June 11, 2010
The Cost of Stroke Treatment (Study)
A recent Canadian study found that the average financial cost of a stroke during the first 6 months is approximately $50,000. The study found that health-care covered around 80% of the costs, leaving the families to cover the additional 20%.
Most of the health-care costs related to hospitalization, whereas the remaining 20% related to lost time from jobs and expenses for the families.
Every year, 50,000 Canadians suffer a stroke and require treatment, which works out to an cost of more than $2.5 Billion each year.
The study examined 12 hospitals across the country, from Halifax to Vancouver, and tracked 232 patients during their stay in the hospital and after they returned home. Tracked costs included:
- appointments
- medications
- purchase of assistive devices like canes or wheelchairs
- home accessibility modifications such as ramps
- caregiver time away from a job
You can read more about the study here.
April 19, 2010
Glenrose Hospital - Virtual Reality Rehabiltation
Edmonton’s Glenrose Rehabilitation Hospital has acquired a new virtual reality system for rehabilitation. The CAREN (Computer-Assisted Rehabilitation Environment) will be installed over the next near, and will be ready for use in early 2011.
The product of Dutch company Motek Medical, CAREN consists of a large cylindrical screen and sophisticated projector system that creates a virtual environment. The user stands on a moving platform facing the screens that simulates motion in the virtual environment.
The Department of National Defence will cover $1.5 million of the $1.75 million price tag, with the Government of Alberta covering the additional $250,000.
Here’s a video of the CAREN in action:
April 16, 2010
Stroke Rehab Toronto
Researchers at the Toronto Rehabilitation Institute have joined forces with game designers at Algoma University in Sault Ste. Marie (700 km away, also in Ontario) to create video games to assist in speech therapy.
Dwayne Hammond, a strategic advisor at Algoma, suggests:
“All games teach, they’re all puzzles of some sort, and so if you develop a game specifically for rehabilitation purposes … it has potential to cause patients to follow their therapy much more than otherwise.”
When asked about the Nintendo Wii, and its use as a clinical modality for movement rehabilitation, Hammond says:
“The Wii is great but certainly I think the expectation is when you start to develop any product for an actual purpose, targeting something, you will be much more effective at that.”
The idea, which turned into the product the team is working on today, involves a therapist using paper cards to help patients exercise their brains. The cards contain illustrations of objects that patients must identify.
The team intends to move the identification program into software that can be used both in a clinical setting, as well as at home in a telerehabilitation capacity.
The team hopes to have created a commercially available product within a year.
Source: CTV, April 16, 2010
Stroke Rehabilitation in BC
The following table from a 2005 report from the BC Stroke Strategy shows patient wait times for post-stroke rehabilitation in British Columbia.
| Physiotherapy | Occupational Therapy | Speech Therapy | |
| Number of Locations Reporting Service | 57 (66%) | 41 (48%) | 21 (24%) |
| Range of wait time: In-Patient | 4 hours - 2 weeks | 24 hours - 7 days | 24 hours - 7 days |
| Range of wait time: Out-Patient | 2 days - 4 weeks | 7 days - 4 weeks | 1 week - indefinite |
This post will be updated with the latest numbers as soon as they are published.
Reporting hospitals’ level of knowledge regarding stroke programs offered as outpatient services or community services was limited in many cases. The most commonly reported hospital programs for stroke patients were general rehabilitation clinics and speech therapy. Community programs varied widely. Several sites reported support for patients and families offered by the Stroke Recovery Association. In fact, this is the most widely offered program of its type in Canada, with 38 groups located in: Cranbrook, Grand Forks, Kamloops, Kelowna, Prince George, Salmon Arm, Trail and District, Vanderhoof, Vernon, Burnaby, North Vancouver, Richmond, Vancouver, Abbotsford, Coquitlam, Langley, Maple Ridge / Pitt Meadows, Mission, Port Coquitlam, Powell River, Sechelt, South Delta, Surrey, White Rock, Alert Bay, Campbell River, Comox Valley, Nanaimo, Parksville, Saanich Peninsula, and Victoria.
April 15, 2010
Telehealth and TeleStroke News
Here’s a quick summary of telehealth news over the last four weeks.
1. CTN and AT&T Telehealth Network Expansion - The University of California’s California Telehealth Network (CTN) has a AT&T a contract to expand telehealth services in the state. Funding for the project comes for the FCC’s Rural Health Care Pilot Program. The project will see the CTN will working with AT&T to construct a statewide network connecting smaller regional hospitals and clinics to larger hospitals, giving rural residents access to more specialists and experts.
2. PricewaterhouseCoopers’s New HealthCast Report - According to a PricewaterhouseCoopers report, health care reform in the United States will results in a widespread effort to keep people well, out of the hospital and more engaged in managing their own health. The report suggests that lesser known provisions of the U.S. Health Reform package put increased emphasis on disease prevention, positive health outcomes and better coordination of care. Additionally, the report suggests the package emphasizes comparative effectiveness research, including more personalized medicine, which paves the way for more individualized care in a more patient-focused health system. According to the report, mass customization of health care services will be enabled by technology including smart phones, EMR databases, home health monitoring, telehealth, as well as wireless communication, social media and other Internet innovations.
3. Review of TeleStroke System in Kearney, Nebraska - The telestroke program in Nebraska uses a high-quality video and audio system to evaluate possible stroke patients in outlying hospitals. Typically, when patients suffer stroke, they have a limited time to receive clot-busting drugs, such as tPA. In this case, a physician only has three hours to make an intervention. Once a stroke patient is brought into an outlying hospital, the on-call neurologist in the system is available to evaluate the patient through telestroke.
April 14, 2010
ReJoyce at GF Strong in Vancouver
ReJoyce was recently on display at the GF Strong Rehabilitation Institute in Vancouver. Below are some pictures of Jennifer Loffree demonstrating ReJoyce to a crowd of Canadian Federal and Provincial politicians, including British Columbia’s Lieutenant Governor.
ReJoyce At GF Strong in Vancouver | Spinal Cord Injury Rehabilitation
ReJoyce is centerpiece of an ongoing spinal cord injury rehabilitation study in Vancouver. The study is investigating the rehabilitation efficacy of ReJoyce in combination with a hand stimulation system for people who have suffered a spinal cord injury. Subjects are treated at home, using our at-home rehabilitation software.
For information about ReJoyce, ongoing clinical trials, or anything else relating to home-based stroke and spinal cord injury rehabilitation, please contact us.
March 26, 2010
ReJoyce For Stroke and Spinal Cord Rehab: Video
This video was put together by Alberta Innovates and published in mid-March. It features interviews with ReJoyce inventors Dr. Jan Kowalczewski and Dr. Arthur Prochazka, as well as clinical trial investigators Dr. Mary Galea and Su Ling Chong. Ginny Bockman, a study participant, is also featured.
Here’s the transcript:
Dr. Prochazka - “As far as we know, this is the first large-scale study of in-home telerehabilitation in the world. I think this is the first study where we have learned how to interact with people in their homes, take them right through a training program of many weeks, measure the outcome, and then also, of course, develop the technology that allows all of this to happen.”
Dr. Kowalczewski - “I really hope it reaches as many people as it can. The reason why I’m saying this is because we’re seeing such positive results in our studies. I really hope that anyone that’s had a stroke or spinal cord injury can really benefit from this.”
Su-ling Chong - “In conventional therapy, you go to a place and you just do the functional tasks. We sneak the functions into the game, and patients enjoy it. Most of the time I have to tell the person that their hour is up because, usually, they just want to keep going.”
Dr. Galea - “A device like the ReJoyce is useful for people because it can be installed in their own home very simply, and people can use it in the comfort of their own home without needing to travel. The telerehabilitation enables the therapist to keep in touch with them, monitor their progress, and deal with any difficulties they might be having. That is a very important way to of continuing to enable people to continue improving without tying them to the hospital’s apron strings. It allows them to get on with their own lives.”
Mrs. Bockman - “When I woke up in the hospital, I couldn’t move my arms; I couldn’t move my hands and I thought, “how am I going to live my life?” When I started doing this [ReJoyce telerehabilitation], a lot more things started coming back to me. I’m able to hold my brush, with my hand, brush my own hair, brush my own teeth, feed myself. Senses have also gone back to playing with a Sony Playstation. I can kick my husband’s but on a lot of games, and I’m happy with that.”
March 18, 2010
Report: Stroke Rehabilitation Services In Canada Are Inadequate
Today, a report in the Canadian Medical Association Journal suggested that Canadian stroke rehabilitation services are inadequate. According to the article, Canada’s stroke rehabilitation programs suffer from:
“inadequate facilities, beds and staff to deliver services; inadequate treatment, including outpatient services, and inadequate funding.”
The article cites Christina O’Callaghan, executive director of the Ontario Stroke Network, who says that three out of every four people who have a stroke severe enough to require hospital admission fail to get sent to rehabilitation.
“It has created a situation in which stroke sufferers often have little option but to languish in long-term care facilities or nursing homes, says Dr. Mark Bayley, medical director of the neuro rehabilitation program at the Toronto Rehabilitation Institute in Ontario. “If some people with more severe strokes were provided with the adequate amount of rehabilitation, a certain number of them would be able to go home. This would save our health care system from having to utilize our very limited and expensive long-term care resources as much as we do currently.”
Read the full report here.
January 14, 2010
Update from Vancouver Trial
ReJoyce telerehabilitation is currently being used in several SCI (Spinal Cord Injury) treatment studies around the world. Here’s a great comment we received today from Vancouver:
“I had a particularly exciting training session with my participant yesterday. For the first time he was able to play Weedo at Level 60 successfully, using the Peg and NO STIMULATION!! Six weeks ago when we started, he was not able to play Weedo with much success at Level One. He and I are both thrilled.”"
Jennifer Loffree, UBC
November 6, 2009
ReJoyce Stroke and SCI Clinical Trials
In addition to several completed trials funded by the Canadian Institutes of Health Research and Spinal Research UK, as well as three multi-centre clinical trials underway funded by the SCI-Solutions Network, Canadian Spinal Cord Injury Telerehabilitation and the Victorian Neurotrauma Initiative (Australian ReJoyce SCI Trials), ReJoyce is now part of two more studies coordinated by researchers at the University of Alberta in Edmonton. The first study compares two levels of FES and ReJoyce-based rehabilitation on the recovery of hand function in chronic stroke survivors: FES and ReJoyce. The second study, also based in Edmonton, investigates the effect of a new type of FES implant in combination with ReJoyce-based therapy on people with SCI.
For more information, please contact us.
