Technology in Stroke Rehabilitation

Can Virtual Reality Help Stroke Patients Recover Arm Use?Stroke-induced impairments result from damage to the brain and the acquired non-use of impaired limbs.Often, stroke patients under-utilize their affected limb even though they still have some motor function.These researchers set out to test whether virtual reality could assist arm rehabilitation in some stroke patients.

Virtual Reality Amplifies Arm Movement.The pilot study included 20 hemiparetic stroke patients who used the “Rehabilitation Gaming System” with a Microsoft Kinect sensor.The system allowed users to control a virtual body via their own movements, seen from a first-person perspective on a computer screen, as they performed tasks in a virtual world. During the intervention, the movement of the virtual representation of the patients’ paretic limb was amplified towards the target, making it appear faster, more accurate, and easier to reach on screen.

Stroke Patients Use Paretic Limb More Often.Following the intervention, there was a significantly higher probability that patients would select their paretic limb for reaching toward a virtual target.This suggests that changing patients' beliefs on their capabilities significantly improves the use of their paretic limb.The researchers concluded that goal-oriented movement amplification in virtual reality enhanced the use of the paretic limb in hemiparetic stroke patients.

Physical Therapy for Young Stroke Patients.Proprioceptive neuromuscular facilitation (PNF), a functional therapy approach used for gradual restoration of patients' motor abilities, is a popular, effective tool in post-stroke treatments.These researchers conducted a prospective follow-up study to evaluate the effects and significance of PNF exercises on 50 young stroke patients, all below age 15 years.Half the patients were treated with the PNF technique of physical therapy, and the other half were treated by passive range of motion exercises only.

Muscle Strength Improves Significantly with Physical Therapy.Muscle strength on the affected side improved considerably after 3 months of PNF and was significantly greater than muscle strength obtained by the passive exercise group.PNF was effective in terms of pain relief, stiffness reduction, and functional improvement.The researchers suggested that clinicians need a more credible evidence base to decide on their interventions for young stroke patients, such as PNF.

Assisted Motor Imagery Training Helps Stroke Rehabilitation.Brain-computer interface-assisted motor imagery training may support hand/arm motor rehabilitation after stroke during hospitalization.In this small study, 4 weeks of brain-computer interface-based intervention was added to usual care.Under the supervision of a therapist, 8 patients were asked to practice motor imagery of their affected hand. In a rehabilitation hospital ward, they received discrete feedback of the movements of a "virtual" hand superimposed on their own.

Brain-Computer Interface May Lead to Better Adherence to Rehabilitation. All patients successfully accomplished the brain-computer interface training.Significant positive correlations were found between satisfaction and motivation.Brain-computer interface performance correlated with interest and motivation.During a focus group, professionals positively acknowledged the opportunity offered by brain-computer interface-assisted training to measure patients' adherence to rehabilitation.

Take-home MessagesIn hemiparetic stroke patients, reinforcement-based therapies may be an effective approach for counteracting learned non-use and may modulate motor performance in the real world.The PNF technique of physical therapy can successfully treat and manage stroke in children. A brain-computer interface-based device can assist motor imagery practice as an add-on intervention for stroke patients in a rehabilitation hospital setting.