How a suburban hospital uses virtual reality for stroke rehabilitation

David Gerfen slips on a headset and finds himself in a food truck, tasked with putting together a made-to-order cheese and tomato sandwich.

When transferred to another virtual environment, Jervin has to use one hand to deflect a blue ball towards him like a throwing machine across a green field.

Gervin, 80, is not an avid player. A stroke survivor wears virtual reality goggles during treatment sessions at Northwestern Medicine Mariangoy Rehabilitation Hospital in Wheaton.

“This is one of our newest games,” said occupational therapist Nicholas Giovanniti, and instructed Jervin to move his weaker right arm. “Okay, I get it. Move forward. Excellent.”

Virtual reality has a significant presence in the healthcare field. Some hospitals offer immersive virtual reality experiences to calm and distract Pain patients Or as a way to escape a chemotherapy appointment. Virtual reality has become a navigational tool, allowing brain surgeons to plan procedures and take a 3D look at tumors.

Mariangwi is exploring a virtual reality system as part of a rehabilitation program for adult stroke victims. Doctors see the potential of virtual reality in helping patients stay motivated in an intense treatment regimen.

        
        
        
        
        
        
        
        
        
        
        
        
        
        
        
        
        
        
        
        
        
        
        
        

“We hope with this new type of technology that patients will be more interested in treatment because it is different,” said Dr. Mahesh Ramachandran, the hospital’s chief medical officer and stroke rehabilitation specialist. “It’s more exciting and fun, rather than doing a monotonous kind of exercise routine.”


Elmhurst resident David Gervin, right, is equipped with a head-mounted display.  Occupational therapist Nicolas Giovanniti makes sure that the device fits correctly and is comfortable for the patient.

Elmhurst resident David Gervin, right, is equipped with a head-mounted display. Occupational therapist Nicolas Giovanniti makes sure that the device fits correctly and is comfortable for the patient.
– Paul Valade | Staff photographer

How does virtual reality work

Sharon Schmidt suffered a debilitating stroke last December while laying out Christmas decorations outside her home in Glendale Heights.

“I couldn’t do anything with my left leg, I couldn’t do anything with my left arm or my left hand, and I had trouble speaking,” Schmidt said.

Schmidt, 74, was introduced to VR entertainment by her grandchildren. When her therapist Marianjoy suggested she wear VR gear, Schmidt was willing to give him a shot.

“Anything that helps you get back to where you were after you had a stroke — I support that,” Schmidt said.

The Rehabilitation Hospital equips patients with a virtual reality system Penumbra. Patients wear goggles and six sensors placed around both hands and their waist, above the elbows and lower back, so that their virtual image matches their movements in real life.

Gervin remained seated while his therapist directed and monitored his virtual exercises using a handheld tablet. Some activities are designed to exercise hand-eye coordination, reaction time and motor control, and a company Says.

“We are working on a sitting balance,” Giovannitti said, encouraging proper posture. “We’re specifically working on his right arm, working on coordination and working on coordination as well as being able to follow directions.”

Mariangwi is testing virtual reality in a study led by Ramachandran and Dr. Druvil Pandya, a neurologist at Northwestern Medicine Central Dupage in Winfield.

First, they assess how well patients can tolerate the virtual reality device. Therapists check for signs of motion sickness, dizziness, or nausea. The study is also limited to up to 20 patients with upper body weakness caused by stroke.

Doctors hope to publish their findings, but when and where will depend on the study’s completion and what the results are.

“Everyone we tested has already given us positive feedback,” Pandya said. “The next step is to look at clinical outcomes, whether that, along with conventional rehabilitation therapy, improves outcomes?”

The researchers described virtual reality as a complement to — not a replacement — for standard therapy. The 20 or so Marianjoy patients will complete six sessions — 30 minutes of virtual reality followed by half an hour of conventional therapy for each session — over a two-week period.


“We call them very special activities so that sometimes they feel like gaming,” said Gina Barry, executive vice president of Penumbra, a Marianjoy virtual reality company.
– Paul Valade | Staff photographer

Incredible Features

Penumbra is not a tech company, but venturing into a virtual reality therapy was the next logical step.

The healthcare company is best known for making catheters used to remove a blood clot and restore blood flow in a stroke patient’s brain. Penumbra built the REAL system with Sixense Enterprises, the virtual reality developer it acquired last year.

“VR offers some great features,” said Geeta Barry, executive vice president and general manager of holistic healthcare at Penumbra. “And we see that it really makes a big difference or difference to patients, as well as to the therapist’s experience because therapists have a whole new way of engaging their patients.”

Therapists gradually increase the level of difficulty so patients work on more advanced activities in the default settings.

“What virtual reality does is it immerses you in the experience,” said Barry, a native of Arlington Heights and a graduate of Buffalo Grove High School. “At a minimum, it makes you happy that you’re enjoying playing a game.”

The system charts the patient’s progress, the amount of time spent in those activities, and the range of motion in the shoulders, elbows, forearms, and wrists. Hide and Seek with animated penguins is designed to exercise a patient’s cervical range of motion.

“This distraction comes from ‘I am getting more out of my therapy experience, because I’m so involved in the activity, I don’t think about the pain,'” Barry said.

The company also points to a 2019 meta-analysis of previous studies suggesting that virtual reality “may apply principles relevant to neuroplasticity,” that is, the brain’s ability to form new neural pathways around damaged areas.


Dr. Mahesh Ramachandran, left, chief medical officer of Northwestern Medicine Mariangwi Rehabilitation Hospital, and Dr Drovil Pandya, Neurologist, Dubag Central Hospital, right, watch Elmhurst resident David Gervin as he navigates a virtual reality environment.

Dr. Mahesh Ramachandran, left, chief medical officer of Northwestern Medicine Mariangwi Rehabilitation Hospital, and Dr Drovil Pandya, Neurologist, Dubag Central Hospital, right, watch Elmhurst resident David Gervin as he navigates a virtual reality environment.
– Paul Valade | Staff photographer

What do patients say?

Giovanniti adjusts the speed and trajectory of the flying blue ball, and Jervin seems to respond intuitively. He extends his arm to strike her away.

“His sitting balance has improved,” Giovannitti said. “It’s really stable there.” Jerry’s wife, Jerry, agreed, saying, “It helps him be a little more coordinated.”

Schmidt progressed from using a walker to a cane. She cheers for her grandchildren at football and baseball games. She can climb stairs on her own.

But almost a year ago, it was difficult to complete a simple virtual task.

“It wasn’t easy to put those birds in their nests,” Schmidt said.

But she is looking forward to her VR sessions.

“I would recommend it to anyone who has had a stroke.”

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