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Characterizing the use of interactive technologies for cognitive rehabilitation in portuguese healthcare institutions

Publication . Paulino, Teresa; Cameirão, Mónica S.

The increasing predominance of cognitive deficits following neurological conditions such as dementia and stroke is a major concern in Portugal. Cognitive rehabilitation has been shown to be fundamental to alleviate some of the deficits, but it is not always customized to the specific profile of each patient. More critically, patients typically do not have rehabilitation while they are in the waiting list or after discharge. One way to address these limitations is using interactive technologies specifically designed for cognitive rehabilitation. Their digital nature allows the customization of parameters enabling personalization and adaptation to each patient’s profile, as well as the possibility of quantification of performance. In addition, these tools have the potential to be used at home, allowing patients to continue their rehabilitation and being monitored remotely, alleviating the burden of institutionalization for both patients and healthcare systems. However, before proposing novel technologies, it is imperative to understand current practices, needs, preferences and expectations of health professionals in this domain. For this purpose, we developed an online questionnaire that was distributed among health professionals in Portugal. 116 participants have responded, with 35% reporting having experience in the use of interactive technologies for cognitive rehabilitation. Our results show that health professionals that use these technologies mainly value ease of interaction, diversity of activities, task personalization to the patient’s cognitive profile, and adaptation based on performance. These and other insights will be used to inform the development of novel tools for cognitive rehabilitation in clinical and home settings.

2021Conference object

Open access

From design to evaluation: a human-centered approach to AI-powered remote cognitive training for stroke patients

Publication . Paulino, Teresa da Conceição Madureira; Cameirão, Mónica da Silva

Stroke is a leading cause of long-term disability worldwide, often resulting in cognitive impairments that significantly impact patients' quality of life and independence. This doctoral thesis presents the design, development of the client-side modules, and evaluation of the NeuroAIreh@b platform, a remote cognitive training system specifically tailored for stroke survivors. The focus of this thesis is dual. First, a focus on a comprehensive human-centered design approach was used to design the modular platform that addresses the specific needs of stroke patients and healthcare professionals. Second, the automation of cognitive training through the development of the software module Reh@Sync allows the training to be performed remotely with reduced need for therapist intervention. The system integrates a set of cognitive training apps that incorporate activities of daily living, enhancing ecological validity and potential skill transfer to real-life situations. One of the key innovations of the Reh@Sync is the implementation of personalization and difficulty adaptation features, which use cognitive profiles and machine learning models to tailor interventions to the individual patient's needs and abilities. Moreover, the engineered system can universally integrate independent apps beyond the cognition dimension, making it a multipurpose system for multidimensional training. The design process involved multiple stakeholders and employed various techniques, including requirements engineering, ideation sessions, prototyping, and iterative usability evaluations. The development phase resulted in a modular system capable of integrating multiple cognitive training apps while maintaining customizability for individual users. The results of a feasibility study with 10 chronic stroke survivors who used the system for 4 weeks showed high levels of adherence, usability, and user satisfaction, indicating the potential for widespread adoption in home based rehabilitation settings. Regarding clinical outcomes after the intervention, we observed significant improvements for a subgroup that showed baseline cognition below the norm. Evaluation of the automation process revealed that the system efficiently personalized and adapted the training to each participant's profile. This research contributes to the fields of cognitive rehabilitation, informatics engineering, and human-computer interaction by providing a detailed account of the design, engineering, and development process of an automated remote cognitive training system for stroke survivors. The findings support the feasibility of self-administered digital cognitive training and highlight areas for future improvements, including expanding the difficulty range to accommodate higher-functioning individuals and incorporating a wider variety of content to enhance engagement.

2025-01-16Doctoral thesis

Embargoed access

Knowledge-driven profile dynamics

Publication . Fermé, Eduardo; Garapa, Marco; Reis, Maurício D. L.; Almeida, Yuri; Paulino, Teresa; Mariana Rodrigues; Garapa, Marco; Aristides da Silva Godinho de Almeida, Yuri; Fermé, Eduardo; Reis, Maurício; Paulino, Teresa

In the last decades, user profiles have been used in several areas of information technology. In the literature, most research works, and systems focus on the creation of profiles (using Data Mining techniques based on user’s navigation or interaction history). In general, the dynamics of profiles are made by means of a systematic recreation of the profiles, without using the previous profiles. In this paper we propose to formalize the creation, representation, and dynamics of profiles from a Knowledge-Driven perspective. We introduce and axiomatically characterize four operators for changing profiles using a belief change inspired approach.

2024-06Journal article

Open access