Barbara Sullivan 0:01
With information on the latest developments in assistive technology and initiatives from the studios of 2RPH in Sydney and around the country on the Radio Reading Network of Australia, we bring you Ablequest.
Each year in Australia, more than 55,000 people suffer from stroke - when the blood supply to the brain is disrupted, although more common with people aged 65 and over, stroke can affect anyone at any time. Recovery involves restoring the patient's mobility and arms and legs and improving quality of life. In recent years, technology has revolutionised rehabilitation with tools such as robotics, virtual reality and wearable devices. These can enhance traditional therapy, monitor progress and provide personalized treatment... and according to today's guests, this technology does not replace therapy, but helps make it more accessible and engaging.
The Royal Rehabilitation Hospital in Ryde is at the forefront of advanced rehabilitation, with its state-of-the-art advanced Tech Centre, which offers devices such as robotic exoskeletons and virtual reality tools. Elaine Wziontek spoke to the Centre's advanced technology and clinical lead and senior physio, Jason Redhead. She also interviewed stroke survivor Graham Hooper about his treatment and progress now a year on after his stroke.
Elaine 1 1:33
So Jason, can you explain what happens when someone has a stroke and how technology with therapy can help?
Jason 1:41
Stroke's one of the leading causes of injury and disability in Australia and globally, that's often when one of the blood vessels in the brain can either be blocked or the blood vessel might burst. And so either of those instances there's a lack of oxygen that gets to the brain. And so without that oxygen, part of that brain may die and may not be able to function. And so after stroke, it's really important that we can increase repetition of practice and exposure to things to allow people to try and maybe get their function back.
After stroke, there's lots of evidence out there around repetition of practice and engagement and being in different environments to allow them to return to their lifestyle, being able to integrate different types of advanced technology into our clinical care. So this might be something like a robotic exoskeleton, or maybe some body weight support system, virtual reality, maybe sensory devices to allow people to participate further into their therapy with maybe a physiotherapist or an occupational therapist, maybe exercise physiologist or a speech therapist, to allow them to engage in their therapy, but also allow them to get back to some participation in their community or improve their quality of life.
Elaine 1 3:01
So can you tell us about the exoskeleton? What does that do? Is it something you wear and you're teaching your brain and your muscles to work properly again?
Jason 3:08
Yes. So we have various exoskeletons. They might be for the upper limb, or they might be for the lower limb. An exoskeleton is a type of technology that has multiple joints and it attaches to your limb, and it uses robotic assistance or body weight support to then allow you to practice different types of movement. So maybe that's attached to your leg, and you might be participating in return to walking. And so you're able to then stand over ground or stand over a treadmill and walk in a symmetrical pattern.
And that repetition of movement that that robot then allows you to do, allows you to engage your muscles and engage your nerves, so that you're then able to start to learn as you movement, so that the brain can start to learn what those movements should be. We try and train you to be able to then do those movements without being reliant on those exoskeletons.
Elaine 4:06
Jason, is it like a baby learning to walk a little bit?
Jason 4:10
Yeah, and as a... baby, we do it naturally. As a child or as an adult who has a stroke, it's really about understanding the pattern of movements, or the pattern of walking, or the pattern of stay, reaching and learning what that might be to do again. And there's lots of little intricacies in terms of what we need to be able to do. And using these different robots allows us to get biofeedback in terms of learning. Maybe that might be entry, might be a visual thing that they interact with. It might be maybe a vibration or electrical stimulation that can take that feedback from these robots and really learn how to move again.
Elaine 4:48
I imagine you've seen a lot of changes over the past five years.
Jason 4:53
We have, and we've seen people who might be early on in their stroke recovery and people who are much longer post this stroke. And so that change that we see can vary from person to person, from everybody who presents post-stroke is very different, but we're able to use this technology in conjunction with our traditional therapy that we might use and really increase their their participation and focus on their whatever their goal might be, whether their goal is returning to walking, or whether their goal is being able to feed themselves again, and we can integrate this technology to allow them to work towards those goals.
Elaine 5:27
Technology won't be taking over completely, and do you out of a job?
Jason 5:31
No. People think that robots are going to take over the world and take over health care, and they play a really important role. But we know from from the literature, the research out there that the person, the therapist, the clinician, plays a really important role in working with the people who have had a stroke, in terms of adapting that technology, adapting that robot to be able to work with the patient, to allow them to get the most out of their recovery following their stroke.
Elaine 5:59
And has there been research to back that up?
Speaker 2 6:02
Yeah, there's so much research out there, particularly relating to engagement post stroke, repetition of practice and participating in those movements, those activities after stroke. But there's also a lot of research that supports the integration of robotic advanced technology in conjunction with traditional therapy that shows greater outcomes following stroke, but also show that that integration of robotic technology is not doing harm. So that tells us that this is a safe intervention for us to be doing after stroke.
And we're starting to see more research coming through as this technology becomes more and more used across clinical practice, which is great to see Admiral rehab, we've done some research around the clinician to really give the clinicians their voice in terms of what they need to learn and understand to be confident to integrate this technology. And we're excited, hopefully about to be published in the coming months, so we're excited to be able to share that very shortly with you.
Elaine 7:04
How do you know if somebody you love is having a stroke?
Jason 7:08
Yeah, it could happen to anybody at any time, and really at any age. And there's an acronym out there called FAST action. Yeah, take fast action. So that's F for face. So looking at their face, is there changes in their facial features? Maybe a facial drop or facial slur. A is for arm, so is there change in sensation or movement in one of their arms, [?beach], S for their slurred speech and T for time is, are those symptoms, are they changing over time?
So that FAST acronym is a really important thing to just be aware of, so that if a loved one, a colleague or family or friend, is maybe presenting with some of those signs and symptoms, then you might be thinking, Hey, there might be something going on here, and maybe we need to seek out some some medical support, some of the new technology that's coming out of America, out of Europe, and even here in Australia. And so as that technology continues to evolve, more easier to use, for the client, for the therapist, more technology is becoming more portable, so it can be taken out into people's homes.
Technology is getting lighter weight, getting more adaptable to the individual. So it's great to see those changes, and we're seeing more and more of that technology being made available here in Australia.
Elaine 8:28
Well, that's great. All right, Jason. Well, thank you very much for chatting to us today. It's been a great pleasure to have you.
Jason 8:36
No worries. Thank you so much.
Elaine 8:39
And that was Jason Redhead, advanced technology and clinical lead at Royal Rehabilitation Hospital at Ryde. And now we're going to talk to Graham Hooper, who's a stroke survivor who benefited from that therapy and technology. So Graham, so what happened to you was there any warning?
Graham 8:59
No warning whatsoever, completely out of the blue, surprised and shocked myself and my family. I was attending a business meeting in the city on Pitt Street, not particularly stressful day, just sitting around a table with two other colleagues, I noticed myself, one of them I knew, and the other guy I met for the first time, and I was sitting at the meeting and yawning, I thought was a bit bizarre. Told myself to pull myself together. And then I went to pick up a glass of water, and I couldn't hold it in my left hand, and my speech started slurring.
The colleague that knew me reasonably well. Said, Graham, are you okay? And I said, Yeah, maybe not. He said, No, I don't think so. I'm calling the ambulance, which he did. So the ambulance arrived very quickly, and 10 minutes between first symptoms and paramedics arriving on site, the paramedics told me later I needed to go back and thank my colleague, because he probably saved my life. So thank you, Ryan, if you happen to be listening.
Elaine 10:02
So you were in hospital for many weeks?
Graham 10:06
Then I went to ICU, and then Drake Ward and then the Rehab Ward. So all up, was 78 days in hospital.
Elaine 10:13
Quite a while, isn't it. So that must have been challenging physically as well as emotionally.
Graham 10:18
Yes, it was. But I do have a good support network, but you do find those things out when you go through something like this. So I even had my commercial banker come and visit me in hospital, which I don't think many people can say they've had their banker visit them in hospital.
Elaine 10:35
That's right, that's amazing. Apart from seeing your banker in a different situation, your movement was affected, how what were their symptoms?
Graham 10:42
Physio told me, when I first came to the Rehab Ward, I couldn't sit up in bed. Needed assistance to get in and out of bed, assistance with showering, assistance to get to the toilet, relying on a lot of people. I was walking with two people assisting me, basically holding me upright.
Elaine 11:01
So what kind of technology has been helpful for you?
Graham 11:05
After I was discharged from hospital, I became an outpatient at Royal Rehab Hospital, and they've got the wonderful technology. There lots of high tech robotics, which was great for me, because if I could instigate a movement, the robot would detect my instigation, and then that would help me complete the movement. So that was helping to retrain the brain. Very encouraging as well, very motivating. That would record my improvement. As you can see, the progress from month to month. Even though it was a very limited movement, there was movement there, and then that would continue to get stronger.
Elaine 11:40
And I understood you wore an exoskeleton when you were on the, you know, the walking machine.
Graham 11:45
Yeah, walking on a treadmill with the robot doing all the work. They can adjust the level of assistance - so it can be 100% assistance, where I just relax and let the robot do the work. But course, the physio is not satisfied with me relaxing, so they turn the assistance level down to 70%... 50% that's where we're at at the moment. So they like to make sure that I'm working hard.
Elaine 12:08
So what technology do you think you will need ongoing, if any?
Graham 12:12
So I'm back driving, that will be ongoing. I'm hopeful of getting my license back shortly with a modified vehicle, which is a modification to the steering wheel, which is effectively a spinning handle, but all the electric suggested thumb press as well for me.
Elaine 12:27
So you only need one hand to work. Is that right?
Graham 12:31
So I've got limited mobility in my left hand at the moment, left hand and left leg. The leg's recovered more quickly than the hand, which is apparently normal, the larger muscles recover quicker. I drive a modified vehicle with my right hand and my right foot.
Elaine 12:48
So sounds like life is looking up for you now?
Graham 12:52
After many months, feeling like I'm returning to normal. It's 12 months now since I had the stroke, returning to returning to work, returning to driving, returning to social activities, yeah, so it's feeling much more normal than when I was in hospital, and focus on things that you do have, not things that you've lost. That's a fantastic attitude. I call it thankfulness, things to be thankful for.
Elaine 13:17
And I guess you're grateful to the team at Royal Ryde as well.
Graham 13:20
Absolutely great team of therapists - all the nurses, doctors and therapists at St Vincent and all the therapists at Royal Ryde, along with all the technology that's available there has really helped me, including speech therapy. So I wouldn't have been confident to speak to you on the radio 12 months ago. Definitely not. Thanks to Alice and Kate, these therapists at Royal Rehab, I can now speak confidently on the phone.
Elaine 13:48
You certainly do well. It's been great to talk to you, Graham. Thank you very much for sharing your experience. And that was Graham Hooper, who's a stroke survivor and shortly returning to his full time role as CEO of Vasey Communities that looks after retirement villages.
Barbara Sullivan 14:12
You have just been listening to Ablequest, a program that looks at developments in assistive technology and initiatives from Elaine Wziontek and Barbara Sullivan, thank you for listening and goodbye till next program.
