Spotlight on Dr. Ayanna Howard
The world of medicine has changed quickly and profoundly in recent decades, with the development of new medications, new research, new cures, new technologies—and new mechanical devices. In the wide world of healthcare, robotics are popping up everywhere. In Superhuman Body, robotics expert Dr. Ayanna Howard, Dean of Engineering at The Ohio State University, gave us a tour through just a few examples of robots that help people. However, there are many types of medical robots that the film didn’t have time to cover. We asked Dr. Howard to put this technology—and her own experience—in perspective.
She first tuned into how robotics could change a person’s life when she was running a STEM summer camp funded by the National Science Foundation. While teaching kids how to program simple code to cause robots to move along the floor, she noticed that one girl was just sitting still at her console. Because of a visual impairment, the student wasn’t able to work with the technology as Dr. Howard had designed it. “That’s where I started down the road I’m on now,” she says. “I started by asking, ‘Why is our technology not accessible to this person, or to a particular target group?’ But soon, my question got bigger: ‘What does it mean in our society when you have a disability?’ I realized that if someone has eyes and ears and arms and legs that function according to how the world was designed, then the world is their oyster—but if they don’t, then I had to think differently.”
Dr. Howard took this mission personally. She recalls an early robotics experiment, where her team was testing a robot they hoped would not only make therapy more fun, but also stand in as a “coach” for children with mobility disorders. “Our robots often play games with children, to guide them in making particular movements. In this early test, a child—let’s call him Charlie—was trying to pop virtual bubbles that appeared on a screen. However, Charlie’s movements were actually quite slow, so at first bubbles were soaring all around him. But he kept trying—and then he did it. Charlie popped a bubble, and there was such a smile on his face. And I always say, if I could take that smile and put it in a jar, you would never, ever be sad in your entire life. At that moment, I realized that we really can design technology to address specific needs. And this technology can bring joy and happiness.”
Dr. Howard’s Medical Robots
Dr. Howard now focuses on helping children with special needs to achieve independence, especially kids with fine motor limitations, such as those resulting from autism or cerebral palsy (CP), a movement disorder that inhibits coordination, stiffens and weakens muscles, and creates tremors. Her robots are usually humanoid—with arms and legs—and they move, or dance, or communicate in some way; some even wink and talk. By having patients mimic their movements, these therapeutic robots can encourage users to move a certain way, relieve pain and stiffness, speed up their reaction times, and increase their flexibility, mobility, and balance.
However, anyone who’s had physical therapy—or recovered from an injury, or trained for a sport—will agree that making noticeable changes in your body’s movement takes time and commitment. “The more you do the same motion over and over and over again—the more you get better,” Dr. Howard says. “So we have kids repeat, repeat, repeat their movements.” All that repetition can become a lonely, seemingly endless process—which is why Dr. Howard believes robots can change the game. “A robot can act as your coach, or your therapy advisor, to help you exercise—to not only remind you, but also teach you how to do things the correct and safe way.” Plus, she says that kids respond to the robots differently than how they respond to an adult helper, or especially a parent. “The kids are in the power position,” she says. “The robot is a little clunky, it’s a little awkward. So children are doing the movement better than a robot. At the same time, they feel that they have the power to move their body the way that they are trying to, and the robot is accepting them for who they are.”
But how do we know if robots work? After all, Dr. Howard says, “If these technologies don’t help your patients, then all you’ve got is a dancing robot.” Her studies have compared the therapeutic progress of children interacting with robots with that of children working only with their human clinicians. “Kids working with the robots improved faster, in their motor skills, range of motion, and speed,” Dr. Howard reports.
Amazingly, the same process works for people of all ages and sizes who might need help with their movement. For example, Dr. Howard’s team “sized up” by designing adult-sized robots that help grown-ups recovering from illness or surgery. “It becomes really difficult in our world,” she reflects, “when you can’t lift your arm up to bite an apple, or buckle up your belt, or button your shirt, or are having issues walking.” One of the humanoid robots that she uses, which reminds most people of a Star Wars character, was developed for stroke-recovery patients and others who are rehabilitating themselves back toward full function. “We have robots that can walk with you. At your pace, maybe a little faster, so you can understand what you’re capable of and push yourself. It’s like walking with an entertaining partner.”
And then Dr. Howard “sized down,” to the other end of the spectrum. In babies, typical motor milestones include moving eyes and neck, lifting the head, rolling over, gripping with fingers—and kicking. Dr. Howard realized that she could program tiny robots to assist infants in “exercise” that would increase their leg mobility and strength. When these computers are placed in mobiles over the crib, the devices can pick up signals from the infants’ natural movements. Once a child’s kicking pattern is established, the mobile can then influence the child through sound and movement. “Infants actually understand rhythm, which is amazing and fascinating,” Dr. Howard says. “So basically, we’re programming the mobile to dance.” Infants can be stimulated to increase the cadence or height of their kicks—so their physical development can be improved by adapting their usual play. It seems that for people of all ages, the more fun robots are, the more likely people will use them, and benefit from their therapy.
Other Kinds of Medical Robots
While not all robots are especially fun, they can be mind-blowing. “Robots have tons of applications in medicine,” Dr. Howard says. “They can be used in everything from surgery, to therapy, to even being injected into the body and exploring what’s going on inside our veins and our hearts.” Below is a short list of some of the most interesting and diverse uses of robotics in medicine.
- SURGERY — Perhaps the most famous medical robot is the da Vinci. It is an incredible machine that assists surgeons in two ways. First, da Vinci allows the surgeon to view the site with 3D high-definition, magnifying the surgical area ten times what the human eye sees. Second, the surgeon is able to use tiny instruments that move like a human hand, but with a greater range of motion. These instruments are operated remotely but precisely, avoiding a large incision and “extending” the surgeon’s reach.[1]
- RADIATION — The CyberKnife might sound like another surgical tool, but instead it delivers a non-invasive, targeted beam of high-energy radiation to tumors with sub-millimeter precision. The robot moves and bends around the patient, repositioning itself at minutely different angles, at the same time minimizing danger to nearby healthy tissue. The CyberKnife has been especially helpful where it’s surgically complex to operate, such as in prostate, head, neck, and liver cancers.[2]
- ROBOTS YOU CAN SWALLOW — There are dozens of potential uses for a tiny robot—one that’s operated remotely while inside the body. Inventors have developed prototypes, including origami robots that unfold after being swallowed. One will allow a surgeon to patch a wound from inside. Another pill robot will deliver targeted medication. But today, one tiny robot is already in use: a robotic capsule endoscope that allows access into the small intestine, which isn’t easily reached with other endoscopy procedures. In one package, the pill includes a vision camera, lighting, and various sensors. The robot travels along the digestive tract, gathering data and taking photos that are sent directly to a recorder on a belt around the patient’s waist.[3]
- DELIVERY ROBOTS — While robots that deliver medical supplies from room to room are becoming more common on healthcare campuses, the system that’s made a lot of headlines is called ZIPLINE. There are two types of Zipline aircraft drones, a fixed-wing version that floats a package to the ground with a small parachute, and another that hovers while it lowers a “droid” containing the package on a tether. In 2011, the autonomous, 70 MPH Zipline first made it possible for remote hospitals in Rwanda to receive medication or units of blood for surgeries in record time; today it also works in several large health systems in the United States.[4]
- EXOSKELETONS — Robotic exoskeletons are wearable, powered devices that deliver mechanical power; they literally assist the wearer to lift objects, move part of the body, or even walk. Although exoskeletons come in a variety of styles, they commonly fall into two categories: a targeted unit is built to avoid injury in workers who need support, especially in the back or shoulders; the second, more comprehensive unit is a rehabilitation tool for patients with spinal cord injury. The latter has allowed people previously confined to wheelchairs to be able to walk again. It’s no wonder that exoskeletons have the potential to truly change lives.
The Future of Robotics
“Robots are supposed to be here to improve our lives,” Dr. Howard says. Her mission of helping people—along with bringing joy and happiness—is shared by thousands of engineers, scientists, doctors, and technicians who love robotics as much as she does. They envision a future filled with robots of all kinds, from medical machines that fill an entire room, to wearable suits, to upcoming “microbots”—miniscule machines that will be injected into our bodies to break up clots, pierce cysts, and deliver cancer drugs.
Dr. Howard sees computers as part of us, as extensions of people—with battery-hearts, computer-brains, circuit-veins, motors that help them move, and even feelings. “The robots I’m interested in use aspects of emotion and empathy to communicate with patients, whether children or adults. We can understand happiness—a smile, a laugh, irrespective of the language we speak—and so can they.”
But her future doesn’t stop there, and it doesn’t stop with medicine. “I see robots in the world, everywhere around us,” she says. “I can imagine walking into the grocery store, giving your list to a robot, and letting it do your shopping—while you go on an errand. I see visiting a classroom where a human teacher teaches a lesson while robot tutors are scattered around the classroom, helping students.” If robots really are an embodiment of us, then they are proof of what the human mind can accomplish. “I realized that if we could get it right, then robots can expand our quality of life,” Dr. Howard says. “They can improve what we do, how we live. They really can have a positive place in our world.”
Resources
[1] Intuitive Surgical, “Robotic-Assisted Surgery with da Vinci Systems,” Intuitive (website), accessed 12 May, 2024, https://www.intuitive.com/en-us/patients/da-vinci-robotic-surgery.
[2] Accuray Incorporated, “CyberKnife System: How It Works,” CyberKnife (website), accessed 12 May, 2024, https://cyberknife.com/cyberknife-how-it-works/.
[3] Mayo Clinic, “Capsule endoscopy,” Mayo Clinic (website), Tests & Procedures, 10 October, 2023, https://www.mayoclinic.org/tests-procedures/capsule-endoscopy/about/pac-20393366.
[4] Zipline, “Welcome to the best delivery experience not on earth,” Zipline (website), accessed 12 May 2024, https://www.flyzipline.com.