Stroke is a serious medical condition that can cause permanent neurological damage, complications, and death. Persistent fine motor dysfunction is a common consequence of stroke and dramatically affects activities of daily living, requiring assessment and rehabilitative techniques that target fine motor skills. Historically, assessment and rehabilitation after stroke has comprised of evaluation and hands-on training with a therapist. There are several key limitations with the current standard clinical practice. First, the assessments are highly subjective. Second, they lack precision to accurately track small improvements and deteriorations in motion function. This makes assessing and tracking patient progress more difficult, also limiting evaluation of possible therapeutic interventions. Thirdly, there is a general lack of motion interventions for stroke that are (a) easy to deploy, (b) provide an accurate tracking of patient progress and (c) are engaging.
Multisensory and engaging experience offered by head-mounted virtual reality (VR) offers a promise to make significant advances in stroke assessment and interventions. Health-care related VR content has been used to plan, treat, and diagnose people in medical conditions including brain autism, phobias, and depression. Research labs, in contrast, have used motion tracking to accurately measure gross motor skills (e.g., reaching), however typically with very artificial and cumbersome experimental set-ups, and without an ability to easily isolate the motor/proprioceptive system from the visual input.
The researchers have designed VR-based methods which leverage commercially available VR headsets and embedded hand-tracking systems. The technology has two parts:
The assessment part which evaluates visual-motor coordination/perception and mimics “finger-to-nose” assessment which is widely clinically used to evaluate motor movement accuracy and track the course of stroke recovery. However, unlike, conventional assessments, the technology had (a) a precise quantification of movement accuracy and (b) the ability to isolate the proprioceptive/motor system from the corresponding visual signals.
The training intervention following stroke that aims to rehab motor function by practicing making accurate motor actions. The key feature of the intervention is the control of the visual input, first starting with a visually rendered hand, and then gradually decreasing the prominence of the visual information until the patient is solely relying on the motor and proprioceptive systems to make hand movements. Thus, the technology allows a gradual isolation and targeting the motor system by preventing patients from relying on the visual input, a manipulation that is not practical to implement outside of VR.
This VR-based technology provides a naturalistic and interactive assessment and training of motor behaviours with naturalistic stimuli. It precisely quantifies the motor actions and provides a unique ability to control the visual input, this allowing isolation of the proprioceptive/motor system. It is accessible in terms of cost, portability, and ease of use by leveraging commercially available VR systems. Current experiment results have shown rapid, highly sensitive and accurate measures of motor behaviours.