New Therapy for Ischemic Right-Hemisphere Stroke
Exploratory Trial Completed!

Visual Stroke Therapy (VST) is a clinical intervention designed to improve recovery outcomes in right-hemisphere ischemic stroke patients.  Cognitive dysfunction among this population includes diminished attention span (issues with storing and recalling recent information), impaired visuospatial abilities, difficulty performing tasks in order (sequencing), and difficulties in numeracy/calculating skills.  Based on exploratory clinical trials, it appears the new Visual Stroke therapy is beneficial to right-brain ischemic stroke patients.  The exploratory trial with eight treatment-group patients demonstrated the therapy was effective in improving short-term memory, visuospatial processing, and sequencing.  Patient comments regarding their VST experience and positive outcomes are presented in the video below.

 As the right hemisphere is primarily responsible for visual imagery and spatial abilities, the therapy provides focused cognitive stimulation using illustrative representations with a concentration on images denoting numeric values.  Numeric representations are presented in the form of abacus configurations.  A 2016 scientific paper in Neuroscience stated this type of exercise, “has the potential to promote working memory capabilities, which is associated with the functional plasticity of the common neural substrates.”

The new therapy includes five components. One component requires patients to use hand signals that both assist right-brain function and provide the therapist a window into the patients’ mental processing. 

The program components are delivered in a deliberate sequence whose order provides a framework that enables the patient to progressively boost function. The clinical effects begin with improved visuospatial processing followed by advancements in short-term memory and sequencing skills.

The Visual Stroke Therapy intervention was developed by Robert Singer, who in 2020 enhanced the program based on the clinical trial outcomes data and restructured the delivery design so that the therapy meets the requirements for reimbursement from third-party payers.  Singer is inventor of record on three biomedical patents: 5,252,102 Electronic Range of Motion Apparatus for Orthosis, Prosthesis, and CPM Machine; and 5,484,394 and 5,219,323 A Method and Apparatus for Rotating a Wrist.  Clinical trials are conducted in partnership with 501(c)3 research nonprofit Responsible Education and Development (READ).

Presently, Singer is working to make the therapy deliverable on a tablet computer.  Delivery via computer will simplify delivery by a medical professional and will make generating session clinical reports for the patients’ files as easy as tapping on a screen.

Rationale for Development and Testing of VST

READ’s exploratory study results coupled with the findings from research conducted in Asia provide justification for an expanded multi-site U.S. study.  Below are some of the citations that support expanded testing of Visual Stroke Therapy.

The Impact of Abacus Training on Working Memory and Underlying Neural Correlates in Young Adults, Shanshan Dong, Chunjie Wang, Yuzheng Hu et al., Neuroscience, 332 2016 181-190, reports abacus-based mental calculations were shown to improve verbal and visuospatial working memory after a twenty-day training regimen. Researchers found abacus training improved calculating skills and has the potential to promote working memory capabilities, which is associated with the functional plasticity of the common neural substrates…Abacus Mental Calculation seems to affect Working Memory in general, and thus it might have the potential to serve as a practical approach to promote individuals’ Working Memory capabilities, as well as an intermediate intervention for those suffering from impaired Working Memory.”

The Metering Experiment Report of Brain, a study conducted at Tohoku University in Japan concluded, “Students who had never used abacus showed activation to only the right hemisphere of the brain.” Mental calculations such as these have also been postulated to improve cognitive functions such as visuospatial skills, working memory, and executive function, as well as episodic and semantic memory.

The Stanford University/University of California, San Diego study, Representing Exact Number Visually Using Mental Abacus, Journal of Experimental Psychology 141(1) 134-149, states “Our study suggests that the soroban abacus is optimally designed to take advantage of grouping cues that permit rapid encoding of objects in visual working memory.”

Professor Toshio Hayashi at Osaka Prefecture University emphasizes that the training of finger movements encourages synapses to be entwined with each other and constructs neuron networks. “Mental calculation can be classified into two groups. One is the abacus method that uses the right brain. The other method is traditional mathematical calculation that uses the left brain.

According to Tohoku University in Japan, with an abacus you convert numbers into the image of beads and use the thumb and the index finger to place them on the actual abacus. This process requires the interaction between the right and left brain and therefore helps stimulate the whole brain. Even for adults, mental calculation using the images of abacus beads stimulates the right brain and becomes a very effective lifelong tool.

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