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Virtual Reality Helps Continue Stroke Rehab at Home

Man in virtual reality headset

PublicDomainPNG, Pixabay)

22 Nov. 2019. Results of a clinical trial show a multi-user computer game using virtual reality helps people recovering from a stroke to continue therapy at home. Findings from the trial appear in the 9 November issue of Archives of Physical Medicine and Rehabilitation (paid subscription required).

Stroke occurs when blood flow to the brain is interrupted, cutting the oxygen needed by brain cells to function. The vast majority (85%) of strokes are caused by blood clots, while many other strokes are caused by blood vessel leakage in the brain. Recovery, often in rehabilitation clinics, can take months or years of continuous exercises. World Stroke Organization says one in four people worldwide will have a stroke in their lifetime, with nearly 14 million people suffering a stroke each year.

A team from biomedical engineering labs shared between North Carolina State University in Raleigh and University of North Carolina in Chapel Hill are creating a virtual reality game to extend structured rehabilitation sessions into the home. Researchers led by biomedical engineering professor Derek Kamper note that recovering from a stroke can depend on an individual’s access to a rehab facility.

“Physical and occupational therapy are important parts of stroke recovery, in terms of helping survivors regain dexterity and functional motor ability,” says Kamper in an NC State news release. “However, stroke survivors often face significant challenges in attending their therapy sessions. For example, many survivors don’t live near facilities that offer relevant therapy services.”

Kamper’s lab and colleagues are developing software called Virtual Environment for Rehabilitative Gaming Exercises or Verge, for the Microsoft Kinect computer game system. The software uses motion sensors built into Kinect to track movements of participants and therapists, and provides three types of exercises in multi-user and single-user modes.

“Our goal was to create an online, virtual reality platform that allows patients and therapists to interact in what is essentially real time,” says Kamper. “Clients could also use the system to work on therapy exercises with loved ones who live far away.”

The researchers tested the Verge software with people recovering from a stroke at the Shirley Ryan AbilityLab in Chicago, a rehabilitation facility for spinal cord and brain injuries.. The team recruited 20 individuals with continuing impaired use of their hands and arms to try the Verge software for four weeks. The researchers randomly assigned half of the group to first use the system in multi-user mode for two weeks, then switch to single-user mode for another two weeks. The other half of the participants started with single-user mode for two weeks, then switched to multi-user mode.

The team measured the number of rehab clients taking part in the exercises and amount of time participants spent doing the exercises in multi-user versus single-user mode. The results show participants completed nearly all (99%) of exercises in multi-user mode, somewhat more than the 89 percent completed in single-user mode. Participants also spent 7.6 more minutes in multi-user than single-user mode.

Participants also recorded more movement of their hands and arms in multi-user mode, 415 meters, than the 327 meters in single-user mode. Using a standard scale of stroke recovery, Verge participants scored about at about the same level as people attending sessions at a full-fledged rehab facility for the same amount of time.

“While these results are promising,” adds Kamper, “we’d like to scale up to a larger, multi-site study that can help us more fully evaluate the technology before making any decisions about how to make it available for widespread clinical use.”

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