Cheyenne's Blog – Uncertainties, asking better questions and making the world a better place with creative thinking

Questions:

1. How motivated are your patients suffering from a stroke in general in class?
2. Is there a certain age group in your opinion, who require more motivation to train, and what age is the most motivated?
3. Are most patients willing to properly conduct their exercises at home or do many avoid it and just continue in class?
4. Which existing tools already exist that have the potential to be developed?
5. Which tools do you see are used the least by patients and are the least fun and motivating?
6. What type of game from real-life scenarios could you see being transformed into a game for stroke patients that would be engaging and fun to use?
7. What is the best tool that most people use at the moment by themselves on the market?

Answers:

1. Much more motivated in practice than in self-training (scale 1-10 according to patients on average 7). Group training also helps a lot with motivation.
2. From experience, age groups such as puberty to around the early 20s and the age group around 45-60 are difficult in their motivation. The questions “why did it hit me and not someone else” keep germinating there. The acceptance of the disease compared to the money is difficult.
The age groups in between appear to be more motivated and less likely to make comparisons with “healthy”.
3. This is usually the rule. Patients practice very little at home or alone.
4. We already use digital things such as lamps, which go out on contact and to practice speed. If there were APPs that were also connected to the practice, one could create one's own exercise programs digitally and if they were practiced in the APP, the therapist would also have a better overview of the progress. Digital groups via teams etc. could also increase motivation.

Easily accessible APPs (I can think of the Babbel language learning APP as a comparison. Short intervals with slowly increasing intensity. You don't notice that you're practicing because it's playful. Here I could imagine that you're hand-mouth -Can exercise coordination, tongue coordination, speed, balance, etc.
5. Everything "classic" (balls, skittles, Thera bands, wall bars etc.) lost their appeal after the early rehabilitation phase (3rd month).
6. That depends entirely on the passion before the stroke: maybe soccer, golf, etc. There are also special splints that help with reactive step triggering. But these are incredibly expensive.
7. There are mirrors for mirror therapy to train the mirror neurons, for ADLs e.g. in the kitchen there are special knives and forks and of course walking aids.

Analysis:

The feedback from the physiotherapist was incredibly useful as they gave more detailed responses to my questions. Mainly, the feedback shows how patients are less engaged in isolation, and in alignment with the doctor’s responses, stated how some methods for improvement such as sports equipment, accessories for the body such as splints, can become very expensive. They also highlight how playful learning increases the intensity and could be more developed, such as app use. Alongside this, through their experience, the stroke patients most affected were in their early twenties and between 45-60. This is good data for my project and research as the features for my gaming solutions can be targeted towards this audience. It was also really important to realize, that typically associated games (balls, skittles, etc.), are not as engaging these days, and new improvements to these original games are necessary.

Email evidence:

Questions:

1. What are the main symptoms of stroke survivors?
2. How can stroke survivors improve their physical and mental condition?
3. Are there specific tools, equipment, therapies, games, etc., required to improve their conditions that are helpful in your opinion?
4. Would you suggest any improvements in the existing resources and tools? What could be further implemented or designed to assist the recovery stages?
5. What therapies primarily work for stroke patients and what seems ineffective for most patients?
6. Do most of your patients motivate themselves to train and exercise independently?
7. Are patients facing difficulties in their healing and exercising journey?

Answers:

to 1: Different, depending on the localization of the stroke. In the typical ACM closure, hemiplegia (spastic or flaccid) and speech disorder when the left hemisphere is affected.
to 2: - physiotherapy - speech therapy - aids such as crutches, walkers, wheelchairs - adjustment of the domestic environment
to 3: speech therapy, physiotherapy, possibly occupational therapy. Walking aids, rollators, etc. stair lifts, care bed, stand-up aid.
Regarding 4. Existing tools and therapies are sufficient
Regarding 5: Physiotherapy, speech therapy, occupational therapy work best. Drug therapy is mostly ineffective in improving symptoms.
6: Varies, some patients are very motivated, other patients let themselves go and are not motivated, often overlaid with depression
Regarding 7: Insufficient financing of the therapy by the health insurance companies (duration and frequency of the therapy).

Analysis:

Overall, the feedback from the doctor highlights the effectiveness and ineffectiveness of the existing therapies. The doctor’s responses to question six clarified that patients require motivation as they can often be consumed with depression. This feedback links directly to my gaming solution, in which colors, lights, and interactive tools are suggested for motivational purposes. The doctor also stated that there are variations in stroke impact and these levels need to be considered for appropriate therapies and tools. Finally, the doctor recognized the lack of financing available for the health service, which presents challenges in completing or developing these remedies.

Evidence:

(Conversation in German, Translation above)

Similar to the games that I read about in my last blog posts, in which patients have to touch and feel things without seeing them, a game could be created where there is a board with different forms and the patient would need to grab them out of a box without seeing them and put them into the appropriate hole where the light comes on. Each form should also have different surfaces.

This would also need to be done within a certain time so the patient gains the motivation to do it as fast as possible or perform the exercise altogether. Controlling the time would work with a timer and the stone would have to be in the gap within the given time.

Each day the patient could work quicker and achieve a faster time score.

Image created with AI

After a stroke, patients lose their senses in many cases (about 50%-80% struggle). They can experience feeling numbness or as if needles are going inside parts of their body, but there is hope with equipment. Making the difference between the feeling of cold and warm can also get more difficult. This results from the part of the brain being destroyed or damaged which regulates and controls sensation. In some cases, the sensation can return automatically, but often it takes constant training to get it back. Regaining it back can work when you exercise so the brain can heal. With stimulation, this can then work to get neural pathways back. However, this only works with constant exercise in which more and more stimulation is taking place and therefore leads to a quicker recovery.
Patients can work with therapists and what highly is important to feel and touch as a patient, so stimulation in connection to sensory can be sent to the brain and create those new neural connections. The best is to include a variety in the exercises, such as feeling pressure, but also light touch and feeling different materials as well as to realize different forms of temperature. All of these examples can help gain back sensory feelings.
Nevertheless, it will only work if patients are consistent and are repetitive with it.
One example is to place different textured materials on a table, to feel them, not look at them, and then to describe what it is.
Another game that exists is to fill a bowl with uncooked rice and place different kinds of objects inside. From there, patients have to find and say what it is. With this trick, the brain keeps on getting the experience of being stimulated.
Patients can also start easier and look at objects while they feel them and then repeat it with their eyes closed.
For patients who struggle with feeling temperature, it is important to feel objects that are warm and then also cold objects.
One last game that already exists, is to close the eyes and have someone touch you at a certain point. After this, patients have to say where they were touched and if they are wrong they have to process where exactly they were touched and train the brain this way.
All the mentioned exercises can save stroke survivors from dangerous accidents in the bathroom or kitchen. Therefore training and not being in the same position too long and keep on improving the stagnation are crucial.
https://www.flintrehab.com/sensory-reeducation-return-of-sensation-after-stroke/
As mentioned several times consistency is the key here, therefore a fun and motivating game that is easy to prepare or only has to be set up once so the patient can train themselves without someone constantly looking over their shoulders could be helpful for many stroke patients.

Before people spent time in front of their laptops and computers, arcade gaming was popular amongst gamers. These games still can be seen around today and the hype lives still on. The machines could be found in malls or in spaces in which people gathered in the time of the late ’70s. Considering the fact that those games provided the player with a different experience with the control, it made it different from playing at home and explains therefore the reason for it still existing in this day.
One of the most famous arcade games from the 80s is Pac-Man, in which the player has to grab the round red control and has to guide the yellow dot Pac-Man to get through as many points as possible while avoiding certain ghosts. Many people tried to score the next higher score over the years, meaning the competition in this game was huge.
The interesting fact here is that this game has no official end until you lose all your lives.
For stroke survivors, it could be interesting to create a similar game with the remote having specific textures similar to the stroke training ball. The remote could be bigger and easier to grab and the remote could be slightly soft so the player would automatically grab and squeeze it. Another idea could be to have different sizes, temperatures, and textures, so it meets every patient’s needs. With the score in mind, the patient could also be motivated to reach a higher one every day and see actual improvement in the game, as well as in the patient’s health.
Of course, not every patient has space for such a huge machine, but smaller versions that could be placed on a table and in which the patient can sit while playing could exist. In other institutions, a more advanced and bigger machine could be integrated, such as in hospitals or at physiotherapists, and would also not take much space away.

https://www.gamedesigning.org/gaming/arcades/

Pac-Man machine

It showed that AI is also already heavily impacting the stroke sector in specific. With its help, it showed that in England the recoveries tripled. It also showed that the overall time was much shorter between when the patients were diagnosed with it and their recovery stages.

AI helps with reading the brain scans and also supports finding the best treatments for each patient, and can find and make quicker decisions. According to Safe Stroke EU, 17 million people are affected by a stroke every year on a global level, and in England alone, there are 85,000 people.

New technology allowed one patient to just go home normally after only two days after the stroke as they could walk normally.

In Hungary, Brainomix e-Stroke was awarded and planned to be integrated into all stroke centers around the country.

In the UK, the system is available in 11 locations and 5 are financed by the AI in health and care award. This award supports making the process for patients quicker and better and saves time for hospitals by backing those new technologies up.

https://www.euronews.com/next/2022/12/27/ai-technology-has-helped-to-triple-patient-recovery-from-strokes-in-england

Since depression is a severe problem after people experience a stroke, I investigated what already exists in connection to that and AI. There is a video game by Thymia that detects the face while patients play the game and picks up more about their disease. With this, the best treatment can be found.

Overall, AI can find and investigate much faster, when it comes to numbers for instance, which can find solutions and treatments much faster than usual. With AI, healthcare can work faster and with fewer costs.

Additionally, AI can also work with gadgets, such as smartwatches to analyze the patient’s health and monitor it. This can avoid patients from making visits to the doctor when not necessary for instance.

With gadgets such as rings, patients could also be reminded to exercise with their tools and engage with their game to benefit quicker. In the form of vibrating it could remind the patient all with the help of AI.

Since AI is becoming so relevant also in the healing sector and is so future-driven, this research is especially relevant to my project.

https://www.insiderintelligence.com/insights/artificial-intelligence-healthcare/

AI is becoming more popular and common among several sectors, including the healthcare sector as it is finding its usefulness in it. It can support faster and better results and can manage threats and issues quicker too. AI also assists with being more correct and detailed. Healthcare especially keeps on working on enhancing the care for the patient. Radiology and cardiology comprise much data and at this point, AI can be important, hence why looking forward humans will only be needed and look into a case if really necessary. AI is also useful when it comes to managing and analyzing data. With this, doctors will be able to make the treatment even more specific and adapt it exactly to the patient’s needs. This will be done by also looking into the medical history of each person beforehand. An app is already existing that uses AI to give advice to patients with the help of the patient’s medical history and by sharing their symptoms. Something like this could theoretically be connected to my intended stroke patient game. Observing the SWOT analysis this could become part of the opportunities if there are several games in the future and an online AI system could suggest the right game which could support the patient. Another app ”AiCure app” assures the patient really takes the medicine via the camera. This could be another suggestion to connect something similar to the game to motivate the patients and capture their improvement. With this, patients could also earn points and reach levels and see it on their phones as well. AI is also already making the creation of drugs cheaper and faster. In the future AI will also support the healthcare sector by finding diseases quicker and making the patient experience quicker. On top of this, it will make research cheaper. With AI it will be possible to reach the full potential in this sector. 

https://www.linkedin.com/pulse/importance-artificial-intelligence-modern-healthcare-system-yamini-m

 

 

As I wanted to find visual solutions for stroke patients I decided to test AI in order to find new games and tools that could help me develop my ideas. The prompts I used on the website ”DALL.E2/OpenAI” were ”Stroke patients playing motivating games to improve their exercising abilities”. I found this tool to be very helpful in order to create an initial moldboard for starting points.

Sprinter Michael Johnson is talking about his experience when he experienced a stroke. He is a professional sprinter and described how he barely realized when he had his stroke and that only his coordination was disrupted and that his arm was tickling weirdly. After he got a check at the hospital he could not even properly walk anymore. At this point walking had to be learned and practiced from zero again. Working out did not just help him walk again, but also relax his mind.