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Assistive Technology and Spinal Cord Injury

Spinal Cord Injury (SCI)

Injury or trauma to the spinal cord resulting from incidents such as a car crash, or from degenerative illnesses or diseases can cause SCI and lead to permanent changes in strength, sensation, and other body functions.

The symptoms of SCI are varied and dependent on the location of the damage to the spinal cord and its severity. The lowest part of the spinal cord undamaged by injury is referred to as the neurological level of the SCI and completeness is the term given to the severity of the injury, with injuries resulting in a total loss of sensory and motor function below the injury termed as complete and those where some sensory or motor function remains referred to as incomplete.

Bush & Co spinal cord injury case managers work closely with clients that have experienced SCI to determine the neurological level and completeness of their injury and develop individual rehabilitation programs that support both short-term recovery and long-term management.

Making a difference

Bush & Co have an established partnership with Stoke Mandeville Spinal Research, an independent charity promoting improved quality of life in people with spinal cord injury through research. SMSR help fund and raise awareness of research projects focused on developing the treatment of SCI to progress physical functioning and enhance daily life.

Restorative therapy interventions can be more effective when associated with a meaningful change in functional motor performance and incorporate assistive technology that is accessible to people both in the clinic and at home.

Technology offers considerable benefits to those with motor, sensory and cognitive impairments, with assistive technology and adaptive equipment often necessary in SCI rehabilitation and daily life for people with catastrophic injuries. For this reason, SMSR has made research into assistive technology one of its priority areas.

Advanced wheelchairs, smart controls, and assistive robotics can help with everyday function and help people gain greater independence, but these can sometimes be prohibitively expensive or unsuitable for domestic settings.

Virtual reality (VR) has been found to improve motor and aerobic function and it is compact, cost-effective, and offers games and activities that promote a wide range of movement to help with a greater number of routine tasks. However, there is limited data available, and it is yet to be widely integrated into rehabilitation programmes.

New research

The Stoke Mandeville Spinal Research Team are currently funding research at the Glasgow Caledonian University into the role virtual reality (VR) can play in improving upper limb function in people with acute and sub-acute tetraplegia following a SCI. The 3-year PhD project will run to early 2025 and work with in-patients at Queen Elizabeth National Spinal Injuries Unit to evaluate the potential for VR to improve hand and arm function.

The research is being led by PhD student Andrew Goodsell under the supervision of Lorna Paul, Professor of Allied Health Science at the Glasgow Caledonian University’s Research Centre for Health. Andrew’s background in game design is being enhanced with clinical expertise gained through medical visualisation studies at the Glasgow School of Art, which combines the examination of the human anatomy with cutting-edge VR technology.

Professor Paul explains how VR can transform the rehabilitation of people with a SCI,

“Physiotherapy helps the recovery of muscles affected by injury and protects those muscles unaffected, but it requires repetitive and sometimes mundane activities and people often struggle for the motivation to continue therapy beyond the initial stages. VR introduces games that engage people and make the therapy fun and interesting without impacting its effectiveness.”

Researching the benefits of VR

People who have SCI and have retained upper limb mobility may overuse their shoulders, arms, and hands, risking further injury and potential loss of movement. Neuromuscular stimulation-assisted exercise following a SCI is effective in improving muscle strength and nervous system recovery, helping to prevent injury, and increasing independence in all phases of rehabilitation.

The research at the Glasgow Caledonian University will adopt a user-centric approach by co-designing VR games and activities with therapists and patients, utilising open-source software with coding that can be easily updated and won’t become obsolete.

In-patient focus groups will help identify popular and frequent movements, with the output fed into the software development and incorporated into the games. Real-time data will be available to help therapists identify how patients are using the technology and the benefits they are enjoying.

Clinical trials will take place in a supervised environment to measure the impact VR has on an individual’s ability to successfully perform a range of functional tasks compared to other in-patients who are following a traditional physiotherapy program. Should the research show VR has a positive effect, a community can be established that allows the sharing of data to progress the use of VR in care settings nationwide.

The research is in its very early stages, but it is hoped the study will show the immersive digitally reconstructed 3D environments provided by VR will be able to enhance or replace physical rehabilitation routines with fun and engaging games that allow a greater number of activities and exercises with the scope to perform unsupervised at home.

Assistive technology in rehabilitation and expert witness reports

Within case management and rehabilitation services at Bush & Co, case managers working with those living with a spinal cord injury, brain injury, limb loss and complex orthopaedic injuries continuously look for new ways to improve outcomes for children, young people, and adults as well as how lifestyle and social goals can be met.

Technology opens new opportunities and Donna Newman, children and young people case manager at Bush & Co, recently worked with a charity called Special Effect. The charity adapts gaming equipment so individuals with motor issues can access gaming. As well as supporting clients to reengage in hobbies, the charity also supports our case managers and clients with communication.

“Special Effects have provided a lot of equipment to assist with communication with a client of mine whilst they wait for specialist equipment to be funded. It’s a great resource…” Alison Stephens, Associate Case Manager | Bush & Co.

Bush & Co also provides assistive technology expert reports which focus on the needs of the individual, combining knowledge and experience in a range of assistive technologies and their application to spinal cord injuries in recommending the support required to improve quality of life and promote independence.

For further information on the work undertaken by Stoke Mandeville Spinal Research, please visit their website.

Get in touch on 01327 876210 for further details or find out more about our Assistive and Adaptive Technology reports here.