Case Study: Clinical Application of v-health Mobile in Acute Stroke Rehabilitation
North Bristol NHS Trust evaluated v-health Mobile, our smart Functional Electrical Stimulation (FES) technology, in an acute hospital setting, focusing on upper limb rehabilitation for a patient with dense hemiplegia. The study demonstrates the clinical feasibility of the technology, highlights the benefits of customisable interventions and explores how it can be used in early recovery to encourage better movement, reduce pain, and make therapy sessions more engaging.
Patient Profile
The patient was a 52-year-old woman, just two weeks after experiencing a stroke caused by a bleed in the brain (intracerebral haemorrhage). As a result, she presented with:
No ability to move her left arm or leg.
Weak feeling and reduced sensation, especially in her fingers.
A loosened shoulder joint (shoulder subluxation), making movement even harder.
Some stiffness in her hand joints caused by swelling.
Applications
The v-health Mobile was used across three consecutive one-hour sessions:
1. Shoulder Pain Management
FES was applied to the shoulder muscles (supraspinatus and deltoid) using dual-channel stimulation to support joint stability without inducing isometric movement*. Initial sessions lasted 15 minutes, gradually increasing to 60 minutes, with no reported discomfort. The intervention followed NICE guidelines for the conservative management of shoulder subluxation and pain.
*Isometric movement is when a muscle tenses up but doesn’t change length. No visible movement happens at the joint. In the context of this study, they stimulated the muscles enough to create a visible muscle contraction, but didn’t force the shoulder joint to move or strain.
2. Sensorimotor Rehabilitation (Arm and Hand Rehabilitation)
FES was applied to the muscles (wrist/finger extensors and finger flexors) using dual-channel stimulation to assist her reaching and grasping tasks involving functional objects like a cup and a brush.
The Custom Sequence feature was used to activate wrist and finger extensors for reach, followed by finger flexors for grasp. This helped replicate more natural motor patterns during functional activities. The ramp time, stimulation duration, and activation sequence were easily configured to match the task requirements.
3. Range of Movement and Gamified Therapy
The Presets feature was used to alternate wrist and finger flexion/extension exercises, achieving effective muscle contractions. The patient reported no pain or discomfort and tolerated the sessions well.
The patient engaged in a gamified activity, Raccoon Rush, which encouraged alternating activation of wrist and finger muscles during gameplay. She found the exercise more enjoyable and motivating in this gamified format. Stimulation was well tolerated, with no adverse effects. Muscle fatigue was noted over time, an expected response during active engagement.
Key Findings
This case study demonstrates the ability of the v-health Mobile to deliver Functional Electrical Stimulation across a range of clinical applications for a patient with dense, low-tone upper limb hemiplegia.
Improved Functional Movement & Texture Recognition → Effective and tolerable muscle contractions. The patient was able to activate her muscles safely and comfortably. The patient tolerated the intervention well, with no reports of discomfort during or after the sessions.
Enhanced Functional Engagement through Gamification → The Raccoon Rush gamified exercise kept the patient engaged and motivated to participate more actively in therapy.
High Degree of Customisation → Therapists reported positively on the device's ability to tailor stimulation patterns closely to replicate natural movement during tasks like reach and grasp. The adaptability of stimulation modes allowed precise adjustments to meet individual patient needs.
Ease of Use and Setup → The wireless design and mobile app interface were highlighted as key features supporting easy setup and use in a clinical environment. Family members were also able to assist with device use under therapist supervision.
Patient & Therapist Feedback
Future Potential
With the addition of data saving and timer functionalities, v-health Mobile shows strong potential for independent or caregiver-supported use in managing shoulder pain, promoting range of motion, and facilitating strengthening activities across acute and long-term rehabilitation pathways.
