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Improving stroke recovery on the pitch

The stroke patient ambles into a freshly painted room on the inpatient floor of Elisabeth Bruyere Hospital in Ottawa and moves in front of a “green screen” (the kind used for TV weather reports), which is directly opposite a home-theatre-size television.

Suddenly, the room is transformed into a soccer pitch. And the patient appears on the massive television screen as the goalie. Her job is to block incoming balls by bobbing up and down, and moving side to side.

This is the virtual reality stroke recovery lab: a research facility, a therapy room and an oasis in the hospital that morphs into different imaginary settings.

It’s here that HSF Canadian Partnership for Stroke Recovery (CPSR) researchers are looking at how they can use virtual reality games to improve post-stroke balance, standing and reaching. They are adding activity to traditional therapy, encouraging people to move more, and introducing an element of fun.

Fun is definitely an important part of this project, which began three years ago with the creation of one of the first virtual reality labs in an inpatient clinical rehabilitation service.

Supported by the HSF Canadian Partnership for Stroke Recovery and Ottawa philanthropists Tony and Elizabeth Graham, the virtual reality lab not only helps patients with physical recovery but also targets memory, concentration and the diagnosis of vision problems.

Neuroscientist Dr. Heidi Sveistrup of the University of Ottawa, clinician scientist Dr. Hillel Finestone of Elisabeth Bruyere Research Institute and kinesiologist and PhD candidate Dan McEwen want to see the findings from their research used in the development of specially tailored community- or home-based therapy programs across the country.

“Our job is really to measure what can be achieved with virtual reality technology and to determine how it can be used as an adjunct therapy,” says Dr. Sveistrup.

The use of virtual reality has particular appeal because “repetition is a huge part of stroke rehabilitation and virtual reality exercise can facilitate repetitive tasks in a safe but challenging environment,” Dr. Finestone adds. While virtual reality in stroke recovery is becoming more popular, until now there have been limited data on how it is used, in what context and what is most effective.

Publication of the results of their three-year research study is expected in the coming months.

The next phase of their research is to study the use of virtual reality for seated patients, who are unable to stand long enough for the existing program.

The Bruyere team has also set up a virtual reality research group, involving post-doctoral fellow Dr. Danielle Levac of McMaster University in Hamilton, to gain feedback from therapists on what needs to be put in place to ensure virtual-reality research can be effectively applied.

Bruyere has a 20-bed unit for stroke inpatients and about 200 new stroke admissions a year. At any time, there are also about 25 people in stroke outpatient rehabilitation programs.

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