Tablets, not just pills, aid recovery

It is accept­ed that tar­get­ed, inten­sive and per­son­alised ther­a­py can make an enor­mous dif­fer­ence in a stroke victim’s recov­ery. But how do we con­nect patients with effec­tive treat­ments in a land­scape of dwin­dling resources?

The answer is increas­ing­ly being sup­plied by smart­phones, tablets and games con­soles. The tech­nol­o­gy is allow­ing many patients to take charge of their own recov­ery and access a ther­a­py stream at home.

Tech­nol­o­gy will be a major focus at the Euro­pean Stroke Con­fer­ence in Nice, from May 6 to 9, when the lat­est devel­op­ments in stroke ther­a­py will be on the agen­da.

Limbs Alive, a bound­ary-chal­leng­ing tech com­pa­ny spun out of the Uni­ver­si­ty of New­cas­tle, has cre­at­ed a suite of games, designed to help return motor func­tions to a patient’s arms, that can be played on tablets and PCs.

One title, Cir­cus Chal­lenge, encour­ages play­ers to move their arms up and down, and from left to right, to con­trol the actions of enter­tain­ers such as jug­glers or clowns who need to keep balls in the air or plates spin­ning. These move­ments, while the mind is con­cen­trat­ing on the images on screen, improve limb func­tion.

With 70 per cent of stroke sur­vivors expe­ri­enc­ing impaired arm move­ment, the games are an engag­ing way to get the repet­i­tive move­ments that are so vital to recov­ery.

“One of the ben­e­fits of reha­bil­i­ta­tion through tech­nol­o­gy is that you can make things more fun, more inter­ac­tive,” says Dr Mad­i­na Kara, a neu­ro­sci­en­tist at the Stroke Asso­ci­a­tion. “Patients may not see that as rehab, but actu­al­ly a game. You may only have access to phys­io­ther­a­pists once a week. Tech­nol­o­gy allows you to get that extra ther­a­py.”

Home-gam­ing devices can pro­vide more bespoke ther­a­py. Devel­op­ment of motion-sen­si­tive games con­soles, such as Nintendo’s Wii and Microsoft’s Kinect sys­tem for the Xbox, which oper­ate by track­ing a person’s body move­ments, has helped cre­ate new oppor­tu­ni­ties for stroke suf­fer­ers.

The Able‑X sys­tem, which has a spe­cial hand­set that can be plugged into a games machine, is designed for patients with more severe paral­y­sis. It allows them to use their stronger arm to co-ordi­nate move­ments from the affect­ed side of the body.

Roke, a British com­pa­ny work­ing in con­junc­tion with the Uni­ver­si­ty of Southamp­ton, has cre­at­ed anoth­er poten­tial­ly potent gam­ing sys­tem that uses the Kinect device to track the move­ments of indi­vid­ual fin­gers.

Patients fol­low an exer­cise rou­tine as direct­ed through a tele­vi­sion screen and the Kinect sen­sor mea­sures the hand joint, angles and the dex­ter­i­ty of fin­gers. This allows ther­a­pists to mon­i­tor the progress of patients and fine tune the hand and fin­ger move­ments that may have been affect­ed by a stroke. The project is now cre­at­ing a series of com­put­er games to bring an aspect of fun into stroke reha­bil­i­ta­tion.

Devel­op­ment of motion-sen­si­tive games con­soles, which oper­ate by track­ing a person’s body move­ments, has helped cre­ate new oppor­tu­ni­ties for stroke suf­fer­ers

The Stroke Asso­ci­a­tion has also har­nessed game tech­nol­o­gy to devel­op Cog­Watch for patients with aprax­ia, the motor plan­ning con­di­tion that makes it dif­fi­cult to car­ry out every­day tasks in the cor­rect sequence.

With inge­nious adap­ta­tion of the Kinect motion track­ing sys­tem, it recog­nis­es objects, such as a mug or ket­tle, and deter­mines if the stroke patient has made an error – for­get­ting to boil the water, for exam­ple, while mak­ing a cup of tea – before prompt­ing them to take the cor­rect course of action.

Games can also aid stroke pre­ven­tion by edu­cat­ing fam­i­ly mem­bers about rel­a­tives who may be at risk of stroke. In the Unit­ed States, researchers from Colum­bia Uni­ver­si­ty have pro­duced a video game called Stroke Hero, aimed at teach­ing young chil­dren to recog­nise the phys­i­cal symp­toms of a stroke.

In a study, pub­lished in the jour­nal Stroke in Feb­ru­ary, a group of nine to ten year olds, who played the game for just 15 min­utes, were 30 per cent more like­ly to recog­nise when a per­son was hav­ing a stroke.

There are also apps to help suf­fer­ers with oth­er issues stem­ming from strokes. Many are avail­able for apha­sia suf­fer­ers, where vic­tims suf­fer prob­lems with their speech.

Apps such as SmallTalk, Easy Speak and Talk Assist, which are avail­able for Apple’s iPhone and iPad, are text-to-talk sys­tems. Users can tap a num­ber of words or sim­ple pho­tographs and the device “speaks” for them. Small icons can be touched on screen, rep­re­sent­ing a range of use­ful phras­es.