Stroke is a debilitating disease of the nervous system. It occurs when a part of the brain is damaged due to an interruption in the blood supply. Usually, a stroke happens when a blood vessel going to the brain gets blocked due to the deposition of fats. Stroke can cause permanent brain damage. Therefore, it is a medical emergency that requires immediate attention. One can experience different degrees of disabilities from a stroke. It depends on the area of the brain which got affected. Generally, people with stroke may have the following kinds of disabilities:
- problems in controlling movement or paralysis,
- disturbance in processing the senses like pain
- issues in language usage and processing (aphasia)
- problems with critical thinking and interacting with others
- loss of memory
- emotional disturbances and depression
- the trouble with eating or swallowing
- problems with bladder control and urination
Is rehabilitation and recovery possible following a stroke?
Depending on how severe the stroke was, rehabilitation and recovery of the lost brain function to some extent is possible after someone gets a stroke. Although rehabilitation cannot reverse the damage that has already occurred in the brain, it can still help a stroke survivor achieve a dignified long-term outcome. Our brains have a remarkable ability to re-form some damaged connections through continuous use and practice. And hence, the brain can relearn the function that it used to do. After a stroke, the main goal of rehabilitation is to optimize the level of independence one can achieve to get the best possible quality of life. For most stroke patients, restoration mainly involves practicing and relearning simple activities such as walking, sitting, standing, lying down, and switching from one position to another. Repair typically starts in the hospital once the patient is stabilized (24 – 48 hours after stroke). An early start of rehabilitative therapies can help the patient transition from hospital to home. Early intervention can also prevent another stroke from happening. The most crucial element in any rehabilitative treatment is that it should be custom designed as per the patient's needs and carefully directed so that the patient can do the repetitive practice of the skill that is lost.
Lost movement in the hands: how the rehabilitation works
A stroke can create horrors in terms of the hand disability. One can ultimately lose the ability to extend fingers and hold and let go of the objects, negatively impacting their social participation and overall life satisfaction. The good thing is if rehabilitation therapy is started early and with continuous practice, these functions can come back in six months. Usually, an arm and hand function return is a good sign of recovery after a stroke. Rehabilitation strategies designed to improve hand and finger movements are mainly based on finger-specific exercises that must be repeated every day intensively. In such cases, home-based rehabilitation devices such as robotic gloves can be of immense help. Home-based rehabilitation devices allow for great flexibility for stroke victims as they can practice the desired skills at their own pace in the comfort of their homes.
Soft robotic gloves for the recovery of hand movements
Soft robotic gloves are gloves that have inflatable chambers. These chambers are connected to a control center, which can repetitively facilitate gentle stretching, bending, and straightening of the fingers. Such a repetitive exercise is needed to restore lost hand function. Through a specific air pressure, fingers and hands will be driven to do grasp training in various physiological activities. The gloves generally work at a shallow pressure mode and are made of highly comfortable materials. Typically, the following are some of the unique features of these soft, robotic gloves that make them desirable for continuous use:
- Soft robotics: The gloves are based on the principles of soft robotics, which means that they do not contain rigid mechanical nuts and bolts and are made of soft-compliant materials. Therefore, a user can wear them without frustration, and they can be worn in an unpowered state comfortably as you do your daily activities. And, whenever you are ready for an exercise session, you can just switch them on.
- Ease of use: The gloves and control center are lightweight, portable, and easy to use. So, the elderly can operate them independently and put them on and off even with one functional hand.
- Intelligent: The gloves have been designed to control the movements of individual joints in the fingers, and they also have adjustable training intensity. These features help significantly improve the user's skills.
- Effortless, continuous exercise: The gloves fuel the muscle strength and help them continuously expand, contract and stretch. And hence, the user can effortlessly do extension and flexion movements of the hand and fingers with high repetitions. This muscle strengthening is beneficial for quick functional improvements.
- Can send data to your therapist: The device is designed so that you can share the data for the exercise sessions with your therapist and get their recommendations without visiting the office.
What if your rehabilitation gloves are connected to a video game?
Studies are coming out now that suggest connecting this soft robotic glove technology with virtual reality and gaming; a phenomenon called gamified rehabilitation. The main aim of gamified rehabilitation is to make the exercise activities more enjoyable and engaging for the users. The games are usually designed on the principles of neuroscience that drive the movement of specific muscles and facilitate forming of new brain connections. The immersive experience provided by the system may encourage the patient to do more exercise and encourage patients to participate in rehabilitation activities regularly. This type of technology is still in the research and development phase. So, it still needs to be determined how much it benefits the users over the traditional soft robotic gloves and how it will impact the long-term functional recovery of stroke patients.
Is there any downside to using soft robotic gloves for rehabilitation?
There are not many drawbacks of the soft robotic glove technology as such. However, these systems are pricey and are not always covered by health insurance. Further, an individual may lose more than one function after a stroke and require several specialist rehabilitation therapists. The home-based rehabilitation programs are generally more suited for those patients who need only one type of rehabilitation therapy.
The soft robotic glove-based approach for rehabilitation after a stroke is promising. It is typically less complex and considered a safer option. However, it is not for everyone. So, you should consult your healthcare provider and the therapist before choosing the best choice for your condition and disability.
Fischer, H. C., Stubblefield, K., Kline, T., Luo, X., Kenyon, R. V., & Kamper, D. G. (2007). Hand rehabilitation following stroke: a pilot study of assisted finger extension training in a virtual environment. Topics in stroke rehabilitation, 14(1), 1-12.
Levin, M. F., Kleim, J. A., & Wolf, S. L. (2009). What do motor "recovery" and "compensation" mean in patients following stroke?. Neurorehabilitation and neural repair, 23(4), 313-319.
Muellbacher, W., Richards, C., Ziemann, U., Wittenberg, G., Weltz, D., Boroojerdi, B., ... & Hallett, M. (2002). Improving hand function in chronic stroke. Archives of neurology, 59(8), 1278-1282.
Ozioko, O., & Dahiya, R. (2022). Smart tactile gloves for haptic interaction, communication, and rehabilitation. Advanced Intelligent Systems, 4(2), 2100091.
Polygerinos, P., Wang, Z., Galloway, K. C., Wood, R. J., & Walsh, C. J. (2015). Soft robotic glove for combined assistance and at-home rehabilitation. Robotics and Autonomous Systems, 73, 135-143.
Proulx, C. E., Beaulac, M., David, M., Deguire, C., Haché, C., Klug, F., ... & Gagnon, D. H. (2020). Review of the effects of soft robotic gloves for activity-based rehabilitation in individuals with reduced hand function and manual dexterity following a neurological event. Journal of rehabilitation and assistive technologies engineering, 7, 2055668320918130.
Ueki, S., Nishimoto, Y., Abe, M., Kawasaki, H., Ito, S., Ishigure, Y., ... & Ojika, T. (2008, August). Development of virtual reality exercise of hand motion assist robot for rehabilitation therapy by patient self-motion control. In 2008 30th Annual International Conference of the IEEE Engineering in Medicine and Biology Society (pp. 4282-4285). IEEE.