This post is the first part of our Stroke Series during the month of August in which we will share recent studies and perspectives on the use of motion analysis technology for the rehabilitation of stroke patients.
Stroke is one of the most common causes of death, affecting many around the world. After a stroke, patients often suffer from cognitive complications with memory, language, attention, concentration and more. Strokes often have lasting effects on the daily function of an individual and often strips them of their independence and quality of life.
The standard of care for stroke patients includes cognitive rehabilitation of either conventional manner with paper and pencil tasks or alternative methods using computers and technology. The rehabilitation focuses on the patient’s affected cognitive function such as visual processing and problem-solving. Alternative approaches have become increasingly popular, as people are finding that conventional cognitive rehabilitation has not produced sufficient outcomes. Alternative approaches including virtual reality introduce interactive technologies which allow patients to practice attention and other tasks during simulations.
A recent study from the IRCCS Centro Neurolesi ‘Bonino Pulejo’ in Messina, Italy focused on the use of virtual reality technology compared to the standard approaches for motor and cognitive function rehabilitation of stroke patients. Twelve patients who had suffered from a stroke underwent traditional cognitive rehabilitation therapy or a virtual reality based alternative treatment plan. For both types of treatment, the patient was asked to perform tasks which focused on executive and visuospatial function, attention, and memory. The conventional sessions included paper and pencil task with paper aids with different levels of difficulty and complexity. The alternative regimen consisted of neurocognitive rehabilitation with sessions using the NIRVANA system by BTS Bioengineering.
The BTS NIRVANA system optimizes optoelectronic infrared sensors with both audio and visual stimuli and feedback. NIRVANA includes a large screen with a projector and an infrared camera for analysis of movement, allowing for interactive sessions. Exercises and games focusing on the control of the trunk, upper and lower limbs, and cognition can be implemented and output a score. The score of these games and tasks can be used to monitor progress and motivate the patient. The NIRVANA system promotes the rehabilitation regimen by integrating fun and interactive components into each session.
The patients were assessed before the treatment, immediately after the end of the treatment regimen duration (8 weeks), and one month later as a follow-up on the patient’s well-being. Each patient was evaluated with the Montreal Cognitive Assessment (MoCA) test, the Functional Independence Measure (FIM), frontal assessment battery (FAB) for executive functions, attentive matrices (AM) for attention, the trunk control test, and the upper limb motricity index scale for the evaluation of motor functions.
Researchers found that on average, patients who experienced rehabilitation through the NIRVANA system demonstrated significant improvement in cognition and functional independence specifically in the visuospatial and attention area. The group of patients who received alternative rehabilitation treatment demonstrated more improvement in their trunk control immediately after the end of the treatment and the one-month follow-up. The results of this pilot study are promising by demonstrating the ability for virtual reality rehabilitative technologies such as NIRVANA for trunk control and motor function in stroke patients.
Many individuals suffer from the aftermath of stroke. For many, current treatment and rehabilitation methods has fallen short and the introduction of alternative technologies may hold promise to help stroke patients increase the quality of life and gain back their independence.
This post was based on the following article, referenced:
De Luca, Rosaria & Russo, Margherita & Naro, Antonino & Tomasello, Provvidenza & Leonardi, Simona & Santamaria, Floriana & Desireè, Latella & Bramanti, Alessia & Silvestri, Giuseppe & Bramanti, Placido & Salvatore Calabrò, Rocco. (2017). Effects of Virtual Reality-Based Training with BTs-Nirvana on Functional Recovery in Stroke Patients: Preliminary Considerations. International Journal of Neuroscience. 128. 00-00. 10.1080/00207454.2017.1403915.