I was talking to an elderly relative when he slumped back, had difficulty breathing and started slurring his speech. About every three minutes, or 152,000 times a year, a stroke occurs in the UK. It is the fourth single largest cause of death.
An ambulance arrived in 10 minutes and within an hour we were in a specialist unit. On the way, the paramedic was relaying information to the stroke unit, both electronically and by radio, and on arrival a CT scan was conducted. The NHS gets a lot of bad press but you don’t hear much about the thousands of cases where your best expectations are exceeded by a considerable margin.
Stroke mortality rates decreased by 46% between 1990 and 2010, which means there are more people surviving now than ever before. One in five acute hospital beds and one in four long-term beds are occupied by stroke patients. Half of stroke survivors are left with a disability, making stroke the largest cause of complex disability. This costs the health and social care budgets about £4.38bn annually.
One-to-one rehabilitation is expensive and healthcare providers are interested in making greater use of technology and finding more effective, less labour-intensive therapies.
For some time robots have been helping with rehabilitation. The patient is strapped into a powered exoskeleton or frame. Before starting to exercise, the patient’s ability to move an arm or leg is input. If they cannot move a limb, the robot moves it for them. If they start to move, the robot provides adjustable levels of assistance, helping the brain and body to learn to work together again. For some patients the robots can be connected to video games to increase interest as it requires at least 500 repetitions of movement to “relearn” and make a lasting change.
There is also now a device that straps on the forearm, extending down to the hand, sending electrical stimulation into the arm that assists the hand in extending, grasping and other types of motion. When worn for about 90 minutes a day, it exercises muscles that have stopped working and re-educates them to help with tasks like picking up small objects or fastening buttons. Research shows it is possible to make improvements in this rerouting of the brain even years after a stroke.
Tablet computers and other consumer technologies are inexpensive ways of providing assistance. Downloadable apps can provide information, help with rehabilitation, and in some cases assist with communication. If a person has difficulty in speaking, there are apps that display and speak words when tapped. For those who have difficulty recognising words, there are apps that display pictures instead, with categories for food, greetings and more, or simply provide a means of saying ‘yes’ or ‘no’.
Games consoles with motion sensors are also being utilised. They help patients practice daily tasks, such as lifting, swinging and grabbing. Video games are good at improving hand-eye coordination and can help in relearning motor skills.
By the age of 75, 1 in 5 women and 1 in 6 men will have had a stroke. With an ageing population, we need to continue exploring ways of using technology to help support and rehabilitate the 1.2 million plus stroke survivors like my relative.
