Development and clinical validation of an adaptive cognitive training virtual tool for stroke patients

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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.

2021Journal article

Open access

Feasibility, Acceptability, and Preliminary Impact of Full-Body Interaction on Computerized Cognitive Training Based on Instrumental Activities of Daily Living: A Pilot Randomized Controlled Trial with Chronic Psychiatric Inpatients

Publication . Câmara, Joana; Ferreira, Luis; Faria, Ana Lúcia; Vilar, Manuela; Bermúdez i Badia, Sergi

Objective: To conduct a pilot randomized control trial to assess the feasibility and acceptability of full-body interaction cognitive training (FBI-CT) inspired by instrumental activities of daily living in chronic psychiatric inpatients and to explore its preliminary impact on cognitive and noncognitive outcomes. Materials and Methods: Twenty psychiatric inpatients met the inclusion criteria and were randomly allocated to the FBI-CT group (n = 10) or the tablet-based CT group (T-CT) (n = 10). Neuropsychological assessments were performed at baseline, postintervention, and 3-month follow-up. Results: Both groups presented high completion rates at postintervention and follow-up. Participants reported high satisfaction following the interventions, with the FBI-CT group exhibiting slightly higher satisfaction. A within-group analysis showed significant improvements in the FBI-CT group for processing speed and sustained attention for short periods (P = 0.012), verbal memory (P = 0.008), semantic fluency (P = 0.027), depressive symptoms (P = 0.008), and quality of life (P = 0.008) at postintervention. At 3-month follow-up, this group maintained verbal memory improvements (P = 0.047) and depressive symptoms amelioration (P = 0.026). The T-CT group revealed significant improvements in sustained attention for long periods (P = 0.020), verbal memory (P = 0.014), and executive functions (P = 0.047) postintervention. A between-group analysis demon strated that the FBI-CT group exhibited greater improvements in depressive symptoms (P = 0.042). Conclusions: Overall, we found support for the feasibility and acceptability of both training approaches. Our findings show promise regarding the preliminary impact of the FBI-CT intervention, but due to study limitations such as the small sample size, we cannot conclude that FBI-CT is a more effective approach than T-CT for enhancing cognitive and noncognitive outcomes of chronic psychiatric inpatients. Clinical trials (number: NCT05100849).

2022Journal article

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