Loading...
Publication
A comparison of two personalization and adaptive cognitive rehabilitation approaches: a randomized controlled trial with chronic stroke patients
| Name: | Description: | Size: | Format: | |
|---|---|---|---|---|
| 3.88 MB | Adobe PDF |
Advisor(s)
Abstract(s)
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.
Description
Keywords
Cognitive rehabilitation Virtual reality Stroke Ecological validity . Escola Superior de Saúde
Citation
Faria, A. L., Pinho, M. S., & i Badia, S. B. (2020). A comparison of two personalization and adaptive cognitive rehabilitation approaches: a randomized controlled trial with chronic stroke patients. Journal of neuroengineering and rehabilitation, 17(1), 1-15.
Publisher
BMC