A simple iPad could help stroke patients recover faster. A stroke specialist in Ottawa has developed a program called RecoverNow, a mobile tablet-based rehabilitation intervention to work on a patient's language and motor skills.
60-year-old Norbert Franke still has the lingering effects of a stroke that hit him a little over two years ago.
“I had a sharp, like a flame,” recalls Franke of that morning on December 2nd, 2014, “just a hot flash, gone and that was it.”
Every 9 minutes, someone in Canada will experience that same sensation. A stroke can kill or leave patients unable to walk, swallow or speak.
It has taken a lot of healing and a lot of work for Norbert to get to this point, walking into the Ottawa Hospital to visit his speech-language pathologist, Karen Mallet.
“Hi, Norbert,” Karen says, tablet in hand, “I’ve got some new apps to work on.”
This new tablet-based program has helped in that recovery process for Franke.
“Please find all the symbols that match the one on the left,” the program on the tablet prompts him. This particular app is aimed at improving auditory comprehension. There are multiple applications, some to help improve speech and language, others to help with movement. For many stroke patients, the tell-tale droop of the mouth indicates a potential problem with aphasia, a problem with production or comprehension of speech; something 40% of stroke patients will encounter. For Franke, the tablet-based exercises dealing with facial expressions were particularly helpful.
“You're moving your tongue, opening your mouth,” he says, “making facial contortions to get the muscles back up and running as fast as possible.”
Dr. Dar Dowlatshahi is a stroke neurologist at the Ottawa Hospital, part of the team that developed this tool called “RecoverNow” in collaboration with Dr. Kumanan Wilson of the Ottawa Hospital’s mHealth Research Team.
“It’s a simple idea,” says Dr. Dowlatshahi, “when we came up with it as first, we were sure someone else had done it.”
No one had. The team launched a pilot project involving 30 stroke patients, Norbert Franke, included, to be part of the first phase of the study. Now, with interest peaking across the country in RecoverNow, they want to roll it out further. Helping to fund it is the University of Ottawa Brain and Mind Research Institute, the Heart and Stroke Foundation Canadian Partnership for Stroke Recovery, the Ottawa Hospital Foundation and the Ottawa Hospital Academic Medical Organization.
“We proved it can be done,” says Dr. Dowlatshahi, “we proved patients like it and that therapists buy in but now we need to do a larger study and show this thing speeds up recovery.”
While stroke patients are in an acute care hospital setting like the Ottawa Hospital, Dr. Dowlatshahi says they will spend about 60 percent of their time waiting for tests, lying in bed, perhaps watching television; time that could be spent working on language and fine motors skills.
“That’s where RecoverNow came from,” says Dr. Dowlatshahi, “We said how can we get into that 60% downtime, evenings, weekends between tests and do it in a way where you don't need another health care professional sitting right there with the patient helping them.”
The data from the tablets is even sent to the patient's therapist so she can monitor it.
“I can see if they're having a difficult time with this task,” says Karen Mallet, a speech-language pathologist with The Ottawa Hospital, “I can make it easier or if they are doing 100%, I can make it harder for them.”
The next stage is to send these tablets home with patients so they can continue to bridge their recovery process. RecoverNow also helped track depression, which is a big factor post-stroke. The plan is to add more physical components, as well, to get these patients mobile faster.
