Opinion: Stroke is the largest cause of adult disability in Ireland, but the use of robotics, VR, brain stimulation, and apps have great potential in helping people make a better recovery from stroke.

Every year in Ireland 10,000 stroke a year occur, which is more than one per hour. It is the third largest cause of death with more people dying from stroke than breast cancer, prostate cancer and bowel cancer combined

Although the number of people dying from stroke is decreasing, stroke is the largest cause of adult disability resulting in approximately 65,000 individuals living with the effects of stroke. That's more than what you would fit in the Aviva stadium.

A stroke is cause by a distribution in blood flow to the brain, which can be caused by either a clot (ischemic stroke) or a brain bleed when a blood vessel bursts (haemorrhagic). 

Both of these prevent blood from reaching all aspects of the brain, this starves our brains of essential oxygen which results in our brain cells-neurons dying; the average stroke kills two million brain cells every minute.

The more neuron death, the more severe the effects of stroke can be. The exact symptoms and severity of the stroke will depend on what area of the brain is affected - the location, the size of the stroke and the speed of treatment.

On Radio 1's Morning Ireland, Paul Keogan, Irish Paralympian and stroke survivor, and Chris Macey, Head of Advocacy with the Irish Heart Foundation, discuss the challenges facing younger stroke survivors in Ireland.

Stroke can have a wide range of effects on our lives with movement problems such as paralysis of one side of the body, weakness of one or more of the muscles in your arms or shoulders, and impaired walking. Communication can be affected, making it particularly difficult to talk or swallow.

There is also more hidden impairments of stroke including issues with memory or thinking, changes in emotion including increased levels of depression and anxiety and extreme fatigue all common occurrences.

New technology is helping us both understand the brain recovery after stroke and also to develop and improve stroke rehabilitation.

Even until recently the brain's mechanisms and how it reorganised itself after injury or stroke was still a mystery, yet new techniques are enhancing our understanding which can ultimately help improve recovery.

Read: How to prevent strokes

Neuroimaging such as MRI allows us to explore areas of the brain that are damaged and the functional specialisms of particular areas of the brain. It obviously provides an important role in diagnosing stroke in hospitals but is also being used in research to explore the link between different areas of the brain and their functions.

Non-invasive brain stimulation is a collection of techniques being used in research and beginning to be translated into clinical use, that uses electrical or magnetic situation to examine the pathways between brain and muscles.

These have been used to predict recovery after stroke, to increase activity in the brain pathways leading to improved movement and to allow researchers insight into brain reorganisation. By understanding more about the complex nature of brain recovery, it helps researchers use this information to develop and improve stroke rehabilitation techniques.

Stroke Rehabilitation

Each stroke and recovery is unique, with variations in the types and range of effects resulting from the damage done by a stroke and in the journey of recovery.

Rehabilitation can help improve peoples function and day to day activities following a stroke. This is done through a variety of different specialisms (such as physiotherapists, speech and language therapists) that generally uses high-intensity practice to help restore lost skills.

Technology is now being applied to help enhance rehabilitation techniques to help individuals post stroke.

One of the biggest issues in stroke movement rehabilitation is stroke patients getting enough time to intensively practice a movement; some animal studies suggest a movement needs to be practised thousands of times to help regain the function.

In the current rehabilitation environment, this is problematic due to resources, time, and finances, but technology has tried to address this.

On Radio 1's The Ray D'Arcy Show, Máirín Ní Bheacháin life changed in her late thirties after a stroke that left her unable to read or write. But she recovered and decided to take a new path in life, leaving her job as a teacher to become a personal stylist.

One is virtual reality (VR) stroke rehabilitation where participants interact with a virtual environment via a screen or immersive glasses. This allows stroke patients to practice movements and skills in a virtual environment that can be done at home or in a hospital setting.

These environments may provide a more engaging, interesting way of practicing tasks. Research has suggested that VR encourages stroke patients to do more practice and can allow the simulation of tasks in a safe environment (i.e. VR kitchen environment).

In recent years, there has been an explosion in the number of robotic devices for use following a stroke.  Robotic devices can be used to supplement physical activity in patients that cannot generate enough movement themselves, such as body suits allowing walking or supportive arm equipment to support reaching.

These devices are varied in their design but reviews suggest that the advantage of robotic devices may be an increase in repetitions, providing mechanical assistance to those more severely affected, giving them an increase in motivation to train and opportunities for independent movement.

There is also a range of mobile apps being developed to enable stroke patients access to a range of exercises to practice at home, communication apps to help people with language impairments after stroke as well, and apps aimed to target emotional and thinking problems following a stroke.

In our day-to-day lives, we are surrounded by technology that can help all of us, including stroke survivors monitor their health such as Fitbit and other physical activity monitors via watches and phone apps.

This allows us a better understanding of a person's general health such as amount of daily activity, heart rate and sleep, all vital components of preventing a stroke and managing life after one.

The number of individuals surviving stroke is increasing, resulting a large number of people living with the consequences of the disability. Technology has touched upon every aspect of our day-to-day lives so it understandable that we turn to it to aid stroke recovery.

There is a number of initiative ways that technology that started in the gaming world has been developed to enhance the style and amount of rehabilitation stroke patients can do.

The evidence base for the use of robotics, VR, brain stimulation, and apps continues to grow and has great potential in helping people make a better recovery from stroke.


The views expressed here are those of the author and do not represent or reflect the views of RTÉ.