Feb 2013 Issue
“Reminding” to boost stroke recovery
New assistive device to make a difference for stroke patients
Stroke patients can now benefit from a new assistive device from PolyU’s Department of Rehabilitation Sciences. The device boosts recovery by reminding patients to work harder on their impaired hands and arms. It is simple and easy to use for the patient as well as the therapists and healthcare professionals.
According to the Hospital Authority, stroke is the leading cause of severe disability in Hong Kong. Stroke survivors are left with partial paralysis where there is limited movement on one side of the body due to damage in the brain. Occupational therapy can help restore functions in the hands, arms and legs but researchers found that arms are slower to recover than legs. This problem is quite common among patients after stroke or brain injury.
As a part of a novel and innovative treatment – “Remind to Move”, PolyU’s new device is called “sensory cueing wristwatch”, which is specially made to better manage in-home exercise programmes for clients with hemiplegic arms due to stroke or children with cerebral palsy. Therapists can now have effective intervention even when patients are in their own homes.
A program will be input into the wristwatch, which in no way can be altered by the patient. Strapped on the affected hand, the sensory-cueing wristwatch sends signals in vibration at fixed time intervals, reminding a patient to do exercises as prescribed. Movements are detected and recorded by a built-in sensor, which helps the therapist analyse the patient’s condition by frequency and range of movement. The records are also a good reference for the family and the carer who are watching over. In this way, rehabilitation is worked into daily life for maximum outcome and patients are also more likely to stick to the exercise regime anytime and anywhere – during travelling, working and shopping. In addition, patients can carry over the rehabilitation program prescribed by the therapists in the hospitals.
The project team leader of sensory-cueing wristwatch and the associate professor of PolyU’s Department of Rehabilitation Sciences Dr Fong Nai-kuen revealed, “The loss of basic skills can leave stroke patients feeling annoyed and depressed in using their hands. They tend to rely more on the good hand to carry out everyday tasks. We called this problem ‘learned non-use’. When unused over time, the upper limbs will further stiffen and weaken, which makes recovery even more difficult. That’s why we have developed a novel device to give stimulation and keep patients’ bad hands moving throughout the day.”
Mr Lau Kin-hung, Chairman of the Hong Kong Stroke Association, has been invited to a pilot study of this new stimulation therapy. He had stroke eight years ago and movements on the right side of his body were restricted ever since. Mr Lau recalled, “I could hardly lift my right arm and hold a glass to drink. From then on, I didn’t bother to use that arm.” However, his leg did recover much faster than his arm. “I must thank the old building I have been staying. There is no lift and I have to climb four flights of stairs to get home every day. Slowly, my legs moved much better and I felt steadier on my feet,” he continued.
After trying out the sensory-cueing wristwatch, Mr Lau felt the big difference. He put on the device for three hours every day and after two weeks of intensive exercise, his arm felt stronger and moved better. “Now that I can lift my arm to my nose and raise a glass without difficulty,” said the satisfied patient.
There are 3 published studies regarding this treatment and a clinical trial has also been carried out on 40 stroke patients in 2 public hospitals. So far, they have done pretty well. In rehabilitation, patients on 3-week sensory cueing treatment have 2400 repetitions on average while the non-therapy group has only 1700 repetitions. With proper stimulation, patients are able to work harder and show bigger improvement in terms of strength, coordination and arm functions.
“The device is aimed to motivate people to help themselves. Our ultimate goal is to provide a simple solution that helps a person with strokes or cerebral palsy to recover at home and return to normal life, without the presence of a therapist,” Dr Fong said.