Note: Each year, we partner with Dr. Amy Sheck’s students at the North Carolina School of Science and Math to profile some unsung heroes of the Duke research community. This is the first of 8 posts.
Dr. Kimberly Hreha’s journey to studying stroke patients was not a straightforward one, but it started very early.
“My mom was a special ed teacher, and so I would go into her class and volunteer. There was an occupational therapist I met and they really kind of drove my decision to become an occupational therapist.”
After earning a masters degree in occupational therapy, Hreha worked as an OT for 5 years and became fascinated by stroke survivors and ways to help them live their lives normally again. She was able to do this when she moved to the Kessler Institute for Rehabilitation and began working with a neurologist to study spatial neglect.
“If a stroke happens in the right hemisphere of the brain, the person neglects the left side of space,” Hreha said. “Imagine yourself standing in a room, and I want you to describe to me what the space is. [You would say] Oh my dresser’s on the right side, my bed’s on the right, my picture frame’s on the right. And you would not tell me anything on the left.”
She further explained that this is not due to blindness in the left eye, the left eye usually can see just fine, it’s simply that the brain ignores the entire left side of space.
Hreha co-developed a solution and treatment for this issue. It uses a pair of goggles with modified lenses, to move you into left space. I got to try it out to see how it worked.
Hreha first had me touch my hand to my chest and then touch a pen she was holding. I did this easily without the goggles on. When I tried again with the goggles on, I completely missed and put my finger too far to the right. I kept trying to touch the pen with the goggles on until I had retrained my brain to touch it consistently. Next, she had me take the goggles off and try touching the pen again. I went to touch the pen, but I missed it because my finger went too far to the left!
Hreha explained to me that she had just gotten me into left space. In stroke patients with left spatial neglect, she told me, they could use the goggles to help train them to stop neglecting left space, helping them to vastly improve their lives.
The goggle therapy, formally called prism adaptation, is a simple treatment that is practiced for 20 minutes a day for 10 days. For this Hreha won the Young Investigator Award in Post-Acute Stroke Rehabilitation in 2018 for her contribution to stroke research. Seeing her passion for her treatment and her happiness to have created something that helps stroke patients was very gratifying for me.
Hreha is also working on finding a connection between stroke patients and dementia, something that she hopes will further help the stroke survivor community. This is a research project that is ongoing for her, and one that she hopes to gain valuable data analysis and research practices skills from.
Finally, she talked to me about her goals for the future. Hreha hopes to do a collaborative study with people at the low-vision clinic, get a grant for her prism adaptation research, and create a right brain stroke clinic at Duke to be able to do large scale research to help right brain stroke patients.
As a researcher, she still also finds time to keep up her OT practice, by working as an OT one full day each month. Keeping true to her love of helping others, she said, “That little part of that clinical time just reminds me why I’m doing the research I’m doing. And that when I’m doing the data work, it is, at the end of the day, about that person who is in front of me in the clinic.”
Guest Post by Prithu Kolar, Class of 2025, North Carolina School of Science and Math.