dr. Jose Ortiz counted the minutes he spent in the back of an ambulance transporting him from Red Lodge to Billings. Timely treatment is imperative to saving one’s life or quality of life during a stroke. And Ortiz at least had a 60 minute drive before he would be admitted to the hospital.
His training in medical school and more than 20 years of practicing family medicine may have given him an edge in quickly identifying the symptoms of a stroke, but when he arrived at Billings Clinic, his entire left side was limp. Ortiz eventually started therapy at the Rehabilitation Hospital of Montana (RHOM) at 3572 Hesper Road in Billings. Now, about three months later, the only visible marker of the event is a slight drip to his smile on the left side.
Every patient at RHOM is expected to complete three hours of demanding therapy a day. To spice up the grueling repetitions, RHOM partnered with tech companies Penumbra and BIONIK Labs to integrate virtual reality (VR) and artificial intelligence (AI) to patient care.
RHOM is now the first and only facility in Montana to utilize this technology.
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“(Rehab) is probably the last frontier for medical robotics,” said Loren Wass, chief commercial officer with BIONIK Labs.
BIONIK Labs produces the InMotion ARM which uses robotics, AI and machine learning (ML) to help patients work on upper extremity rehabilitation when they have a neurological disorder such as a stroke, Wass said.
The patient is seated in front of a monitor and their forearm is strapped into the device. Guided by games on the screen, the patient grips a handle and moves their arm forward and back, challenging them to get in more reps.
The AI and ML allows the device to collect data and adapt to the patient’s needs. The machine produces progress reports, makes treatment recommendations and it can follow protocol driven treatments.
In a conventional therapy session, the patient completes about 30 to 60 movements in an hour, while BIONIK’s InMotion ARM devices achieve 600 to 1,000 movements in the same amount of time.
While the BIONIK Labs device isn’t something you might see in your living room, the virtual reality tools are. The REAL y-Series is a comprehensive VR rehabilitation tool that helps distract the patient from any discourse or limiting thoughts or feelings, said Jen Graves, RHOM CEO.
Similar to an Oculus, the REAL y-Series headset fits over the eyes to immerse the user into a whole new environment.
Straps with sensors are then attached to the hands, upper arms and over the shoulders and back to generate a body in the VR world that is similar to the patient’s.
Plunged into a carnival themed pinball game, patients reach to hit the balls coming toward them. The game tests shoulder range of motion including flexion and extension, reactive movement, core control, motor skills and tests their vision while engaging in a high stimulation environment that distracts from physical pain or fatigue.
In another environment, the patient finds themselves behind a deli counter. On one side they see a sandwich order and on the other are all the ingredients to build the sandwich. The game focuses on sequencing and memory work, object recognition, shoulder and cervical range of motion and coordination.
Penumbra occupational therapist Jessica Hauert is trained to select activities specific to the patient’s needs and watches the patient’s progress from a handheld tablet.
Hauert finds that many older patients are familiar with things like tablets and VR through their families, and are eager to try it in therapy.
“Patients often work harder because when they’re transported to another world…they forget that they’re doing really hard work. They’re reaching higher and working a lot harder because they’re having fun,” said Jennifer Wong, VP of market development with Immersive Healthcare at Penumbra.