Brain Recovery Zone (BRZ) is an immersive and engaging home recovery tool that is helping to plug the gaps in community rehab.
Consultant clinical neuropsychologist Dr Katherine Dawson co-founded the BRZ app with rehabilitation medicine consultant Dr Abayomi Salawu in 2019.
Colleagues in Speech and Language Therapy, Clinical Psychology and Occupational Therapy subsequently came on board.
The BRZ team discuss how the app is helping recovering stroke patients understand their condition and reconnect with the world around them.
What is the Brain Recovery Zone VR platform?
The Brain Recovery Zone is a virtual reality software application designed for use with head mounted virtual reality display units.
It is a purposely designed rehabilitation app for patients with acquired brain injury, targeting areas of education on brain injury, emotional regulation, fatigue, attention training and communication difficulties.
How does it work?
The BRZ app enables the patient to develop insight into their difficulties and utilise the engaging content to enhance their recovery.
It incorporates:
- Education modules: Videos explaining what has happened to the brain following injury (including brain injury and stroke) and outlining common difficulties
- Communication modules: Exercises and advice on how communication is affected following injury
- Fatigue management modules: Video explaining fatigue and how this affects brain functioning and the importance of pacing
- Emotional regulation module: A range of immersive experiences, designed to help the person calm and recharge. These include evidence based psychological strategies including controlled breathing, muscle relaxation, mindfulness and guided meditation.
The platform also offers graded attentional training in real life settings.
Environments with different levels of auditory and visual stimulation allow individuals to safely build tolerance to attentional difficulties which compound fatigue and confidence.
What equipment is needed?
- It is an all-in-one virtual reality headset
- No additional equipment needed
- Face inserts are easy to clean and hygienic
- Brain Recovery Zone platform software is loaded on and ready to use
Can you summarise the benefits of VR?
VR will enable individuals to engage in rehabilitation as early as possible with the aim of reducing impairment and related disability.
This will supplement the existing traditional modes of rehabilitation provision and enable the required dosage and intensity of rehabilitation to be delivered.
Crucially, rehabilitation through virtual reality (VR rehab) provides a readily available means to tackle the known barriers to rehabilitation. It can be used:
- To provide a good understanding of the nature of the injury, for both individuals and family, which assists with increasing insight and feelings of control.
- To enable patients to understand the reasons why they should proactively manage stress, anxiety, and fatigue.
- To provide a means of coping with cognitive changes, including attention, memory and executive functioning difficulties
- To manage communication difficulties.
- To provide real-time control and monitoring of the patient by the specialist.
- Remote adaptation of the exercises and interventions and for task difficulty to be readily adjusted to maintain motivation and engagement through the use of gamification and reward system
- Savings in travel costs and waiting time
- The high fidelity in VR systems allows for the creation of realistic environments that can mirror real life environments that patients will encounter. The virtual nature of VR implies that real risks are minimised or non-existent for patients.
What do you see as the greatest challenges facing stroke patients and their families?
There are over 13.7 million new strokes each year worldwide.
Due to advances in medical care and technology, more people are surviving acquired brain injuries. So, it is not surprising that public services are struggling and in some cases, no community rehab services are offered at all.
Individuals are managed extremely well in hospital. But following discharge, they and their families often face difficulties that impact upon their physical abilities, communication, thinking and memory, emotions and behaviour.
Their ability to live independently and connect with others in the world is significantly affected and a lot of their roles and routines alter.
You can argue that relationships, connections, routines and habits scaffold and contain us. We can see the impact on our mental health of having these taken away from us with COVID pandemic, and that’s without a brain injury.
Furthermore, some of the deficits after acquired brain injury are lifelong. Offering a means to manage them that does not require additional pharmacologic intervention is a desirable goal.
Dr Katherine Dawson
How can you help?
Rehabilitation works on the basis of learning. Mass repetition can aid learning but repeating rehabilitation strategies is often a challenge especially when mood is low and individuals are struggling with fatigue, or they have limited opportunities to practice skills.
We can provide access to standardised rehabilitation and remote therapy, delivered through telerehabilitation.
With the addition of VR and video gaming technologies, we as a team believe the scope for remote therapy delivery has widened significantly.
What are your priorities for the months and years ahead?
We have many!
As a team, we have a product road map but we feel really strongly that we want to work with our community to shape the next stages of development.
Initial feedback has indicated a role for more cognitive rehabilitation based immersive exercises. The great benefits of VR include being able to embed such exercises into more real life experiences.
We also have plans to build in a bespoke remote management and update system.
Finally, we are about to embark on a multi-centre trial and are still open for willing centres to join the project.
Dr Abayomi Salawu
Final thoughts?
Ultimately we see the BRZ app as developing into a rehabilitation platform with a suite of interventions for various conditions impacting on the brain.
Essentially, imagine you are about to embark on a marathon. One person trains and the other doesn’t.
The person who trains will do better. This is the power law of practice. So, we think the medium of VR has a great deal of potential.
Aspects of digital healthcare are inevitable and will allow us to ‘up’ the dosage of intervention and measure engagement.
As a team, we also think if we are clinically able to guide where tech can improve rehab, rather than having it ‘done to us’, that will also really help with patient experiences and outcomes.
BRZ team
For more information, please visit: brainrecoveryzone.com
Enquiries to: info@brainrecoveryzone.com
