An Investigation into Stroke Patients’ Utilisation of Feedback from Computer-based Technology

Abstract

Strokes are the largest single cause of disability in the UK (DH, 2007). It is estimated that the incidence of first strokes will increase by 30% between 2000 and 2025 (Truelson et al., 2006). Evidence indicates that intensive post−stroke rehabilitation improves function, independence and quality of life (Kwakkel, 2004; Pollock et al., 2007), but according to the Chartered Society of Physiotherapy, the demand for rehabilitation outweighs supply (CSP, 2007). Nevertheless, recent technological advances have promoted the development of tools that may potentially complement the direct efforts of therapists and could in the future even act as surrogates (Liebermann et al., 2006). They include robotassisted movement therapy (Kwakkel et al., 2008), virtual reality technology (Henderson et al., 2007) and inertial tracking devices (Mountain et al., 2010). These systems have the potential to provide consistent, detailed, individually adapted feedback to the user (Intercollegiate Stroke Working Party, 2008) in the absence of the therapist. However, much of the evidence supporting conventional post-stroke rehabilitation suggests that feedback is provided verbally face to face by a therapist and typically involves hands-on therapy (Hartvelt and Hegarty, 1996; Ballinger et al., 1999; DeJong et al., 2004; Wohlin-Wottrich et al., 2004). The demand for post stroke rehabilitation means that service demand cannot be met and other solutions are necessary. Additionally there are unanswered questions regarding the reliance that a stroke survivor can have upon a therapist for both motor learning skills (Magill, 2007) and the self management of the resultant longterm disability (Jones, 2006).