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Percorrer por autor "Faria, Ana Lúcia"

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  • Benefits of virtual reality based cognitive rehabilitation through simulated activities of daily living: a randomized controlled trial with stroke patients
    Publication . Faria, Ana Lúcia; Andrade, Andreia; Soares, Luísa; Bermúdez i Badia, Sergi
    Background: Stroke is one of the most common causes of acquired disability, leaving numerous adults with cognitive and motor impairments, and affecting patients’ capability to live independently. There is substancial evidence on post-stroke cognitive rehabilitation benefits, but its implementation is generally limited by the use of paper-and-pencil methods, insufficient personalization, and suboptimal intensity. Virtual reality tools have shown potential for improving cognitive rehabilitation by supporting carefully personalized, ecologically valid tasks through accessible technologies. Notwithstanding important progress in VR-based cognitive rehabilitation systems, specially with Activities of Daily Living (ADL’s) simulations, there is still a need of more clinical trials for its validation. In this work we present a one-month randomized controlled trial with 18 stroke in and outpatients from two rehabilitation units: 9 performing a VR-based intervention and 9 performing conventional rehabilitation. Methods: The VR-based intervention involved a virtual simulation of a city – Reh@City - where memory, attention, visuo-spatial abilities and executive functions tasks are integrated in the performance of several daily routines. The intervention had levels of difficulty progression through a method of fading cues. There was a pre and postintervention assessment in both groups with the Addenbrooke Cognitive Examination (primary outcome) and the Trail Making Test A and B, Picture Arrangement from WAIS III and Stroke Impact Scale 3.0 (secondary outcomes). Results: A within groups analysis revealed significant improvements in global cognitive functioning, attention, memory, visuo-spatial abilities, executive functions, emotion and overall recovery in the VR group. The control group only improved in self-reported memory and social participation. A between groups analysis, showed significantly greater improvements in global cognitive functioning, attention and executive functions when comparing VR to conventional therapy. Conclusions: Our results suggest that cognitive rehabilitation through the Reh@City, an ecologically valid VR system for the training of ADL’s, has more impact than conventional methods. Trial registration: This trial was not registered because it is a small sample study that evaluates the clinical validity of a prototype virtual reality system.
    2016Artigo científico Acesso aberto Ver mais
  • Capturing expert knowledge for the personalization of cognitive rehabilitation: study combining computational modeling and a participatory design strategy
    Publication . Faria, Ana Lúcia; Pinho, Maria Salomé; Bermúdez i Badia, Sergi
    Background: Cognitive impairments after stroke are not always given sufficient attention despite the critical limitations they impose on activities of daily living (ADLs). Although there is substantial evidence on cognitive rehabilitation benefits, its implementation is limited because of time and human resource’s demands. Moreover, many cognitive rehabilitation interventions lack a robust theoretical framework in the selection of paper-and-pencil tasks by the clinicians. In this endeavor, it would be useful to have a tool that could generate standardized paper-and-pencil tasks, parameterized according to patients' needs. Objective: In this study, we aimed to present a framework for the creation of personalized cognitive rehabilitation tasks based on a participatory design strategy. Methods: We selected 11 paper-and-pencil tasks from standard clinical practice and parameterized them with multiple configurations. A total of 67 tasks were assessed according to their cognitive demands (attention, memory, language, and executive functions) and overall difficulty by 20 rehabilitation professionals. Results: After assessing the internal consistency of the data—that is, alpha values from .918 to .997—we identified the parameters that significantly affected cognitive functions and proposed specific models for each task. Through computational modeling, we operationalized the tasks into their intrinsic parameters and developed a Web tool that generates personalized paper-and-pencil tasks—the Task Generator (TG). Conclusions: Our framework proposes an objective and quantitative personalization strategy tailored to each patient in multiple cognitive domains (attention, memory, language, and executive functions) derived from expert knowledge and materialized in the TG app, a cognitive rehabilitation Web tool.
    2018Artigo científico Acesso aberto Ver mais
  • Comparing adaptive cognitive training in virtual reality and paper-pencil in a sample of stroke patients
    Publication . Faria, Ana Lúcia; Paulino, Teresa; Bermúdez i Badia, Sergi
    The growing number of people with cognitive deficits creates an urgent need for new cognitive training solutions. Paper-and-pencil tasks are still widely used for cognitive rehabilitation despite the proliferation of new computer-based methods, like VR-based simulations of ADL’s. The health professionals’ resistance in adopting new tools might be explained by the small number of validation trials. Studies have established construct validity of VR assessment tools with their paper-and-pencil versions by demonstrating significant associations with their traditional construct-driven measures. However, adaptive rehabilitation tools for intervention are mostly not equivalent to their counterpart paper-and-pencil versions, which makes it difficult to carry out comparative studies. Here we present a 12-session intervention study with 31 stroke survivors who underwent different rehabilitation protocols based on the same content and difficulty adaptation progression framework: 17 performed paper-and-pencil training with the Task Generator and 14 performed VR-based training with the Reh@City. Results have shown that both groups performed at the same level and there was not an effect of the training methodology in overall performance. However, the Reh@City enabled more intensive training, which may translate in more cognitive improvements.
    2019Documento de conferência Acesso aberto Ver mais
  • A comparison of two personalization and adaptive cognitive rehabilitation approaches: a randomized controlled trial with chronic stroke patients
    Publication . Faria, Ana Lúcia; Pinho, Maria Salomé; Bermúdez i Badia, Sergi
    Background: Paper-and-pencil tasks are still widely used for cognitive rehabilitation despite the proliferation of new computer-based methods, like VR-based simulations of ADL’s. Studies have established construct validity of VR assessment tools with their paper-and-pencil version by demonstrating significant associations with their traditional construct-driven measures. However, VR rehabilitation intervention tools are mostly developed to include mechanisms such as personalization and adaptation, elements that are disregarded in their paper-and-pencil counterparts, which is a strong limitation of comparison studies. Here we compare the clinical impact of a personalized and adapted paper-and-pencil training and a content equivalent and more ecologically valid VR-based ADL’s simulation. Methods: We have performed a trial with 36 stroke patients comparing Reh@City v2.0 (adaptive cognitive training through everyday tasks VR simulations) with Task Generator (TG: content equivalent and adaptive paper-and-pencil training). The intervention comprised 12 sessions, with a neuropsychological assessment pre, post-intervention and follow-up, having as primary outcomes: general cognitive functioning (assessed by the Montreal Cognitive Assessment - MoCA), attention, memory, executive functions and language specific domains. Results: A within-group analysis revealed that the Reh@City v2.0 improved general cognitive functioning, attention, visuospatial ability and executive functions. These improvements generalized to verbal memory, processing speed and self-perceived cognitive deficits specific assessments. TG only improved in orientation domain on the MoCA, and specific processing speed and verbal memory outcomes. However, at follow-up, processing speed and verbal memory improvements were maintained, and a new one was revealed in language. A between-groups analysis revealed Reh@City v2.0 superiority in general cognitive functioning, visuospatial ability, and executive functions on the MoCA. Conclusions: The Reh@City v2.0 intervention with higher ecological validity revealed higher effectiveness with improvements in different cognitive domains and self-perceived cognitive deficits in everyday life, and the TG intervention retained fewer cognitive gains for longer.
    2020Artigo científico Acesso aberto Ver mais
  • Customizing a cognitive stimulation program for individuals with dementia through a participatory design approach
    Publication . Spínola, Mónica; Câmara, Joana; Ferreira, Luis; Faria, Ana Lúcia; Bermúdez i Badia, Sergi
    Background: Different intervention strategies, such as reminiscence and music-based therapies, effectively mitigate the cognitive decline of individuals with dementia (IwD). An important challenge when implementing these approaches lies in the need for content customization. We de signed Musiquence platform, a framework that allows the customization of music and reminiscence content in cognitive stimulation activities. (2) Methods: Here, we present a participatory design methodology for designing a seven-week customized cognitive stimulation program (CCSP) for IwD using Musiquence. We ran focus groups with 19 formal caregivers, who provided information regarding themes and music to be used in activities for IwD, and gathered preferences from 20 IwD. (3) Results: The CCSP consists of seven cycles of tasks combining the activities available in Musiquence, the seven preferential themes of IwD, and the seven songs most frequently referenced by formal caregivers. (4) Conclusions: Finally, we provide a set of guidelines to implement a participatory design approach for content development together with IwD.
    2022Artigo científico Acesso aberto Ver mais
  • Development and evaluation of a web-based cognitive task generator for personalized cognitive training: a proof of concept study with stroke patients
    Publication . Faria, Ana Lúcia; Bermúdez i Badia, Sergi
    Cognitive impairments impose important limitations in the performance of activities of daily living. Although there is important evidence on cognitive rehabilitation benefits, its implementation is limited due to time and human resources demands. Moreover, many cognitive rehabilitation interventions lack a solid theoretical framework in the selection of paper-andpencil tasks by the clinicians. In this endeavor, it would be useful to have a tool that could generate standardized paper-and-pencil tasks, parameterized according to patients’ needs. In this paper, we combine the advantages of information and communication technologies with a participatory design approach with 20 health professionals to develop a novel cognitive rehabilitation web-tool: the NeuroRehabLab Task Generator (NTG). The NTG is a free and online available tool that systematically addresses multiple cognitive domains, and easily generates highly personalized paper-and-pencil training tasks. A field evaluation of the NTG with ten stroke patients showed moderate and strong correlations of patients’ task performance with their cognitive assessment in multiple cognitive domains. That is, corroborating its usefulness both as an assessment and as rehabilitation tool.
    2015Documento de conferência Acesso restrito Ver mais
  • Do papel-e-lápis à realidade virtual: uma nova abordagem para reabilitação cognitiva personalizada
    Publication . Faria, Ana Lúcia; Pinho, Maria Salomé; Bermúdez i Badia, Sergi
    2016Documento de conferência Acesso aberto Ver mais
  • Efficacy of adaptive cognitive training through desktop virtual reality and paper-and-pencil in the treatment of mental and behavioral disorders
    Publication . Câmara, Joana; Ferreira, Rute; Teixeira, Liliana; Nóbrega, Joana; Romeira, Carina; Bermúdez i Badia, Sergi; Faria, Ana Lúcia
    Cognitive defcits are a core feature of mental and behavioral disorders, leading to poor treatment adherence and functional ity. Virtual reality (VR) methodologies are promising solutions for cognitive interventions in psychiatry once they provide greater ecological validity. This study assessed and compared two content-equivalent cognitive training (CT) interventions, delivered in desktop VR (Reh@City v2.0) and paper-and-pencil (Task Generator (TG)) formats, in patients with mental and behavioral disorders. 30 patients were randomly assigned to the Reh@City v2.0 group and the TG group. Both groups of patients underwent a time-matched 24-sessions intervention. Neuropsychological assessments were performed at baseline, post-intervention, and follow-up. A within-groups analysis revealed signifcant improvements in visual memory and depres sive symptomatology after the Reh@City intervention. The TG group improved in processing speed, verbal memory, and quality of life (social relationships and environmental domains). Between groups, Reh@City led to a greater reduction in depressive symptomatology, whereas the TG group showed higher improvements in social relationships aspects of quality of life. At follow-up, previous gains were maintained and new improvements found in the Reh@City (global cognitive func tion, language, visuospatial and executive functions) and the TG groups (attention). The Reh@City signifcantly reduced depressive symptomatology, and the TG led to greater improvements in processing speed, abstraction, and social relationships domain of quality of life at follow-up. Both interventions were associated with important cognitive, emotional, and quality of life benefts, which were maintained after two months. Reh@City and TG should be considered as complementary CT methods for patients with mental and behavioral disorders. Trial registration The trial is registered at ClinicalTrials.gov, number NCT04291586.
    2021Artigo científico Acesso aberto Ver mais
  • Envelhecer na perspetiva psicológica e social: promoção da saúde, qualidade de vida e estimulação cognitiva no idoso
    Publication . Ramos, Carla; Gil, Katherine; Sousa, Marta; Fernandes, Patrícia; Teixeira, Rubina; Faria, Ana Lúcia
    Atualmente, o autocuidado, a prevenção na saúde e a melhoria da qualidade de vida de cada indivíduo, têm levantado várias questões no que diz respeito à saúde no envelhecimento, pois a esperança média de vida aumentou, e com isso surgiu a necessidade de melhorar os cuidados nesta faixa etária. Com o avanço da tecnologia e com o aumento da literacia digital junto das pessoas mais velhas, vão surgindo novos métodos para manter ou melhorar a saúde mental nesta população. Este trabalho pretende refletir sobre o idoso e a sua saúde mental, sendo que esta temática será abordada num contexto universal e, de forma sintetizada, também no contexto da Região Autónoma da Madeira. Iremos debruçar-nos sobre o envelhecimento, em contexto social, na promoção de saúde, qualidade de vida e alterações psicológicas e neurológicas no idoso, como por exemplo aquelas provocadas pelos quadros demenciais.
    2021Capítulo de livro Acesso aberto Ver mais
  • Envelhecimento na terceira idade
    Publication . Encarnação, Carla; Santos, Guadalupe; Gonzalez, Luzbeni; Barradas, Natacha; Sousa, Paulo; Faria, Ana Lúcia
    A população portuguesa é caracterizada pela sua maioria idosa, sendo esta uma realidade com tendência crescente nos próximos anos. Envelhecer é um processo natural e gradual do ser humano, caracterizado pela alteração no funcionamento do organismo, pela debilidade do sistema imunológico e maiores necessidades nutricionais. Estas transformações fisiológicas são frequentemente associadas ao aparecimento de doença. Na perspetiva de promover o envelhecimento ativo, este trabalho terá como alvo de estudo a alimentação e a sua influência no aparecimento e desenvolvimento de doença. Para tal, propomo-nos a contextualizar a saúde do idoso, as suas necessidades nutricionais com as doenças mais frequentas apresentadas pelo idoso, nomeadamente: as cardiovasculares, oncológicas, diabetes, neurodegenerativas, osteoporose e a desidratação. A incidência do estudo na alimentação tem como finalidade a consciencialização da sua prática como medida preventiva à doença, promovendo um envelhecimento ativo, qualidade de vida e o aumento da esperança média de vida.
    2021Capítulo de livro Acesso aberto Ver mais