Enhancing Post-Stroke Rehabilitation using Microsoft’s HoloLens 2

A Focus on Activities of Daily Living

Introduction


Stroke remains the second-leading cause of death and the third-leading cause of death and disability combined, creating significant challenges for patients and healthcare providers (Feigin, et al. 2022) Traditional methods of post-stroke rehabilitation, while effective, can be labor-intensive, expensive, and not easily accessible for all patients. Moreover, these methods often fail to fully replicate the complex and diverse activities of daily living (ADL) that patients face in their homes and communities (Lee, et al., 2022). This gap in therapy has led to a call for innovative, engaging, and flexible rehabilitation approaches that can be tailored to individual patient needs and circumstances.
One promising avenue for such innovation lies in mixed reality (MR) technologies, which can create immersive, interactive environments for patients to practice and improve their skills in ADLs (Karamians, et al. 2020). Among these technologies, Microsoft's HoloLens 2 stands out due to its superior comfort, wider field of view, and advanced hand and eye tracking capabilities.
My research project aims to explore the potential of HoloLens 2 in enhancing post-stroke rehabilitation, focusing specifically on improving patients' abilities to perform ADL. Through designing targeted, interactive MR scenarios, we seek to provide a patient-centered rehabilitation approach that can be adjusted to the individual's progress, promoting active learning and engagement in the recovery process.
The project hopes to capitalize on the immersive, interactive potential of HoloLens 2 to bridge the gap between clinical rehabilitation practices and real-world ADL, and to enhance the quality of life of stroke survivors by providing a more realistic, engaging, and flexible approach to post-stroke rehabilitation.
Through my research, we seek not only to advance the knowledge base of MR in rehabilitation, but also to provide practical insights and tools that could be used by clinicians, therapists, and patients to optimize stroke recovery outcomes.


Problem Statement


Stroke is a major health concern globally, often leading to significant impairments that interfere with a patient's ability to perform activities of daily living (ADLs), such as eating, dressing, bathing, and navigating their homes and communities (Langhorne, et al., 2009; Legg, et al., 2004). Traditional methods of post-stroke rehabilitation, while crucial, often fail to fully meet the needs of patients. They are generally centered in clinical environments and may not adequately reflect the complexity and diversity of real-world ADLs (Langhorne, et al., 2009; Legg, et al., 2007). This gap limits the transition of skills from therapy sessions to home environments, contributing to a lower quality of life for stroke survivors.
Furthermore, access to rehabilitation services can be constrained due to factors such as geographical location, availability of skilled therapists, and financial resources. This restricts the ability of many patients to engage in frequent, long-term therapy, which is often needed for optimal recovery.
The advent of MR technologies like HoloLens 2 offers an innovative path for rehabilitation, with potential for highly engaging, personalized, and accessible therapy. However, the application of such
technology in stroke rehabilitation, particularly focused on ADLs, remains largely underexplored. Similar research has been conducted with focus on using HoloLens (first generation) as support in ADL for people with Alzheimer's disease. The team concluded that the technology was feasible but advances in hardware and patient interface were necessary (Rohrbach, et al. 2019).
The challenge, therefore, lies in the development and validation of a HoloLens 2-based MR system for post-stroke rehabilitation that effectively bridges the gap between clinical therapy and real-world ADLs. The system must be engaging, customizable to individual needs and progress, and capable of being deployed outside of traditional clinical settings. The potential impact of such an MR-based approach on patient engagement, accessibility of therapy, and overall recovery outcomes remains an open and significant question in the field of stroke rehabilitation.

Objective/Purpose


The primary objective of this project is to investigate the efficacy of Microsoft's HoloLens 2 mixed reality system as a tool for enhancing post-stroke rehabilitation, with a particular focus on improving patients' abilities to perform activities of daily living (ADLs).
The project aims to:

  1. Design and develop interactive MR scenarios simulating ADLs using HoloLens 2, providing an immersive, realistic context for patients to practice and hone their skills.
  2.  Evaluate the usability and acceptability of the HoloLens 2 system in a rehabilitation setting, considering factors such as comfort, engagement, and user experience.
  3.  Assess the impact of the MR-based rehabilitation approach on patient outcomes, including improvements in ADL performance, independence, and quality of life.
  4.  Investigate the feasibility of deploying the HoloLens 2-based rehabilitation system outside traditional clinical environments, to increase accessibility of therapy.

By achieving these objectives, the project aims to contribute to the development of innovative, effective, and accessible rehabilitation strategies that can enhance the quality of life for stroke survivors. The findings could have significant implications for the future of post-stroke therapy, moving it beyond traditional methods and towards more patient-centered, technologically advanced solutions.

 

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References 

  • Lee, K. E., Choi, M., & Jeoung, B. (2022). Effectiveness of Rehabilitation Exercise in Improving Physical Function of Stroke Patients: A Systematic Review. International Journal of Environmental Research and Public Health, 19(19), 12739. https://doi.org/10.3390/ijerph191912739
  • Karamians, R., Proffitt, R., Kline, D., & Gauthier, L. V. (2020). Effectiveness of Virtual Reality- and Gaming-Based Interventions for Upper Extremity Rehabilitation Poststroke: A Meta-analysis. Archives of physical medicine and rehabilitation, 101(5), 885–896. https://doi.org/10.1016/j.apmr.2019.10.195
  • Langhorne, P., Coupar, F., & Pollock, A. (2009). Motor recovery after stroke: a systematic review. The Lancet. Neurology, 8(8), 741–754. https://doi.org/10.1016/S1474-4422(09)70150-4
  • Legg, L., Drummond, A., Leonardi-Bee, J., Gladman, J. R., Corr, S., Donkervoort, M., Edmans, J., Gilbertson, L., Jongbloed, L., Logan, P., Sackley, C., Walker, M., & Langhorne, P. (2007). Occupational therapy for patients with problems in personal activities of daily living after stroke: systematic review of randomised trials. BMJ (Clinical research ed.), 335(7626), 922. https://doi.org/10.1136/bmj.39343.466863.55
  • Feigin, V. L., Brainin, M., Norrving, B., Martins, S., Sacco, R. L., Hacke, W., Fisher, M., Pandian, J., & Lindsay, P. (2022). World Stroke Organization (WSO): Global Stroke Fact Sheet 2022. International journal of stroke : official journal of the International Stroke Society, 17(1), 18–29. https://doi.org/10.1177/17474930211065917
  • Rohrbach, N., Gulde, P., Armstrong, A. R., Hartig, L., Abdelrazeq, A., Schröder, S., Neuse, J., Grimmer, T., Diehl-Schmid, J., & Hermsdörfer, J. (2019). An augmented reality approach for ADL support in Alzheimer's disease: a crossover trial. Journal of neuroengineering and rehabilitation, 16(1), 66. https://doi.org/10.1186/s12984-019-0530-z