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The development and validation of a hand-based stroke rehabilitation product

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Virtual reality helps stroke patients overcome hand movement impairments

A virtual reality game that uses off-the-shelf virtual reality equipment is proving to be an effective rehabilitation tool for stroke survivors.

Digital Economy

Because a stroke disrupts the neural connection that runs from the brain to the hand muscles, many stroke survivors experience significant, often chronic, hand movement impairments. These impairments can range from muscle stiffness and decreased strength to a loss of dexterity or uncontrolled flexion. “Even though these hand impairments can severely impact one’s daily life, there’s been little work on improving the hand functionality of stroke patients,” says Joseph Galea, a researcher in motor neuroscience at the University of Birmingham. With the support of the EU-funded ImpHandRehab project, Galea intends to change that.

From playing games to improving performance

One of the main roadblocks to developing hand interventions for stroke patients has been costs – the motion tracking equipment needed to measure the movement of individual fingers is extremely expensive. To clear this hurdle, this European Research Council supported project turned to off-the-shelf virtual reality (VR) technology. “The first thing we did was demonstrate that the finger tracking software found in most new commercial VR headsets is accurate enough for use in a rehabilitation setting,” explains Galea. “Not only is this technology viable for our rehabilitation purposes, it’s also very affordable.” Next, researchers developed two highly engaging VR games that require the user to perform increasingly complex hand movements. “The stroke patient must control the movement of virtual objects like a balloon and avoid obstacles by using increasingly bigger, faster and more accurate finger movements,” remarks Galea.

Reward as motivation

He notes that one important finding was that the user’s level of engagement with the game correlated to the rewards being offered. Thus, the more points or coins at stake, the better the user performed. Most importantly, researchers concluded that having played the games for a prolonged period of time, the improved hand performance would persist even when the VR headset was removed. Although the ImpHandRehab system can create long-lasting improvements in hand function for stroke patients, Galea stresses that it is meant to complement current rehabilitation techniques. “We see our solution as augmenting traditional techniques,” he explains. “Ideally, it will be a solution that patients can use at home as a means of further strengthening their rehabilitation efforts.”

Overcoming COVID challenges

Even though the ImpHandRehab project succeeded at developing cost-effective, hand-based interventions using affordable, state-of-the-art VR technology, doing so during a global pandemic was anything but easy. “COVID had a huge impact on our work,” says Galea. “Initially, we could only do our testing online with participants who happened to have their own VR headsets at home.” The project also had to develop a COVID-friendly device. “Originally, we planned to use a bespoke glove, but, due to sanitary concerns, we switched gears and used camera-based technology instead,” adds Galea. Now, with pandemic mitigation measures being relaxed, the project has been able to test the system live. They also secured funding to test the intervention with stroke patients within a clinical setting.


ImpHandRehab, virtual reality, VR, VR headset, VR games, stroke, stroke patient, stroke survivors, hand movement impairment, rehabilitation, motion tracking

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