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Virtual training helps injuries following a thrombosis in the brain

Rehabilitation of the hands and arms following a stroke does not have to follow traditional occupational therapy and physiotherapy. Researcher Iris Brunner from Aarhus University shows in a new research project that virtual training using a computer is a suitable supplement to traditional training.

When patients need to relearn movements that they have completely or partly lost after a thrombosis or cerebral haemorrhage, the usual cure is rehabilitation with physiotherapy and occupational therapy training. But now it appears that virtual training using a computer while wearing gloves with sensors may be equally effective for the rehabilitation of hand and finger movements.

This is the main result of a new study that has just been published in the journal Neurology by physiotherapist, associate professor and PhD Iris Brunner from the Department of Clinical Medicine at Aarhus University. Iris Brunner is affiliated with the University Clinic for Neurorehabilitation, Hammel Neurocenter. 

The study comprised 120 participants with an average age of 62. All participants had suffered a stroke within the three months prior to the start of the study and had reduced mobility of the hands and arms, and all subjects rehabilitated 4-5 times a week for four weeks – but with the difference that half of them received traditional training and the other half virtual training. The participating patients were under treatment at either Hammel Neurocenter, Skive Neurorehabilitation or one of three rehabilitation institutions in Norway and Belgium.

Best to train speed and precision

"In both groups, there were significant improvements in the patients' motor skills, but there was no difference between the results of the two groups," says Iris Brunner. However, she hesitates to recommend virtual training as an alternative to traditional rehabilitation. 

"To begin with we should see the virtual training as a supplement, a new tool in the toolbox, which is particularly suitable for training speed and precision. But there is also something that you miss out on, which is the tactile sense of surface structure as well as the feel of the weight you are lifting, throwing or grabbing," says Iris Brunner. 

She explains that some of the training programmes are designed to look like computer games, where you can e.g. pilot a plane or drive a car with your hand movements. Just as in a computer game, there is a measurable result in the form of a score that you can work on improving, which has shown itself to be motivating for many patients.

"Future studies will have to show whether the virtual training can be developed so that the effect of the training can be further increased," says Iris Brunner.

Special interest for big countries

She thus addresses the interest which some countries can have shown in offering virtual training to patients with long transportation time and the corresponding high costs of coming to traditional treatment.
Perhaps this is why geographically elongated Norway has shown interest in the project in advance – with, among others, the Norwegian Research Council and the Norwegian Physiotherapists' Foundation for Continuing Education helping to finance the study – while news media in the USA and Russia have asked about the possibilities inherent in virtual training.

Worldwide, approx. 17 million people suffer a stroke (apoplexy) every year, which is the common name for thrombosis of the brain and cerebral haemorrhage. The disease is the second most frequent cause of acquired disabilities and a frequent cause of death throughout the western world. 

In Denmark, the number of annual strokes is around 14,000. At least two-thirds of the patients have problems with reduced arm and hand function.


The research results - more information 

  • Facts about type of study: Randomised controlled multi-centre study, clinical research.
  • Partners from Denmark and abroad: The University of Bergen (where the study began), KU Leuven in Belgium and five rehabilitation institutions in Norway, Denmark and Belgium.
  • External funding: The study is financed by the Norwegian Research Council, Helse West, Norway, the Norwegian Foundation for Continuing Education in Physiotherapy, The Central Denmark Region’s Research Pool and the Danish Physiotherapists' Foundation.
  • Direct link to the abstract on which the media coverage is based can be found at Pubmed: https://www.ncbi.nlm.nih.gov/pubmed/29142090

Contact

Associate Professor, PhD Iris Charlotte Brunner
Aarhus University, Department of Clinical Medicine, Hammel Neurocenter, University Clinic for Neurorehabilitation
Email: Iris.Brunner@rm.dk
Mobile: (+45) 6056 8195
Direct tel.: (+45) 7841 9078