This Is Why Happy Machinations A story of rehab and robotics. By Ryan Cardinal, PT, DPT | March 2012 Podcast: Listen to 'This Is Why' Anna Good is like any other 7-year-old girl you might meet—sweet, smart, and full of energy—except that she has cerebral palsy. Her mother, Susie, shuttles her from therapy to therapy, activity to activity. Susie isn't content with the status quo for Anna. She wants her daughter to be able to run, play, keep up with her friends, and lead a normal life. I understand that. Susie reminds me of my own mother, who shuttles my youngest brother among his therapies for hemimegalencephaly, a rare disorder similar to cerebral palsy. Ultimately, it's all about opportunity. Children with disabilities want the opportunity to be normal. Parents of children with disabilities want to give their kids every opportunity to lead a full life. And that's what physical therapists (PTs) do: We enable. We present opportunities. I love working in pediatrics. I find great fulfillment in helping children gain functionality, develop new skills, and match their peers. When I started as a PT, I was content simply to show up every day and do my best to help my patients. But eventually I think most of us, whatever our profession, question the "what" and "why" of our jobs. As I encountered children whose spasticity was unmanageable or whose coordination was uncontrollable, I felt frustrated at the limits of our knowledge, even though it's always growing. I never thought to myself, "I want to work with robots," Yet, 6 years after graduating from Indiana University as a doctor of physical therapy, I find myself back at the school, completing my PhD in health and rehabilitation sciences and doing just that. Fortuitously, my return coincided with the creation of the Riley Hospital for Children Robotic Rehabilitation Center—a collaboration between the university's physical therapy department and Riley Hospital for Children at Indiana University Health. I work as a graduate assistant with Indiana University physical therapy department researchers to develop and conduct robotic-based studies, and to manage the center's clinical operations, which involve the use of 5 different robots to address impairments of the lower and upper extremities. This role allows me to continue working with kids while seeking, through various lines of inquiry, to expand understanding and treatment options for our pediatric patients. Robotics is a new frontier in physical therapy, particularly in pediatrics. Embraced by some, met with hesitation by others, it's another prism through which to study the way we treat patients. Theoretically, robotics allows us to capitalize on what we know about neural plasticity and motor learning—facilitating consistent, repetitive movements in a controllable environment. It is my hope that robotics will become part of the overall rehabilitation plan—a tool PTs can use routinely to enhance a child's treatment. For that to happen, however, more conclusive research is needed. Anna has been an active participant in the Robotic Center since it opened in September 2010. She has completed full treatment protocols on both the Hocoma Lokomat® and the InMotion Technologies Manus®, which are lower and upper extremity robots, respectively. Following upper extremity training, Anna began using her affected arm to eat. After lower extremity training, she started using her walker to grocery shop with Susie, rather than having to ride in the cart. Anna doesn't care about our research results. She's just happy to take advantage of these opportunities. I, in turn, am excited, every time I work with Anna, by the opportunity my profession and niche offer me to help Anna along her lifelong journey. Ryan Cardinal, PT, DPT, is a PT at the Riley Hospital for Children Robotic Rehabilitation Center and a graduate assistant in the Indiana University Department of Physical Therapy. Both are in Indianapolis.