This month we want to introduce you some breath taking technologies applied in stroke rehabilitation which are at the same time efficient and of a lot of fun, the Haptic Virtual Reality therapy. We will give you an example of such treatment and you may want to have a try. Secondly, we have been talking about the risk factors and prevention several times in our previous newsletters, however do the risks differ in gender? We are going to focalize in women to find out if there are more impacts in this population.

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The NeuroAiD™ Team at Moleac

Stroke is the third leading cause of death in the US and strokes are more deadly for women. Of every five deaths from stroke, two occur in men and three in women. Certainly, men women share some of the typical risk factors of stroke, like high blood pressure, atrial fibrillation, high cholesterol and smoking. However, some risk factors are unique to women or seem to increase the risk of stroke in a woman more than in a man.

However, some risk factors are unique to women or seem to increase the risk of stroke in a woman more than in a man.

Five things seem to increase women’s risk of stroke:

1. Hormone use.  In healthy post-menopausal women, long-term use of estrogen alone or estrogen plus progestin slightly raised the risk of stroke. They are the components of birth-control pills – although considered safe for most young healthy women. But they can raise the stroke for women over 35, especially in those who smoke. Hormone replacement therapy can be another
2. Pregnancy. The risk of stroke during pregnancy and weeks following birth is about 2.4 times greater than for similar no pregnant women. It can be also considered as the result of the change of the hormone.
3. Long sleeping time. Women require more sleep than men. As we mentioned in our previous newsletter, a person who sleeps longer like eight to nine hours per night, had a higher risk for stroke.
4. Family history of stroke. It seems to have more impact on women than men. Stroke risk doubles for a woman if someone in her immediate family members has had a stroke. It impacts men as well, but not as much as women.
5. Migraine headaches. More women than men get migraines. Particularly, those migraines with auras are linked to an increased risk of stroke. Women who smoke and use birth control pills are at higher risk for both migraines and stroke.

As you already think about it, theses above factors can even raise a higher risk of stroke if they are found simultaneously in an individual. The risk can be factorized.
If you are a woman, and you can’t control some of these factors, you can help to counteract them by living a healthy lifestyle. Especially, talk to your doctor about all of your birth control options if you are over 35 years old or if you smoke.
Not only in the risk factors, have the complicated situations occurred also in symptoms.  Women’s stroke symptoms are often quite different than the typical symptoms that men experience.

Ralph L. Sacco, MD, the spokesperson for the American Stroke Association explains:  “For example, certain pain syndromes and change of consciousness, which we don't always think about as typical stroke symptoms, may be seen more frequently in women than men. In addition to pain, women may also experience nausea, chest pain, heart palpitations, or difficulty catching their breath.”

Stroke gives gender differences. That is why it is extremely important for women to understand their risk of stroke and be aware that they might have a different set of warning signs than men. Above all, don’t brush off stroke symptoms because you think it's a disease that strikes men — it can sneak up on women who aren't aware that they are every bit at risk.

Sources:
International Workshop on Medical Measurement and Applications
Everyday health
CBS news

More and more new technologies have been used in stroke rehabilitation. Here is an example of one of such futurist exercises. Thanks to the armature which is shown in figure 1, on the computer screen as figure 2, the patient will see a maze and a stick with a thin cylindrical shaped handle. In addition to grabbing the stick, the main task here is to navigate the maze using the stick. The exercise’s main objective is to improve the steadiness of the hand while performing a task, which also requires some concentration to avoid collision with the walls. The time used to complete the task as well as the number of times of collisions is used to assess the performance of a stroke patient.

Two technologies could be found in this interesting demonstration. One is said as “haptic”, a detection of sense of touch of human being. It may be considered as today’s most fashionable and modern technology. For instance, you may like very much your iPhone. Haptic technology has made it possible to investigate in detail how the human sense of touch works by allowing the creation of carefully controlled haptic virtual objects. These objects can be used to test human’s haptic capabilities, which would be quite difficult to achieve otherwise. They can be considered as new research tools contributing to the understanding of how touch and its underlying brain functions work.

Another specific term found here is Virtual Reality (VR). It is computer technology that simulates real-life learning and allows for increased intensity of training while providing augmented sensory feedback. For many years, VR technology has proven its ability as an adaptive tool especially for interaction with computers. It can provide an interface to the real world and a more realistic environment. In daily life, you may see others playing or yourself enjoying the Wii of Nintendo, which is typically a VR system. In our previous issues, we have talked about the motor imagery, VR can be seen as an extension of classic motor imagery. VR technology can be also used in stroke rehabilitation and it is often focusing on a specific practice regimen for recovery of upper extremity function.

In the exercise which we presented at the beginning, two technologies were associated. Virtual environments were strongly linked with and assisted by haptic-based systems. Along with visual sensory, more realistic sensations of touch can be produced.

Scientists have shown that haptic VR devices can continue to improve a stroke patients’s recovery . Some studies have been conducted on haptic-based rehabilitation of certain body of stroke patients. According to its “touch” characteristics, mostly the exercises were designed for hand rehabilitation consisting a series of game-like tasks to address certain parameters of hand movement.



What are the advantages of Haptic VR rehabilitation system? Firstly it’s a very engaging rehabilitation exercise, as patients fell immersed in the simulated world. This is very important in terms of the patient’s motivation. Secondly, Haptic VR technology can fully quantify any progress made by the patient. Interested? Ask your rehab doctor for more information and if there is any center of rehabilitation in your region which is capable of provide such interesting and effective exercises.

Sources:
International workshop on medical measurement and applications, 2007
University of Southern California