centers,
for hospitals to make you better. And the second thing I want to leave you
with is that this is one company. We’re EGZOTech, actually. This is one robot, one company, one team, and what we’re trying to do
is redefine a whole industry, to redefine our thinking, and it cannot be done by a single robot. Unfortunately, it cannot. We do need to act together as a society. We do need to focus
on the problems at hand, and those are global problems
that need our attention. Doing it together, we need to redefine and to bring back life into healthcare. Thank you very much. (Applause)

2 thoughts on “Robotic revolution in healthcare: Michał Mikulski at TEDxWarsaw

  1. You should know that there is a Robotic revolution coming in healthcare. To what degree are you comfortable having #robots  as part of your #healthcare  system? The technology is coming, but there are many questions about how welcoming people to having robots in their lives. #engineering   #mechatronics

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