Robot pets
We have robot pet dogs and cats, and even a monkey and a horse. They respond to touch/voice commands, carry out movements and vocalise. They are primarily used to promote engagement by the patient, encourage pleasant feelings which helps set them in a good mood to participate in therapy, promote positive bonds with staff, and as a source of distraction should the patient start engaging in disruptive behaviours. For selected patients who have favourite smells, we can spray specific odours on the pets, so that all of the sensory modalities are engaged for a pleasant experience.

Voice-activated intelligent agents
We’re using Google Assistant with a patient who had quadriplegia following a gunshot injury. It enables him to control his television and lights, retrieve his schedule for the day, play his favourite music and sports clips, and make both voice and video calls to family and friends. Measures of wellbeing, behaviour and mood are monitored to see if they change as a result of this intervention.

Exergames
We’ve built up an exergame resource using the Nintendo Wii. This includes both hardware and a range of software games. In collaboration with colleagues in physiotherapy and speech and language therapy, and a er carefully documenting the past habits and leisure activities of a patient, games are selected to help promote engagement in these therapies, and generally give the patient a sense of both enjoyment and achievement.

Neuro-rehab apps
We’re using neuro-rehab apps to help with the needs of specific patients. Thus, we are using a scanning app, Visual Attention produced by Tactus Therapy, to help improve scanning in patients who show visual neglect following a condition such as stroke.

Intelligent clock displays
We are trialling clock displays which, in addition to day, date & time, have reminder features to help patients remember items such as scheduled activities, and via wifi can also be linked remotely to family and friends so that messages or pictures can be sent directly to the patient. We are also trialling a clock display which gives audio output of display information to touch, so as to benefit the visually impaired who may not be able to read the clock display.

Virtual reality apps
We have a Google Cardboard-based virtual reality app, WayBack, which features a video from the coronation in 1952, and which enables the patient to immerse themselves in scenes from the video. We will be introducing other VR apps, including geography-based ones. As with the aforementioned robot pets intervention, their primary purpose is to encourage pleasant feelings which help to set the patient in a goodmood, as a form of reminiscence therapy, and as a source of distraction should the patient start engaging in disruptive behaviours.

Odours, music, images and light for relaxation classes
Relaxation classes have generally been unimodal, with either verbal instructions or music. We are trying to use multiple modalities, ideally in synchrony, to enhance feelings of wellbeing in relaxation classes.

Using the latest technologies, we configure the setting where relaxation classes take place, so that selected room lighting can be generated, relaxing music or sounds are played, a pleasant odour is released and relaxing images such as sunset on a beach are displayed.

Regular feedback from patients, families and sta is obtained during implementation of all the interventions mentioned. And, as far as possible, practical outcome measures are included to evaluate the effectiveness of the interventions. The 21st Century has given us new technologies which can potentially broaden the independence and wellbeing horizons of neurological patients. As healthcare professionals, we need to respond to the challenges associated with their implementation, and this requires both commitment and creativity.

This article was co-written by Elysium’s Narinder Kapur, Callum Watson, Heena Parmar and Amy Watts.