Using digital technology to deliver high intensity upper limb rehabilitation following stroke: can we 'game' the system?

Project Description

Over 150,000 people suffer a stroke each year in the UK and over half of all stroke survivors live with disability; indeed, stroke is one of the leading causes of disability. While evidence suggests around 80% of stroke survivors learn to walk independently, over 75% have persistent arm weakness that becomes a major contributor to their chronic physical disability and related mental health problems. In the past, a state of nihilism existed with regards to upper limb rehabilitation with a prevailing view that significant improvement was not possible. However, recent research implementing high dose and intensity rehabilitation for the paretic upper limb is shifting mindsets. For example, an influential UK-based study in 2018 that delivered 90 hours of 1:1 therapy over three weeks found significant, meaningful improvements regardless of stroke severity.

Nevertheless, six years on, the impact of these findings on stroke services across the UK is non-existent. Among the reasons for this appears to be recognition that offering such high levels of therapy is both practically and economically unachievable, and the resulting gap between ‘what is possible’ and ‘what is delivered’ has never been greater.

New digital approaches to rehabilitation may provide both a practical and economically viable solution and promising results from studies are emerging. This doctoral programme of research will build on these findings to explore the impact of high intensity upper limb rehabilitation following stroke using digital technology with a holistic focus addressing both movement-specific outcomes and the wider influence on physical and mental health.