“Sat on elephant. Swam on turtle. Dancing in Tardis.”
While this may sound like something from a particularly crazy dream, for stroke survivors, this is a reality – or rather virtual reality – which is delivering measurable benefits to their recovery.
Through accessing EVA Park, the world’s first multi-user online world, people with aphasia across the globe are being given unique opportunities to re-learn and practice their speech, while also developing social connections and confidence.
So while social interactions and venturing out to the shops may seem a daunting prospect in everyday life, in EVA Park, users can enjoy a carefree trip to the hairdresser, bar or disco, or even go dancing in the Tardis, should they wish.
And by being enabled to do so in the safety of a virtual environment, evidence is showing that this progress with speech is, for many users, being replicated in the real world.
“That’s the holy grail, for people to practice the contexts and develop their skills and then introduce them into real life,” says Professor Jane Marshall, who has led the research from the beginning of the project in 2012.
“So if you want to go to a cafe, you can practice in EVA Park and then translate that into a real life environment.”
And the statistics are showing that to be the case, with studies revealing many people with aphasia see an improvement in functional communication after using EVA Park, which has been pioneered by City, University of London.
Through the creation of avatars, which then live out whatever adventures they wish in EVA Park, interacting with fellow avatars along the way, improvements are being seen in areas of speech including story telling skills and word retrieval.
“We’ve had a very positive response but I think a big part of it is because it’s a huge laugh, it’s very sunny and joyful, as well as being slightly bonkers,” says Professor Marshall, whose background is in speech and language therapy.
“While it’s a simulation of a real world environment, you can also get the opportunity to do crazy things, such as our participant who sat on the elephant, swam on the turtle and danced in the Tardis.
“Your avatar can be whoever you want to be. You can go wild. We have some rather matronly ladies in their 60s whose avatars have mohican haircuts, and why not?
“But I think the impact of that can be very powerful – one man told us it was like being on holiday, there is the same kind of escapism through being in EVA Park from experiencing aphasia in everyday life.
“Another, who had paralysis down one side of his body after his stroke, told us that he loved how this wasn’t who he was in EVA Park and his avatar could walk, fly and roller skate.”
The development of EVA Park came from the recognition that an online-based activity may bring people together in ways that would not always happen in real life – an approach typified by the restrictions caused by the COVID-19 pandemic.
“If you’re going to groups and have to travel some distance, that can be costly, and it can sometimes be difficult for therapists to get to patients if people live in remote areas of the world,” says Professor Marshall.
“In Australia, for example, we have people using EVA Park who live very remotely, so probably wouldn’t travel to use it, but because they can do it at home on their screen – it’s not an immersive experience, so they don’t even need a headset – it’s very accessible.
“Through operating in a virtual world, there are no restrictions, so it’s also a world away from the pandemic. And while many people have turned to technology over the past year, we have always recognised its benefits in therapy and that is why we created EVA Park.”
Since the development of EVA Park in 2012, the use of technology in therapy has become more widely recognised and used, which, says Professor Marshall, will continue to deliver benefits.
“I think technology in its widest sense has a huge contribution to make for people who have had a stroke,” she says.
“There are many mainstream technologies in use now, such as word prediction technology, which can help enormously. Therapists are using apps and technology much more than ever before, and that’s an important strand.
“And there are great benefits in delivering therapy sessions remotely through using Zoom, Skype or Teams, which are really being seen at the moment. So technology has a huge role to play.
“I think EVA Park occupies a place in that spectrum, but probably at the smaller end of the scale, and we inject a bit of fun in there too.”
While the platform has users from as far afield as the United States, Australia and the Bahamas and has been hailed for the quality of its creation and outcomes, Professor Marshall says the goal is improving the lives of its users rather than global expansion.
“We are international, but we are small. We’re university researchers rather than Apple and just don’t have the infrastructure to make the software available to a huge global user community,” she says.
“However, we are very happy with what we are doing and the groups we are working with, and our ambitions are in delivering improvements for them with their aphasia. If we are doing that, then we are very happy.”
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