Pre-action games & exercises via tele-rehabilitation: A prototype for supplemental stroke therapy

Abstract

We describe Pre-Action Games & Exercises (PAGEs) a prototype for supplemental tele-rehabilitation. PAGEs are therapist-guided exercises for chronically impaired stroke survivors: basically a computer-based platform of brain exercises based on control of virtual limbs. Survivors control virtual limbs, simultaneously actuating wearable, motorized orthoses which physically manipulate impaired limbs. Physical manipulations mirror survivor controlled virtual limb movements. PAGEs are designed to assist physical and occupational therapists to treat increased numbers of stroke survivors (estimated, in the US, Canada, Mexico and Europe to be 18 million individuals). Key elements of PAGEs tele-rehabilitation are outlined. Tele-rehabilitation is suggested as a modality for therapist-supervised, survivor-selfadministered and repetitive brain-to-body exercises either in clinics and/or at home or anywhere at any time.Thus, the genetically determined pace of reduction of the primary venous plexuses determines the final shape of the dural venous system and its compensatory abilities. *Correspondence to: James Merrill, NeuroJungle, LLC 434 Lacy Woods Tallahassee, FL 32312, USA, Tel: 978-764-4295; E-mail: james@neurojungle.com Received: October 28, 2019; Accepted: November 13, 2019; Published: November 18, 2019 Introduction PAGES are designed to be a supplemental tool for therapists. Advances in pre-hospital, specialized mobile unit medical diagnosis and treatment, i.e. onboard first responder interventions, result in more stroke cases treated sooner and with positive results. For example, in cases of ischemic stroke, onboard administration of tPA (Tissue-Type Plasminogen Activator) is, in some cases, practiced as pre-hospital thrombolytic therapy.1 It is saving lives and improving outcomes. A new, May 2018, US Food and Drug Administration approved technology enables onboard diagnosis of severe strokes. It may be used by mobile unit paramedics.2 The technology combines transcranial ultrasound with an artificial intelligence (AI) component. AI algorithms compare on-board patient findings with thousands of stored images of severe stroke survivors to help diagnose the current survivor’s condition: therefore a pre-hospital early alert to neurosurgeons. In addition, inhospital endovascular surgical advances3 to ‘coil-out’ blood clots and other medical and surgical advances have increased survival rates and work-loads carried by physical and occupational therapists.