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Trialling video games in stroke rehabilitation

Emma Breheny
1 August 2016

Keeping people active after stroke is an important challenge for physiotherapists to address. Stroke patients on rehabilitation wards are active for less than 13 per cent of their day, with few opportunities to be physically active.

The use of video games and virtual reality technology for rehabilitation in stroke patients is a burgeoning solution to the problem; however, there are many commercially available products (such as XBox Kinect) that are not yet suitable for those with functional impairment.

The Jintronix Rehabilitation System software, JRS WAVE, designed in collaboration with physiotherapists and occupational therapists, fills this gap. Dr Marie-Louise Bird, APAM, from the University of Tasmania’s Faculty of Health, Dr John Cannell, APAM, senior clinician at the Tasmanian Health Service and 15 other clinicians at Launceston General Hospital are conducting a randomised control trial using the JRS WAVE with stroke inpatients.



‘What’s new about this is it’s the first software of its kind that’s customised for stroke. It’s also controller-free motion capture. Patients aren’t connected to anything so there’s an element of freedom. And the therapist will be beside them challenging them with their balance or walking to the point where the patient is in control. We’re pushing the limits like we would in any other form of therapy,’ John says.

Running the trial in an acute hospital setting means many of the participants had stroke episodes only two to three weeks prior. The system has application across assessment, rehabilitation and feedback, according to Marie-Louise.

‘There are some tools within JRS WAVE that simulate some of our clinical tests like functional reach, sit-to-stand and the amount of weight the patient is bearing on each foot, which is really valuable for clinicians,’ she says.

A bonus for researchers is the system’s ability to record sessions and capture data on accuracy of performing a task, number of events, time spent with each game, and more. There’s also an automatic recalibration function that’s based on the participant’s past history of performing a task. 

Significantly, patients seem to like it. ‘One of the unexpected learnings is the potential for people to use this independently after discharge without the therapist there. They actually want to do it because they’re quite engaged with it. Now it’s just a matter of figuring out how it can work within a service delivery model,’ Marie-Louise says

Once the research is published, the team hope to explore alternative treatment models that either free up physiotherapy time, allow rehabilitation to begin in bed using mobile systems, or allow patients to continue rehabilitation at home using the system. The team is also working with researchers at Deakin University who are using JRS with functional imaging to explore the neurological effects of rehabilitation in stroke patients.

More broadly, there’s scope for this type of technology to be used for other conditions where functional improvements are sought.

 

   Motion capture technology improving patient engagement on rehabilitation wards
  Amy Rathjen, APAM, is undertaking a study to see whether pedometers encourage patients in rehabilitation wards to move more, thus improving mobility outcomes.
   Trialling video games in stroke rehabilitation
  A team of Tasmanian researchers are nearing the end of the first trial in the southern hemisphere of the Jintronix Rehabilitation System, an exercise-based video game for stroke patients.
   Taking physio to rural Tasmania
  Nine members of the TAS Branch set up a pop-up clinic at the state’s premier agricultural event, Agfest, to engage with and inform the public on the benefits of physiotherapy.
   Lorimer Moseley in Tasmania this November
  At this year’s TAS Branch Summer Breakfast, Lorimer Moseley will be sharing emerging research on how we detect dangerous events in our tissues and the implications for physiotherapists’ treatment of people in pain.
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