{"id":3422,"date":"2023-03-21T09:24:10","date_gmt":"2023-03-21T09:24:10","guid":{"rendered":"https:\/\/blogs.imperial.ac.uk\/ighi\/?p=3422"},"modified":"2024-10-23T10:02:48","modified_gmt":"2024-10-23T10:02:48","slug":"keeping-ontrack-with-stroke-rehabilitation","status":"publish","type":"post","link":"https:\/\/blogs.imperial.ac.uk\/ighi\/2023\/03\/21\/keeping-ontrack-with-stroke-rehabilitation\/","title":{"rendered":"Keeping OnTrack with stroke rehabilitation"},"content":{"rendered":"

The Helix Centre<\/a>, part of the Institute of Global Health Innovation<\/a>, is helping stroke patients to manage their recovery and increase their independence, with a wearable tool that provides support for the rehabilitation of their arm and hand.<\/p>\n

\"Sana
Sana talks to the Helix Centre\u2019s Clare McCrudden about the OnTrack technology<\/figcaption><\/figure>\n

OnTrack Rehab<\/a> is a platform that combines tracking of arm movements through a smart watch with personalised virtual coaching and dedicated clinical support. The system allows stroke patients to convert every-day activities into productive rehabilitation, and stroke therapists to monitor and help guide the patients\u2019 progress. The development of the platform has been led by a multidisciplinary team at Helix including Gianpaolo Fusari (Project Lead) and Clare McCrudden (Engagement Lead). Gianpaolo and Clare recently ran a data collection experiment involving 20 stroke survivors to improve the software behind OnTrack.<\/p>\n

Sana<\/strong>, a stroke survivor, volunteered to participate in this experiment, and met with us to describe her experience. Senior Occupational Therapist Simone Welch<\/strong> works in the stroke team at Charing Cross Hospital (Imperial College Healthcare NHS Trust), and chatted with us about the medical support for stroke survivors.<\/p>\n

 <\/p>\n

Experiencing stroke<\/u><\/strong><\/h2>\n

In 2021, Sana experienced weakness in her left side following a medical procedure, and ultimately was diagnosed with a stroke. \u201cI felt lucky in my stroke \u2013 though not lucky to have a stroke! \u2013 because stroke outcomes could be more significant.\u201d<\/p>\n

Sana\u2019s physical symptoms such as some limited arm movement required ongoing management and rehabilitation as well as sensory-based issues, like those of many stroke survivors. But it can be difficult for those who\u2019ve had a stroke to know what to expect. Sana described that support came not only from her medical team, but beyond \u2013 reading information on the internet to understand her issue, and the information provided by medical charities.<\/p>\n

\"Sana
Sana is fitted with sensor technology to track her movements in order to improve the software embedded in the OnTrack system.<\/figcaption><\/figure>\n

During a visit to hospital, an NHS physio checked that Sana could do simple everyday tasks, like brush her hair. But at home, it was more challenging to engage with the ongoing exercises.<\/p>\n

Sana felt that the support and rehab she needed wasn\u2019t as easy to see as most of her impairments were more hidden and not so obvious. \u201cI am grateful that it could have been worse but if I had something more significant and visible then people would be taking me more seriously.\u201d So when the Stroke Association sent a physiotherapist to her house for assessment and gave her exercises it was the beginning of better support.<\/p>\n

\u201cWhen it\u2019s painful you just don\u2019t want to do [the exercises],\u201d Sana said. With the difficulty of engaging with exercises, plus limited face-to-face support during the pandemic and the lack of services tailored for younger people who\u2019ve had a stroke, tailored support is needed.<\/p>\n

As a young person surviving a stroke, Sana wanted to see support that would allow for variabilities in age and outcome, rather than a \u2018one size fits all\u2019 approach.\u00a0 So the invitation to participate in OnTrack\u2019s stroke rehabilitation was appealing. Sana felt that by participating in the research, her experience was able to help others, especially when those people did not fit the \u2018usual\u2019 stroke survivor\u2019s demographic.<\/p>\n

One aspect of OnTrack that Sana liked was the idea of \u201cmeaningful movements\u201d. Physiotherapy rehabilitation requires hundreds of specific or purposeful movements each day, which felt unattainable. But with the smart-watch style device, Sana describes feeling more able to achieve goals \u2013 through every-day tasks such as brushing hair and doing dishes \u2013 which count as meaningful arm movements for rehab.<\/p>\n

\u201cThis would have been useful to me;\u00a0 I need to engage with something interactive,\u201d Sana said. That\u2019s where the app helps \u2013 measuring activity and giving motivation\/feedback reinforced through different channels within the watch and app, and through the support provided by therapists.<\/p>\n

\"Image
OnTrack app interface which records movement<\/figcaption><\/figure>\n

Sana\u2019s message to survivors: \u201cIt does get better.\u201d\u00a0 Sana recommends to engage with the exercises, and found YouTube videos and stroke support charities helpful in her recovery.<\/p>\n

Stroke therapy<\/u><\/strong><\/h2>\n
\"Woman
Simone Welch<\/figcaption><\/figure>\n

Simone first saw the OnTrack technology in its very early stages \u2013 when in-person service provision was really limited during the pandemic. \u201c[It] provided an intervention that allowed [stroke survivors] to continue with the upper limb recovery\u201d, said Simone, as well as to participate in research.<\/p>\n

Within 24 hours of being admitted to the HyperAcute stroke unit where Simone works, the patient will be referred for a therapy assessment \u2013 be it speech, physical or occupational therapy. But the rehab certainly doesn\u2019t end there. Where some boroughs have intensive community stroke therapy available, including at the patient\u2019s own home, the vast majority of rehab happens when the patient is on their own. \u201cThere is a concept called self-management which is really, really important,\u201d where patients take on responsibility for their progress and their rehabilitation.<\/p>\n

Simone wants her patients to be able to be discharged and return home. And the app would really support them to be able to track how they’re doing with their arm and hand recovery when not in hospital. When stroke patients like Sana have an arm weakness, OnTrack Rehab can send reminders, and help them to focus on what they need to achieve. \u201cSo it\u2019s a bit like a step counter for the arm,\u201d explains Simone.<\/p>\n

As any movement of the arm \u2013 actual exercises or using your arm to wash your face or to feed yourself \u2013 is beneficial, tracking with OnTrack is a really positive solution.<\/p>\n

Keeping on track<\/u><\/strong><\/h2>\n

There\u2019s plenty of hope about what OnTrack could help with. Simone said: \u201cI think it would help guide conversations between therapist and patient on how they can do more outside of their sessions.\u201d Plus, it gives data that therapists can go through with their patient to support them to reach their goals.<\/p>\n

\u201cThere\u2019s a lot you can do to support someone’s overall quality of life and their well-being\u201d, says Simone. The app could prompt therapists to ask: \u201cI can see you were really active at this time of the day, but not so much here \u2013 what was happening?\u201d This is particularly important when therapists may only see their patient for an hour, as the app allows you to know what\u2019s happening in the other 23 hours of the day.<\/p>\n

\"A
OnTrack smart watch<\/figcaption><\/figure>\n

For OnTrack Rehab, Clare and Gianpaolo are working to evaluate the device and its impact with more people and this year a new clinical trial will begin.<\/p>\n

Gianpaolo said: \u201cThe data and insights that we gathered with the collaboration of Sana and other stroke survivors during Phase 1 has helped us to improve the OnTrack experience as a whole.\u00a0 One big change that we can\u2019t wait to test during Phase 2 is the inclusion of smarter prompts delivered directly to the patient\u2019s wrist, hopefully we will be able to see how these tailored messages motivate people to increase the use of their arm in more varied activities.\u201d<\/p>\n

\u201cWe are delighted to have members of the research study as part of a wider group of stroke survivors and carers guide us through the next phase of OnTrack Rehab, piloting it in the NHS. We expect to be able to enhance the both patient and carer\u2019s experience, and also embed new co-designed features to keep users motivated and supported.\u201d said Clare<\/p>\n

\n

Find out more about <\/em>OnTrack<\/em><\/a> and the user-centred designs created by the <\/em>Helix Centre<\/em><\/a>.<\/em><\/p>\n","protected":false},"excerpt":{"rendered":"

The Helix Centre, part of the Institute of Global Health Innovation, is helping stroke patients to manage their recovery and increase their independence, with a wearable tool that provides support for the rehabilitation of their arm and hand. OnTrack Rehab is a platform that combines tracking of arm movements through a smart watch with personalised […]<\/p>\n","protected":false},"author":1691,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[11640,301380,301327],"tags":[],"class_list":["post-3422","post","type-post","status-publish","format-standard","hentry","category-design","category-helix-centre","category-patient-and-public-involvement-and-engagement-ppie"],"yoast_head":"\nKeeping OnTrack with stroke rehabilitation - Institute of Global Health Innovation<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/blogs.imperial.ac.uk\/ighi\/2023\/03\/21\/keeping-ontrack-with-stroke-rehabilitation\/\" \/>\n<meta property=\"og:locale\" content=\"en_GB\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Keeping OnTrack with stroke rehabilitation - Institute of Global Health Innovation\" \/>\n<meta property=\"og:description\" content=\"The Helix Centre, part of the Institute of Global Health Innovation, is helping stroke patients to manage their recovery and increase their independence, with a wearable tool that provides support for the rehabilitation of their arm and hand. 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