By EMILY SCHABACKER, The Billings Gazette

BILLINGS, Mont. (AP) — Dr. Jose Ortiz counted the minutes he spent in the back of an ambulance transporting him from Red Lodge to Billings. Prompt treatment is imperative to save life or quality of life during a stroke. And Ortiz had at least a 60-minute drive before he was admitted to the hospital.

His medical school training and more than 20 years practicing family medicine may have given him early recognition of stroke symptoms, but when he arrived at the Billings Clinic, his entire left side was flaccid. Ortiz eventually began therapy at the Rehabilitation Hospital of Montana (RHOM) in Billings.

Now, about three months later, the only visible marker of the event is a slight droop in her smile on the left side.

Each RHOM patient must follow three hours of demanding therapy a day. To spice up grueling rehearsals, RHOM has partnered with tech companies Penumbra and BIONIK Labs to bring virtual reality (VR) and artificial intelligence (AI) to patient care, reports The Billings Gazette.

RHOM is now the first and only facility in Montana to use this technology.

“(Rehab) is probably the last frontier in medical robotics,” said Loren Wass, Chief Commercial Officer of BIONIK Labs.

BIONIK Labs produces the InMotion ARM which uses robotics, AI and machine learning (ML) to help patients work on upper limb rehabilitation when suffering from a neurological disorder such as a stroke cerebral, Wass said.

The patient is seated in front of a monitor and their forearm is attached to the device. Guided by on-screen games, the patient grabs a handle and moves their arm back and forth, challenging them to perform more reps.

AI and ML allow the device to collect data and adapt to the needs of the patient. The machine produces progress reports, makes treatment recommendations, and can track protocol-based treatments.

In a conventional therapy session, the patient performs approximately 30-60 movements in an hour, while BIONIK’s InMotion ARM devices perform 600-1000 movements in the same amount of time.

While the BIONIK Labs device isn’t something you might see in your living room, virtual reality tools are. The REAL y-Series is a comprehensive VR rehabilitation tool that helps distract the patient from any discouraging or limiting thoughts or feelings, said Jen Graves, CEO of RHOM.

Similar to an Oculus, the REAL y-Series headset fits over the eyes to immerse the user in a whole new environment.

Straps with sensors are then attached to the hands, upper arms, and shoulders and back to generate a body in the VR world that is similar to that of the patient.

Immersed in a carnival-themed game of pinball, patients reach out to hit the balls heading their way. The game tests the shoulders range of motion including flexion and extension, responsive movement, trunk control, motor skills and tests their vision while engaging in a high stimulation environment that distracts from the pain or physical fatigue.

In another environment, the patient finds himself behind a deli counter. On one side they see a sandwich order and on the other all the ingredients to build the sandwich. The game focuses on sequencing and memory work, object recognition, range of motion, and shoulder and neck coordination.

Penumbra Occupational Therapist Jessica Hauert is trained to select activities specific to the patient’s needs and monitors the patient’s progress from a handheld tablet.

Hauert finds that many older patients know about things like tablets and virtual reality through their families, and are eager to try them in therapy.

“Patients often work harder because when they’re transported to another world…they forget that they’re really working hard. They go further and work a lot harder because they’re having fun,” said Jennifer Wong, vice president of market development for Immersive Healthcare at Penumbra.

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