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.