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Daria Tsoupikova/EVL

A stroke patient interacts with a virtual reality environment using an electronic glove to "pour tea" during a therapy session. He can see his actions in 3-D via the special headset.

Innovative virtual reality technology revolutionizes stroke therapy

by Rian Ervin and Thomas Owen
March 01, 2012


Daria Tsoupikova/EVL

The Mad Hatter's Tea Party virtual environment is a creation for stroke therapy, using virtual animation software and 3-D models.


Produced by Rian Ervin/MEDILL. Data from the National Stroke Association. 

The majority of stroke victims experience moderate to severe impairments that require special care.

Thomas Owen/MEDILL

Make life 3-D. The Electronic Visualization Laboratory is bringing 3-D visualization to health, education and global applications. 

Rian Ervin/MEDILL

Avatars, virtual reality and the Death Star: A glimpse into the Electronic Visualization Laboratory.

Stroke patients can now rev up recovery as a guest at the Mad Hatter’s Tea Party with the March Hare as their therapist.

Playing 3-D games in a fantasy virtual reality environment such as Alice in Wonderland is a new avenue for rehabilitation and it sure beats monotonous sessions of moving objects from one box to another to repair motor skills.

“Virtual reality therapy is so popular right now because patients get bored,” said artist Daria Tsoupikova, an associate professor at the University of Illinois at Chicago’s School of Art and Design.

With virtual reality, patients get excited. “They can see something colorful, they can see some kind of environment, other characters, and have a story behind the therapy,” she said.

Advances in stroke therapy are rapidly evolving with virtual reality techniques. Tsoupikova, along with Derek Kamper, the principal investigator, Dr. Nikolay Stoykov, a biomedical engineer, Randy Vick, an art therapist, Yu Li, an art research assistant and a group of occupational therapists and engineers from the Hand Rehabilitation Laboratory at the Rehabilitation Institute of Chicago, collaborated to develop a virtual reality environment to assist stroke patients with hand rehabilitation.

RIC began with a project utilizing a specially calibrated glove that patients wear in conjunction with a virtual reality environment. In this virtual world, the patient is guided through a series of therapeutic hand movements.

Now, Tsoupikova is working with computer scientists at the UIC’s Electronic Visualization Laboratory and RIC physicians to further develop the glove technology.

Tsoupikova recently received a Fulbright Scholarship and spent four months at the Arts et Métiers Paris Tech in France where she worked testing software for an online home therapy system.

Tsoupikova’s virtual world has the Alice in Wonderland theme. The patient is a guest at the Mad Hatter's Tea Party and the host of the party, the March Hare, is the patient’s therapist.

The March Hare leads the patient through a variety of exercises interacting with animated objects in the virtual tea party scene. Patients use grasp-and-release techniques and finger movements.

The rehabilitation program Tsoupikova created is simple. The user logs in online with a user ID and password, sees themselves as a guest at the tea party, and their therapist as the March Hare. The therapist then shows the patient a series of exercises and asks them to repeat the movements.

“It is like a multi-user 3-D game with your goal being rehabilitation,” said Tsoupikova. “The therapist will be able to see if the patient is doing the movement correctly or incorrectly.”
Home systems would benefit patients who often have limited mobility after a stroke.

“The problem is,” Tsoupikova said, “most stroke patients not only have an impaired hand, but they have other problems too.” Many of them are in wheelchairs, and are unable to use public transportation to get to their therapy sessions.

Two-thirds of stroke survivors experience motor deficits, according to the American Stroke Association, and conventional rehabilitation can be a lengthy process. Now, new virtual reality therapies such as Tsoupikova’s are paving the way to a future of efficient rehabilitation.

“EVL offers many choices to create the 3-D environment,” said Li. Li has worked on the project for four years from the beginning concept of a virtual environment, to the start of pre-clinical trials.

To create the Mad Hatter scene, Li begins by generating 3-D models using Maya animation software. Next, Photoshop is used to texture the models. Animations are based on the movements of a volunteer actor to give the March Hare realistic gestures. Finally, the 3-D models and animations are exported to Virtools and user-friendly exercises are added.

The RIC team chose the Alice in Wonderland theme by asking a group of patients who had previously worked with virtual reality which theme they would like.

“At the same time, because the tea party is a magical place where anything can happen, virtual reality can take advantage of that,” she said. The tea party is a world where teacups and dishes flying through the air won’t be unrealistic to a patient. That allows for a lot of wild practice with movement to restore hand mobility.

In Chicago, Tsoupikova works with biomedical engineers, computer scientists, an electrical engineer and three occupational therapists. In France, however, Tsoupikova worked with specialists to develop functionality of the March Hare therapist.

“What I developed in France is a prototype,” Tsoupikova explained. “I tried different software and technology. I was trying to see what the advantages and disadvantages were.”

While Tsoupikova’s prototype is currently available at RIC for internal research working with patients, she is working with her RIC team on the proposal for a five-year research grant from the National Institute of Disability and Rehabilitation.

The grant will renew their current RIC project and include Tsoupikova’s prototype as an example of what the project is working towards in the future.
Ranked the “Best Rehabilitation Hospital in America” by U.S. News & World Report every year since 1991, RIC sees hundreds of stroke patients every year making it the ideal location to begin virtual reality rehabilitation research.

Virtual reality therapy for stroke victims has promising potential. It has been shown to help improve motor impairment, a 2011 study published by the American Stroke Association found.

The study examined previous studies specifically related to virtual reality therapy for stroke patients, and found that 11 out of 12 studies showed a significant benefit from rehabilitation with virtual reality.

With its quest to bring 3-D technology to the forefront of society, EVL is ideally equipped to use its development of computer visualization, collaborative software, and innovative research to improve health and wellness.

Wide-ranging and collaborative initiatives with Northwestern University, RIC, Argonne National Laboratory, the Adler Planetarium, NASA and Sharp Laboratories of America - to name just a few partners - place EVL as a leading pioneer in its field.

“I believe this is just the beginning,” said Nikolay Stoykov, a research scientist for the virtual reality rehabilitation project. “Remember, we thought that we had figured out the cell phone, and then the iPhone came along.”