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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.

2019Conference object

Open access

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.

2022Journal article

Open access

TREINO COGNITIVO NO PÓS-AVC: UM ESTUDO-PILOTO COM A PLATAFORMA NEUROAIREH@B

Publication . Câmara, Joana; Paulino, Teresa; Spínola, Mónica; Branco, Diogo; Cameirão, Mónica; Faria, Ana Lúcia; Ferreira, Luis; Moreira, André; Silva, Ana Rita; Vilar, Manuela; Simões, Mário; Bermúdez i Badia, Sergi; Fermé, Eduardo

O treino cognitivo (TC) através das novas tecnologias representa uma estratégia de intervenção promissora na mitigação dos défices cognitivos pós-AVC. Neste estudo-piloto, avaliamos o impacto a curto prazo de um novo sistema de TC com maior validade ecológica – a plataforma NeuroAIreh@b –, numa amostra de sobreviventes de AVC na fase crónica. Recrutámos dez sobreviventes de AVC que foram submetidos a uma avaliação neuropsicológica (ANP) pré intervenção. Posteriormente, iniciaram uma intervenção de TC implementada via tablet, com recurso à versão protótipo da plataforma NeuroAIreh@b, envolvendo oito sessões de 45 minutos. Nestas sessões, realizaram quatro tipos de tarefas de TC baseadas em atividades de vida diária (AVDs) (por ex., selecionar os ingredientes corretos para fazer uma receita, pagar as compras no supermercado). Foram efetuadas ANPs pós-intervenção para avaliar o impacto da intervenção a curto prazo. Uma análise intra-grupal com o teste de Wilcoxon revelou diferenças estatisticamente significativas no Montreal Cognitive Assessment (MoCA) e na pontuação total do Inventário de Avaliação Funcional de Adultos e Idosos (IAFAI). Globalmente, o TC através da plataforma NeuroAIreh@b parece ser benéfico na fase crónica do AVC, conduzindo a ganhos na cognição geral (MoCA) e na capacidade funcional (IAFAI). Estes resultados preliminares com a versão protótipo da plataforma NeuroAIreh@b são encorajadores e sugerem a generalização dos ganhos obtidos em contexto terapêutico para as AVDs.

2022Journal article

Open access

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.

2020Journal article

Open access