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Sample records for computer-assisted cognitive rehabilitation

  1. Prerequisites for Computer-Aided Cognitive Rehabilitation.

    Science.gov (United States)

    Legrand, Colette

    1989-01-01

    This paper describes computer-aided cognitive rehabilitation for mentally deficient persons. It lists motor, cognitive, emotional, and educational prerequisites to such rehabilitation and states advantages and disadvantages in using the prerequisites. (JDD)

  2. Computer Assisted REhabilitation (CARE) Lab: A novel approach towards Pediatric Rehabilitation 2.0.

    Science.gov (United States)

    Olivieri, Ivana; Meriggi, Paolo; Fedeli, Cristina; Brazzoli, Elena; Castagna, Anna; Roidi, Marina Luisa Rodocanachi; Angelini, Lucia

    2018-01-01

    Pediatric Rehabilitation therapists have always worked using a variety of off-the-shelf or custom-made objects and devices, more recently including computer based systems. These Information and Communication Technology (ICT) solutions vary widely in complexity, from easy-to-use interactive videogame consoles originally intended for entertainment purposes to sophisticated systems specifically developed for rehabilitation.This paper describes the principles underlying an innovative "Pediatric Rehabilitation 2.0" approach, based on the combination of suitable ICT solutions and traditional rehabilitation, which has been progressively refined while building up and using a computer-assisted rehabilitation laboratory. These principles are thus summarized in the acronym EPIQ, to account for the terms Ecological, Personalized, Interactive and Quantitative. The paper also presents the laboratory, which has been designed to meet the children's rehabilitation needs and to empower therapists in their work. The laboratory is equipped with commercial hardware and specially developed software called VITAMIN: a virtual reality platform for motor and cognitive rehabilitation.

  3. Computer-Vision-Assisted Palm Rehabilitation With Supervised Learning.

    Science.gov (United States)

    Vamsikrishna, K M; Dogra, Debi Prosad; Desarkar, Maunendra Sankar

    2016-05-01

    Physical rehabilitation supported by the computer-assisted-interface is gaining popularity among health-care fraternity. In this paper, we have proposed a computer-vision-assisted contactless methodology to facilitate palm and finger rehabilitation. Leap motion controller has been interfaced with a computing device to record parameters describing 3-D movements of the palm of a user undergoing rehabilitation. We have proposed an interface using Unity3D development platform. Our interface is capable of analyzing intermediate steps of rehabilitation without the help of an expert, and it can provide online feedback to the user. Isolated gestures are classified using linear discriminant analysis (DA) and support vector machines (SVM). Finally, a set of discrete hidden Markov models (HMM) have been used to classify gesture sequence performed during rehabilitation. Experimental validation using a large number of samples collected from healthy volunteers reveals that DA and SVM perform similarly while applied on isolated gesture recognition. We have compared the results of HMM-based sequence classification with CRF-based techniques. Our results confirm that both HMM and CRF perform quite similarly when tested on gesture sequences. The proposed system can be used for home-based palm or finger rehabilitation in the absence of experts.

  4. Maxillary arch rehabilitation using implant-supported computer-assisted design-computer-assisted manufacturing-milled titanium framework

    Directory of Open Access Journals (Sweden)

    Tulika S Khanna

    2017-01-01

    Full Text Available Esthetic and functional rehabilitation of completely edentulous maxillary arch with fixed implant supported prosthesis is a challenging task. Newer technologies such as computer assisted design computer assisted manufacturing (CAD CAM and cone beam conventional tomography play an important role in achieving predictable results. Full mouth porcelain fused to metal (PFM individual crowns on CAD CAM milled titanium framework provides positive esthetic and functional outcome. This is a case report of rehabilitation of partially edentulous maxillary arch patient. Staged rehabilitation of this patient was planned. In the first stage, root canal treatment of key abutment teeth was done, nonsalvageable teeth were removed, and immediate interim overdenture was provided. In the second stage, five Nobel Biocare dental implants were placed. After integration impressions were made, CAD CAM milled titanium bar was fabricated. Individual PFM crowns were made and cemented. This method gives better esthetic compared to acrylic fused to metal hybrid prosthesis with the advantage of retrievability just like screw retained prosthesis. Hence, this technique is good for rehabilitation of patients with high esthetic demands.

  5. [Computer-assisted therapy and video games in psychosocial rehabilitation for schizophrenia patients].

    Science.gov (United States)

    Brun, G; Verdoux, H; Couhet, G; Quiles, C

    2018-02-28

    Video games and virtual reality have recently become used by clinicians for training or information media or as therapeutic tools. The purpose is to review the use of these technologies for therapy destined for schizophrenia patients. We conducted a review in October 2016 using Pubmed, Scopus and PsychInfo using the following Medical Subject Headings (MESH): "video games", "virtual reality" and "therapy, computer-assisted/methods", each associated with "schizophrenia". Papers were included in the review if: (a) they were published in an English, Spanish or French-language peer-reviewed journal, (b) the study enrolled patients with schizophrenia or schizo-affective disorder, (c) the patients used a therapeutic video game or therapeutic virtual reality device. Eighteen publications were included. The devices studied are mainly therapeutic software developed specifically for therapeutic care. They can be classified according to their therapeutic objectives. These targets corresponded to objectives of psychosocial rehabilitation: improvement of residual symptomatology, cognitive remediation, remediation of cognition and social skills, improvement of everyday life activities, support for occupational integration. Very different devices were proposed. Some researchers analysed programs developed specifically for patients with schizophrenia, while others were interested in the impact of commercial games. Most of the studies were recent, preliminary and European. The impact of these devices was globally positive, particularly concerning cognitive functions. Computer-assisted therapy, video games and virtual reality cannot replace usual care but could be used as adjunctive therapy. However, recommending their use seems premature because of the recent and preliminary character of most studies. Moreover, a link is still lacking between this field of research in psychiatry and other fields of research, particularly game studies. Finally, it might be interesting to analyse more

  6. Reaction time for processing visual stimulus in a computer-assisted rehabilitation environment.

    Science.gov (United States)

    Sanchez, Yerly; Pinzon, David; Zheng, Bin

    2017-10-01

    To examine the reaction time when human subjects process information presented in the visual channel under both a direct vision and a virtual rehabilitation environment when walking was performed. Visual stimulus included eight math problems displayed on the peripheral vision to seven healthy human subjects in a virtual rehabilitation training (computer-assisted rehabilitation environment (CAREN)) and a direct vision environment. Subjects were required to verbally report the results of these math calculations in a short period of time. Reaction time measured by Tobii Eye tracker and calculation accuracy were recorded and compared between the direct vision and virtual rehabilitation environment. Performance outcomes measured for both groups included reaction time, reading time, answering time and the verbal answer score. A significant difference between the groups was only found for the reaction time (p = .004). Participants had more difficulty recognizing the first equation of the virtual environment. Participants reaction time was faster in the direct vision environment. This reaction time delay should be kept in mind when designing skill training scenarios in virtual environments. This was a pilot project to a series of studies assessing cognition ability of stroke patients who are undertaking a rehabilitation program with a virtual training environment. Implications for rehabilitation Eye tracking is a reliable tool that can be employed in rehabilitation virtual environments. Reaction time changes between direct vision and virtual environment.

  7. Effects of acupuncture and computer-assisted cognitive training for post-stroke attention deficits: study protocol for a randomized controlled trial.

    Science.gov (United States)

    Huang, Jia; McCaskey, Michael A; Yang, Shanli; Ye, Haicheng; Tao, Jing; Jiang, Cai; Schuster-Amft, Corina; Balzer, Christian; Ettlin, Thierry; Schupp, Wilfried; Kulke, Hartwig; Chen, Lidian

    2015-12-02

    A majority of stroke survivors present with cognitive impairments. Attention disturbance, which leads to impaired concentration and overall reduced cognitive functions, is strongly associated with stroke. The clinical efficacy of acupuncture with Baihui (GV20) and Shenting (GV24) as well as computer-assisted cognitive training in stroke and post-stroke cognitive impairment have both been demonstrated in previous studies. To date, no systematic comparison of these exists and the potential beneficial effects of a combined application are yet to be examined. The main objective of this pilot study is to evaluate the effects of computer-assisted cognitive training compared to acupuncture on the outcomes of attention assessments. The second objective is to test the effects of a combined cognitive intervention that incorporates computer-assisted cognitive training and acupuncture (ACoTrain). An international multicentre, single-blinded, randomised controlled pilot trial will be conducted. In a 1:1:1 ratio, 60 inpatients with post-stroke cognitive dysfunction will be randomly allocated into either the acupuncture group, the computer-assisted cognitive training group, or the ACoTrain group in addition to their individual rehabilitation programme. The intervention period of this pilot trial will last 4 weeks (30 minutes per day, 5 days per week, Monday to Friday). The primary outcome is the test battery for attentional performance. The secondary outcomes include the Trail Making Test, Test des Deux Barrages, National Institute of Health Stroke Scale, and Modified Barthel Index for assessment of daily life competence, and the EuroQol Questionnaire for health-related quality of life. This trial mainly focuses on evaluating the effects of computer-assisted cognitive training compared to acupuncture on the outcomes of attention assessments. The results of this pilot trial are expected to provide new insights on how Eastern and Western medicine can complement one another and

  8. A qualitative study adopting a user-centered approach to design and validate a brain computer interface for cognitive rehabilitation for people with brain injury.

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    Martin, Suzanne; Armstrong, Elaine; Thomson, Eileen; Vargiu, Eloisa; Solà, Marc; Dauwalder, Stefan; Miralles, Felip; Daly Lynn, Jean

    2017-07-14

    Cognitive rehabilitation is established as a core intervention within rehabilitation programs following a traumatic brain injury (TBI). Digitally enabled assistive technologies offer opportunities for clinicians to increase remote access to rehabilitation supporting transition into home. Brain Computer Interface (BCI) systems can harness the residual abilities of individuals with limited function to gain control over computers through their brain waves. This paper presents an online cognitive rehabilitation application developed with therapists, to work remotely with people who have TBI, who will use BCI at home to engage in the therapy. A qualitative research study was completed with people who are community dwellers post brain injury (end users), and a cohort of therapists involved in cognitive rehabilitation. A user-centered approach over three phases in the development, design and feasibility testing of this cognitive rehabilitation application included two tasks (Find-a-Category and a Memory Card task). The therapist could remotely prescribe activity with different levels of difficulty. The service user had a home interface which would present the therapy activities. This novel work was achieved by an international consortium of academics, business partners and service users.

  9. Preliminary Evaluation of a Personal Healthcare System Prototype for Cognitive eRehabilitation in a Living Assistance Domain

    Directory of Open Access Journals (Sweden)

    Matteo Pastorino

    2014-06-01

    Full Text Available The integration of rehabilitation systems in an ambient assisted living environment can provide a powerful and versatile tool for long-term stroke rehabilitation goals. This paper introduces a novel concept of a personalized cognitive rehabilitation system in a naturalistic setting. The proposed platform was developed within the CogWatch project, with the intent of fostering independence in activities of daily living in patients with apraxia and action disorganization syndrome. Technical usability was evaluated in a series of pilot experiments, which illustrate how this approach may help to retrain patients in activities of daily living. The first system prototype has been tested with 36 participants divided into three groups, providing an exploratory evaluation of the usability of this solution and its acceptability. The technical solutions used within the CogWatch project are targeted to meet both the end users’ needs from the interaction and usability point of views and the clinical requirements associated with the use of such systems. The challenges behind the development of ambient assisted living systems for cognitive rehabilitation are discussed.

  10. Computer Assisted Programmed Instruction and Cognitive ...

    African Journals Online (AJOL)

    The study probes into the effect of Computer Assisted Instruction and Cognitive preference style on achievement of secondary school Physics Students in Ogun State of Nigeria. The population of the study comprises the SS II students in Abeokuta Educational Zone. 186 students sample were drawn from the population for ...

  11. A web ontology for brain trauma patient computer-assisted rehabilitation.

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    Zikos, Dimitrios; Galatas, George; Metsis, Vangelis; Makedon, Fillia

    2013-01-01

    In this paper we describe CABROnto, which is a web ontology for the semantic representation of the computer assisted brain trauma rehabilitation. This is a novel and emerging domain, since it employs the use of robotic devices, adaptation software and machine learning to facilitate interactive and adaptive rehabilitation care. We used Protégé 4.2 and Protégé-Owl schema editor. The primary goal of this ontology is to enable the reuse of the domain knowledge. CABROnto has nine main classes, more than 50 subclasses, existential and cardinality restrictions. The ontology can be found online at Bioportal.

  12. [Cognitive rehabilitation of amusia].

    Science.gov (United States)

    Weill-Chounlamountry, A; Soyez-Gayout, L; Tessier, C; Pradat-Diehl, P

    2008-06-01

    The cognitive model of music processing has a modular architecture with two main pathways (a melody pathway and a time pathway) for processing the musical "message" and thus enabling music recognition. It also features a music-specific module for tonal encoding of pitch which stands apart from all other known cognitive systems (including language processing). To the best of our knowledge, rehabilitation therapy for amusia has not yet been reported. We developed a therapeutic method (inspired by work on word deafness) in order to determine whether specific rehabilitation based on melody discrimination could prompt the regression of amusia. We report the case of a patient having developed receptive, acquired amusia four years previously. His tone deafness disorder was assessed using the Montreal Battery of Evaluation of Amusia (MBEA), which revealed impairment of the melody pathway but no deficiency in the time pathway. A computer-assisted rehabilitation method was implemented; it used melody discrimination tasks and an errorless learning paradigm with progressively fading visual cues. After therapy, we noted an improvement in the overall MBEA score and its component subscores which could not be explained by spontaneous recovery (in view of the number of years since the neurological accident). The improvement was maintained at seven months post-therapy. Although post-therapy improvement in daily life was not systematically assessed, the patient started listening to his favourite music again. Specific amusia therapy has shown efficacy.

  13. 43 Computer Assisted Programmed Instruction and Cognitive ...

    African Journals Online (AJOL)

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    between Cognitive Preference Style and Computer Assisted Programmed ... teaching the subjects makes a wide range of students who have moderate numerical ability and ... on achievement of physics students, more so when such strategy has .... explaining prompting, thinking, discussing, clarifying concepts, asking ...

  14. Computer-based cognitive rehabilitation: the CoRe system.

    Science.gov (United States)

    Alloni, Anna; Sinforiani, Elena; Zucchella, Chiara; Sandrini, Giorgio; Bernini, Sara; Cattani, Barbara; Pardell, Daniela Tost; Quaglini, Silvana; Pistarini, Caterina

    2017-02-01

    This work aims at providing a tool for supporting cognitive rehabilitation. This is a wide field, that includes a variety of diseases and related clinical pictures; for this reason the need arises to have a tool available that overcomes the difficulties entailed by what currently is the most common approach, that is, the so-called pen and paper rehabilitation. We first organized a big number of stimuli in an ontology that represents concepts, attributes and a set of relationships among concepts. Stimuli may be words, sounds, 2D and 3D images. Then, we developed an engine that automatically generates exercises by exploiting that ontology. The design of exercises has been carried on in synergy with neuropsychologists and speech therapists. Solutions have been devised aimed at personalizing the exercises according to both patients' preferences and performance. Exercises addressed to rehabilitation of executive functions and aphasia-related diseases have been implemented. The system has been tested on both healthy volunteers (n = 38) and patients (n = 9), obtaining a favourable rating and suggestions for improvements. We created a tool able to automate the execution of cognitive rehabilitation tasks. We hope the variety and personalization of exercises will allow to increase compliance, particularly from elderly people, usually neither familiar with technology nor particularly willing to rely on it. The next step involves the creation of a telerehabilitation tool, to allow therapy sessions to be undergone from home, thus guaranteeing continuity of care and advantages in terms of time and costs for the patients and the National Healthcare System (NHS). Implications for rehabilitation Cognitive impairments can greatly impact an individual's existence, appreciably reducing his abilities and autonomy, as well as sensibly lowering his quality of life. Cognitive rehabilitation can be used to restore lost brain function or slow down degenerative diseases

  15. Effect of computerized cognitive rehabilitation program on cognitive function and activities of living in stroke patients

    OpenAIRE

    Yoo, Chanuk; Yong, Mi-hyun; Chung, Jaeyeop; Yang, Yeongae

    2015-01-01

    [Purpose] The objective of this study was to examine the effect of cognitive rehabilitation using a computer on cognitive function and activities of daily living in stroke patients presenting impairment of cognitive function. [Subjects] Forty-six stroke patients were divided into two groups (a training group and control group) through random assignment. [Methods] The training group received rehabilitation therapy and an additional computerized cognitive rehabilitation program using The RehaCo...

  16. Technology-assisted rehabilitation interventions following pediatric brain injury.

    Science.gov (United States)

    Wade, Shari L; Narad, Megan E; Shultz, Emily L; Kurowski, Brad G; Miley, Aimee E; Aguilar, Jessica M; Adlam, Anna-Lynne R

    2018-04-01

    Following traumatic brain injury (TBI), children experience a variety of physical, motor, speech, and cognitive deficits that can have a long-term detrimental impact. The emergence and popularity of new technologies has led to research into the development of various apps, gaming systems, websites, and robotics that might be applied to rehabilitation. The objective of this narrative review was to describe the current literature regarding technologically-assisted interventions for the rehabilitation of motor, neurocognitive, behavioral, and family impairments following pediatric TBI. We conducted a series of searches for peer-reviewed manuscripts published between 2000 and 2017 that included a technology-assisted component in the domains of motor, language/communication, cognition, behavior, social competence/functioning, family, and academic/school-based functioning. Findings suggested several benefits of utilizing technology in TBI rehabilitation including facilitating engagement/adherence, increasing access to therapies, and improving generalizability across settings. There is fairly robust evidence regarding the efficacy of online family problem-solving therapy in improving behavior problems, executive functioning, and family functioning. There was less compelling, but still promising, evidence regarding the efficacy other technology for motor deficits, apps for social skills, and computerized programs for cognitive skills. Overall, many studies were limited in the rigor of their methodology due to small heterogeneous samples and lack of control groups. Technology-assisted interventions have the potential to enhance pediatric rehabilitation after TBI. Future research is needed to further support their efficacy with larger controlled trials and to identify characteristics of children who are most likely to benefit.

  17. Progress of assessment and rehabilitation therapy of cognitive impairment

    Directory of Open Access Journals (Sweden)

    Yuan-yuan TAO

    2017-07-01

    Full Text Available  Cognitive impairment is one of major disorders after brain injury. With the rapid development of rehabilitation medicine in China, more and more attention was focused on it. The methods of assessment and rehabilitation therapy of cognitive impairment are more widely used in clinic. Based on traditional methods of assessment and rehabilitation therapy, driven by the development of computer, Internet and Internet of Things, more and more new methods emerged. This article intends to review the commonly used assessment and rehabilitation therapy of cognitive impairment and their progress. DOI: 10.3969/j.issn.1672-6731.2017.05.002

  18. [Adding the perspective of emotion on cognitive rehabilitation].

    Science.gov (United States)

    Nakagome, Kazuyuki

    2011-01-01

    Cognitive rehabilitation has been gradually disseminated in Japan lately. Cognitive rehabilitation is distinct from other psychosocial rehabilitation methods, which aims to enhance cognitive function per se, by various training tools, using paper and pencil tasks, computer games, etc. It stands on the hypothesis that enhancing cognitive function should lead to improvement in social functioning. However, it is becoming clear that cognitive rehabilitation on its own is not strongly effective on social functioning, but rather it appears effective when combined with other methods of rehabilitation. Moreover, it does not treat the emotional problems, which is essential considering the treatment endpoint, to enhance "subjective well-being". Emotional problems arise much often at social interaction in patients with schizophrenia, which can be amended by improving their social cognition as well as social skills. Recently, one of the social cognition training programs has been developed in USA by Penn and his colleagues, named SCIT (Social Cognition and Interaction Training) . The program treats a number of factors involved in social cognition, a) emotion perception, b) attributional style, and c) theory of mind, using various techniques such as Socrates quotes. In previous studies, SCIT showed good effectiveness in various aspects of social cognition for inpatients, whereas the finding was not as clear for outpatients. It may be assumed that integrating SCIT into a cognitive rehabilitation program should alleviate emotional stress the patients often encounter at social interaction in their daily activities. Presumably the next candidate target for psychosocial treatments coming after cognition and emotion should be "intrinsic motivation".

  19. Progress of assessment and rehabilitation therapy of cognitive impairment

    OpenAIRE

    Yuan-yuan TAO; Rong SUN; Lu-ping SONG

    2017-01-01

     Cognitive impairment is one of major disorders after brain injury. With the rapid development of rehabilitation medicine in China, more and more attention was focused on it. The methods of assessment and rehabilitation therapy of cognitive impairment are more widely used in clinic. Based on traditional methods of assessment and rehabilitation therapy, driven by the development of computer, Internet and Internet of Things, more and more new methods emerged. This article intends to revie...

  20. [Cognitive remediation and cognitive assistive technologies in schizophrenia].

    Science.gov (United States)

    Sablier, J; Stip, E; Franck, N

    2009-04-01

    Cognitive impairments are a core feature in schizophrenia. They impact several cognitive abilities but most importantly attention, memory and executive functions, consequently leading to great difficulties in everyday life. Most schizophrenia patients need assurance and require assistance and help from care workers, family members and friends. Family members taking care of a patient have additional daily work burden, and suffer psychological anguish and anxiety. Therefore, improving cognitive functions in schizophrenia patients is essential for the well-being of patients and their relatives. Reducing these deficits may decrease the economic burden to the health care system through lower numbers of hospital admissions and shorter hospitalisation periods, for example. Cognitive rehabilitation was developed to address the limited benefits of conventional treatments on cognitive deficits through the use of assistive technology as a means of enhancing memory and executive skills in schizophrenia patients. To provide clinicians with comprehensive knowledge on cognitive trainings, programs of remediation, and cognitive assistive technologies. Literature review. A search in the electronic databases (PubMed, EMBASE, Index Medicus) for recent articles in the last 10 years related to cognitive remediation published in any language using the words: cognitive and remediation or rehabilitation and schizophrenia, and a search for chapters in psychiatry and rehabilitation textbooks. We found 392 articles and 112 review paper mainly in English. First, we identified cognitive remediation programs that were beneficial to schizophrenia patients. Programs available in French (IPT, RECOS, and RehaCom) and others (CET, NET, CRT, NEAR, APT and CAT) were identified. In addition, since memory and executive function impairments could be present in people without schizophrenia, we reviewed inventories of cognitive assistive technologies proven to enhance cognitive skills in other populations

  1. Design and Implementation of an Assistive Controller for Rehabilitation Robotic Systems

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    Duygun Erol

    2007-09-01

    Full Text Available The goal of our research is to develop an assistive controller for robotic rehabilitation of the upper extremity after stroke. The controller is used to provide robotic assistance to participants to help them to track a desired motion trajectory required for the rehabilitation task in an accurate and concentrated manner. This rehabilitation task is designed to ensure concentrated repetitive motion that requires cognitive processing. Experimental results on unimpaired participants are presented to demonstrate the effectiveness and feasibility of the proposed controller.

  2. Effectiveness of computerized cognitive rehabilitation training on symptomatological, neuropsychological and work function in patients with schizophrenia.

    Science.gov (United States)

    Lee, Woo Kyeong

    2013-06-01

    There has been plenty of interest in cognitive rehabilitation for schizophrenia here in Korea since the year 2000. But the efficacy studies of cognitive remediation intervention are still deficient. The primary purpose of this study was to develop a computer-assisted cognitive remediation program and conduct a clinical trial in a group of schizophrenic patients. Sixty patients with schizophrenia were randomly assigned to a computerized cognitive rehabilitation (Cog-trainer) group plus usual rehabilitation (UR) or to a usual rehabilitation (UR) group only. Clinical, neuropsychological and functional outcome variables were assessed at baseline and after intervention. The Cog-trainer group received 20 sessions of computerized cognitive remediation training over 3 months. This training program consists of 10 units, with each unit being divided into three stages: (i) practice; (ii) application; and (iii) advanced. Compared to the UR group, the Cog-trainer exhibited a significant improvement in attention, concentration and working memory. The Cog-trainer group also showed improvement in the work quality subscale of the work behavior inventory. However, there were no significant benefits of computerized cognitive remediation where symptoms were concerned. These results indicate that computerized cognitive rehabilitation training can contribute to an improvement in the cognitive function of people with schizophrenia. The changes in cognitive outcomes can also contribute to improvement in job functioning. Further study of generalization to other functional outcome measures will be necessary. Long-term follow-up studies are needed to confirm the maintenance of such improvements. Copyright © 2013 Wiley Publishing Asia Pty Ltd.

  3. The effects of a Korean computer-based cognitive rehabilitation program on cognitive function and visual perception ability of patients with acute stroke

    OpenAIRE

    Park, Jin-Hyuck; Park, Ji-Hyuk

    2015-01-01

    [Purpose] The purpose of this study is to investigate the effects of a Korean computer-based cognitive rehabilitation program (CBCR) on the cognitive function and visual perception ability of patients with acute stroke. [Subjects] The subjects were 30 patients with acute stroke. [Methods] The subjects were randomly assigned to either the experimental group (EG) or the control group (CG). The EG subjects received CBCR with the CoTras program. The CG subjects received conventional cognitive reh...

  4. A new cognitive rehabilitation programme for patients with multiple sclerosis: the 'MS-line! Project'.

    Science.gov (United States)

    Gich, Jordi; Freixenet, Jordi; Garcia, Rafael; Vilanova, Joan Carles; Genís, David; Silva, Yolanda; Montalban, Xavier; Ramió-Torrentà, Lluís

    2015-09-01

    Cognitive rehabilitation is often delayed in multiple sclerosis (MS). To develop a free and specific cognitive rehabilitation programme for MS patients to be used from early stages that does not interfere with daily living activities. MS-line!, cognitive rehabilitation materials consisting of written, manipulative and computer-based materials with difficulty levels developed by a multidisciplinary team. Mathematical, problem-solving and word-based exercises were designed. Physical materials included spatial, coordination and reasoning games. Computer-based material included logic and reasoning, working memory and processing speed games. Cognitive rehabilitation exercises that are specific for MS patients have been successfully developed. © The Author(s), 2014.

  5. Integrating cognitive rehabilitation: A preliminary program description and theoretical review of an interdisciplinary cognitive rehabilitation program.

    Science.gov (United States)

    Fleeman, Jennifer A; Stavisky, Christopher; Carson, Simon; Dukelow, Nancy; Maier, Sheryl; Coles, Heather; Wager, John; Rice, Jordyn; Essaff, David; Scherer, Marcia

    2015-01-01

    Interdisciplinary cognitive rehabilitation is emerging as the expected standard of care for individuals with mild to moderate degrees of cognitive impairment for a variety of etiologies. There is a growing body of evidence in cognitive rehabilitation literature supporting the involvement of multiple disciplines, with the use of cognitive support technologies (CSTs), in delivering cognitive therapy to individuals who require cognitive rehabilitative therapies. This article provides an overview of the guiding theories related to traditional approaches of cognitive rehabilitation and the positive impact of current theoretical models of an interdisciplinary approach in clinical service delivery of this rehabilitation. A theoretical model of the Integrative Cognitive Rehabilitation Program (ICRP) will be described in detail along with the practical substrates of delivering specific interventions to individuals and caregivers who are living with mild to moderate cognitive impairment. The ultimate goal of this article is to provide a clinically useful resource for direct service providers. It will serve to further clinical knowledge and understanding of the evolution from traditional silo based treatment paradigms to the current implementation of multiple perspectives and disciplines in the pursuit of patient centered care. The article will discuss the theories that contributed to the development of the interdisciplinary team and the ICRP model, implemented with individuals with mild to moderate cognitive deficits, regardless of etiology. The development and implementation of specific assessment and intervention strategies in this cognitive rehabilitation program will also be discussed. The assessment and intervention strategies utilized as part of ICRP are applicable to multiple clinical settings in which individuals with cognitive impairment are served. This article has specific implications for rehabilitation which include: (a) An Interdisciplinary Approach is an

  6. Feasibility of school-based computer-assisted robotic gaming technology for upper limb rehabilitation of children with cerebral palsy.

    Science.gov (United States)

    Preston, Nick; Weightman, Andrew; Gallagher, Justin; Holt, Raymond; Clarke, Michael; Mon-Williams, Mark; Levesley, Martin; Bhakta, Bipinchandra

    2016-01-01

    We investigated the feasibility of using computer-assisted arm rehabilitation (CAAR) computer games in schools. Outcomes were children's preference for single player or dual player mode, and changes in arm activity and kinematics. Nine boys and two girls with cerebral palsy (6-12 years, mean 9 years) played assistive technology computer games in single-user mode or with school friends in an AB-BA design. Preference was determined by recording the time spent playing each mode and by qualitative feedback. We used the ABILHAND-kids and Canadian Occupational Performance Measure to evaluate activity limitation, and a portable laptop-based device to capture arm kinematics. No difference was recorded between single-user and dual-user modes (median daily use 9.27 versus 11.2 min, p = 0.214). Children reported dual-user mode was preferable. There were no changes in activity limitation (ABILHAND-kids, p = 0.424; COPM, p = 0.484) but we found significant improvements in hand speed (p = 0.028), smoothness (p = 0.005) and accuracy (p = 0.007). School timetables prohibit extensive use of rehabilitation technology but there is potential for its short-term use to supplement a rehabilitation program. The restricted access to the rehabilitation games was sufficient to improve arm kinematics but not arm activity. Implications for Rehabilitation School premises and teaching staff present no obstacles to the installation of rehabilitation gaming technology. Twelve minutes per day is the average amount of time that the school time table permits children to use rehabilitation gaming equipment (without disruption to academic attendance). The use of rehabilitation gaming technology for an average of 12 minutes daily does not appear to benefit children's functional performance, but there are improvements in the kinematics of children's upper limb.

  7. Efficacy of cognitive rehabilitation using computer software with individuals living with schizophrenia: A randomized controlled trial in Japan.

    Science.gov (United States)

    Iwata, Kazuhiko; Matsuda, Yasuhiro; Sato, Sayaka; Furukawa, Shunichi; Watanabe, Yukako; Hatsuse, Norifumi; Ikebuchi, Emi

    2017-03-01

    Cognitive impairment is common in schizophrenia, and is associated with poor psychosocial functioning. Previous studies had inconsistently shown improvement in cognitive functions with cognitive remediation therapy. This study examined whether cognitive remediation is effective in improving both cognitive and social functions in schizophrenia in outpatient settings that provide learning-based psychiatric rehabilitation. This study is the first randomized controlled trial of cognitive remediation in Japan. Study participants were individuals with schizophrenia from 6 outpatient psychiatric medical facilities who were randomly assigned either a cognitive remediation program or treatment as usual. The cognitive remediation intervention includes Cognitive training using computer software (CogPack; Japanese version) administered twice a week and a weekly group over 12 weeks and was based on the Thinking Skills for Work program. Most study participants were attending day treatment services where social skills training, psychoeducation for knowledge about schizophrenia, group activities such as recreation and sport, and other psychosocial treatment were offered. Cognitive and social functioning were assessed using the Brief Assessment of Cognition in Schizophrenia (BACS) and Life Assessment Scale for Mentally Ill (LASMI) at pre- and postintervention. Of the 60 people with schizophrenia enrolled, 29 were allocated to the cognitive remediation group and 31 were allocated to the treatment as usual group. Processing speed, executive function, and the composite score of the BACS showed significantly greater improvement for the cognitive remediation group than the treatment as usual group. In addition, there was significant improvement in interpersonal relationships and work skills on the LASMI for the cognitive remediation group compared with the treatment as usual group. Changes from pretreatment to posttreatment in verbal fluency and interpersonal relationships were

  8. [The cognitive paradigm in the rehabilitation of schizophrenia - focusing on cognitive remediation].

    Science.gov (United States)

    Muth, Veronika; Gyüre, Támas; Váradi, Enikö

    2015-09-01

    Neurocognitive deficits are core features of schizophrenia and well known to the specialists, concerning researches in Hungary as well. Significance of the topic derives from the fact that according to our present knowledge this is the prime symptom principally affecting everyday functioning and limits benefit of rehabilitation opportunities. The classic psychiatric rehabilitation toolset, either pharmacological or psychosocial, does not provide effective and specific assistance to alleviate the symptoms of the neurocognitive deficits. Despite the increasing presence of the neurocognitive-oriented rehabilitation in international publications and professional forums, cognitive development is rather neglected topic in the Hungarian literature; while the therapeutic practice - with the exception of one institution - is absent from the repertoire of the Hungarian rehabilitation. The purpose of this study is the multi-faceted presentation of recent results in the field of the cognitive remediation, describing the position of cognitive training and its place in the rehabilitation of schizophrenia, with the aim to gain reputation and promote clinical practice among the Hungarian experts. Cognitive remediation is a behavioral training, based on learning theory, with the aim of extensive and long-lasting improvement of cognitive functions of patients suffering from schizophrenia or other mental disorders. Despite the deceptively similar acronym it is important to distinguish this method from the cognitive behavioral therapy which shows similarity in its learning theory basis, but remediation involves much more educational features. Cognitive remediation is not a unified technique, different settings are known, but regardless of form factors it clearly has a specific and positive effect on the neurocognitive functions. It fits well into the rehabilitation methodology, in fact this embeddedness significantly increases its effectiveness and supports emergence of skills in

  9. Efficacy of a Computer-Assisted Cognitive Rehabilitation Intervention in Relapsing-Remitting Multiple Sclerosis Patients: A Multicenter Randomized Controlled Trial

    Science.gov (United States)

    Kosmidis, Mary H.; Zampakis, Petros; Malefaki, Sonia; Ntoskou, Katerina; Nousia, Anastasia; Bakirtzis, Christos; Papathanasopoulos, Panagiotis

    2017-01-01

    Cognitive impairment is frequently encountered in multiple sclerosis (MS) affecting between 40–65% of individuals, irrespective of disease duration and severity of physical disability. In the present multicenter randomized controlled trial, fifty-eight clinically stable RRMS patients with mild to moderate cognitive impairment and relatively low disability status were randomized to receive either computer-assisted (RehaCom) functional cognitive training with an emphasis on episodic memory, information processing speed/attention, and executive functions for 10 weeks (IG; n = 32) or standard clinical care (CG; n = 26). Outcome measures included a flexible comprehensive neuropsychological battery of tests sensitive to MS patient deficits and feedback regarding personal benefit gained from the intervention on four verbal questions. Only the IG group showed significant improvements in verbal and visuospatial episodic memory, processing speed/attention, and executive functioning from pre - to postassessment. Moreover, the improvement obtained on attention was retained over 6 months providing evidence on the long-term benefits of this intervention. Group by time interactions revealed significant improvements in composite cognitive domain scores in the IG relative to the demographically and clinically matched CG for verbal episodic memory, processing speed, verbal fluency, and attention. Treated patients rated the intervention positively and were more confident about their cognitive abilities following treatment. PMID:29463950

  10. Computerized Cognitive Rehabilitation: Comparing Different Human-Computer Interactions.

    Science.gov (United States)

    Quaglini, Silvana; Alloni, Anna; Cattani, Barbara; Panzarasa, Silvia; Pistarini, Caterina

    2017-01-01

    In this work we describe an experiment involving aphasic patients, where the same speech rehabilitation exercise was administered in three different modalities, two of which are computer-based. In particular, one modality exploits the "Makey Makey", an electronic board which allows interacting with the computer using physical objects.

  11. Potential of Cognitive Computing and Cognitive Systems

    Science.gov (United States)

    Noor, Ahmed K.

    2015-01-01

    Cognitive computing and cognitive technologies are game changers for future engineering systems, as well as for engineering practice and training. They are major drivers for knowledge automation work, and the creation of cognitive products with higher levels of intelligence than current smart products. This paper gives a brief review of cognitive computing and some of the cognitive engineering systems activities. The potential of cognitive technologies is outlined, along with a brief description of future cognitive environments, incorporating cognitive assistants - specialized proactive intelligent software agents designed to follow and interact with humans and other cognitive assistants across the environments. The cognitive assistants engage, individually or collectively, with humans through a combination of adaptive multimodal interfaces, and advanced visualization and navigation techniques. The realization of future cognitive environments requires the development of a cognitive innovation ecosystem for the engineering workforce. The continuously expanding major components of the ecosystem include integrated knowledge discovery and exploitation facilities (incorporating predictive and prescriptive big data analytics); novel cognitive modeling and visual simulation facilities; cognitive multimodal interfaces; and cognitive mobile and wearable devices. The ecosystem will provide timely, engaging, personalized / collaborative, learning and effective decision making. It will stimulate creativity and innovation, and prepare the participants to work in future cognitive enterprises and develop new cognitive products of increasing complexity. http://www.aee.odu.edu/cognitivecomp

  12. Computer-assisted technologies used in oral rehabilitation and the clinical documentation of alleged advantages - a systematic review.

    Science.gov (United States)

    Jokstad, A

    2017-04-01

    The objective of this systematic review is to identify current computer-assisted technologies used for managing patients with a need to re-establish craniofacial appearance, subjective discomfort and stomatognathic function, and the extent of their clinical documentation. Electronic search strategies were used for locating clinical studies in MEDLINE through PubMed and in the Cochrane library, and in the grey literature through searches on Google Scholar. The searches for commercial digital products for use in oral rehabilitation resulted in identifying 225 products per November 2016, used for patient diagnostics, communication and therapy purposes, and for other computer-assisted applications in context with oral rehabilitation. About one-third of these products were described in about 350 papers reporting from clinical human studies. The great majority of digital products for use in oral rehabilitation has no clinical documentation at all, while the products from a distinct minority of manufacturers have frequently appeared in more or less scientific reports. Moore's law apply also to digital dentistry, which predicts that the capacity of microprocessors will continue to become faster and with lower cost per performance unit, and innovative software programs will harness these improvements in performance. The net effect is the noticeable short product life cycle of digital products developed for use in oral rehabilitation and often lack of supportive clinical documentation. Nonetheless, clinicians must request clinically meaningful information about new digital products to assess net benefits for the patients or the dental professionals and not accept only technological verbiage as a basis for product purchases. © 2017 John Wiley & Sons Ltd.

  13. The rehabilitation engineering research center for the advancement of cognitive technologies.

    Science.gov (United States)

    Heyn, Patricia Cristine; Cassidy, Joy Lucille; Bodine, Cathy

    2015-02-01

    Barring few exceptions, allied health professionals, engineers, manufacturers of assistive technologies (ATs), and consumer product manufacturers have developed few technologies for individuals with cognitive impairments (CIs). In 2004, the National Institute on Disability Rehabilitation Research (NIDRR) recognized the need to support research in this emergent field. They funded the first Rehabilitation Engineering Research Center for the Advancement of Cognitive Technologies (RERC-ACT). The RERC-ACT has since designed and evaluated existing and emerging technologies through rigorous research, improving upon existing AT devices, and creating new technologies for individuals with CIs. The RERC-ACT has contributed to the development and testing of AT products that assist persons with CIs to actively engage in tasks of daily living at home, school, work, and in the community. This article highlights the RERC-ACT's engineering development and research projects and discusses how current research may impact the quality of life for an aging population. © The Author(s) 2014.

  14. Functional and Structural Brain Plasticity Enhanced by Motor and Cognitive Rehabilitation in Multiple Sclerosis

    Directory of Open Access Journals (Sweden)

    Luca Prosperini

    2015-01-01

    Full Text Available Rehabilitation is recognized to be important in ameliorating motor and cognitive functions, reducing disease burden, and improving quality of life in patients with multiple sclerosis (MS. In this systematic review, we summarize the existing evidences that motor and cognitive rehabilitation may enhance functional and structural brain plasticity in patients with MS, as assessed by means of the most advanced neuroimaging techniques, including diffusion tensor imaging and task-related and resting-state functional magnetic resonance imaging (MRI. In most cases, the rehabilitation program was based on computer-assisted/video game exercises performed in either an outpatient or home setting. Despite their heterogeneity, all the included studies describe changes in white matter microarchitecture, in task-related activation, and/or in functional connectivity following both task-oriented and selective training. When explored, relevant correlation between improved function and MRI-detected brain changes was often found, supporting the hypothesis that training-induced brain plasticity is specifically linked to the trained domain. Small sample sizes, lack of randomization and/or an active control group, as well as missed relationship between MRI-detected changes and clinical performance, are the major drawbacks of the selected studies. Knowledge gaps in this field of research are also discussed to provide a framework for future investigations.

  15. Cognitive rehabilitation for patients with schizophrenia in Korea.

    Science.gov (United States)

    Lee, Won Hye; Lee, Woo Kyeong

    2017-02-01

    Psychosocial rehabilitation programs received mental health professional support in addition to traditional medication therapy. Many psychosocial programs were developed since the 1990s, including cognitive remediation therapy. In this review, we focus on cognitive remediation therapy in Korea since the 1990s. We review several cognitive rehabilitation programs developed in Korea and their outcome studies and suggest future research directions and prospects. We reviewed cognitive rehabilitation programs including social cognitive training as well as more recent forms of computerized cognitive rehabilitation. Although there are differences in cognitive domains by training targets, almost all neurocognitive remediation trainings in Korea have beneficial effects on early visual processing, various attention types, and executive function. Future studies need to investigate the mechanisms and various mediators underlying the relationships between cognitive functions and functional outcomes. With more comprehensive cognitive and social cognitive programs, we can enhance both cognition and functional outcomes of the patients with schizophrenia. Copyright © 2016 Elsevier B.V. All rights reserved.

  16. From Musical Grammars to Music Cognition in the 1980s and 1990s: Highlights of the History of Computer-Assisted Music Analysis

    Directory of Open Access Journals (Sweden)

    Nico Schüler

    2007-12-01

    Full Text Available While approaches that had already established historical precedents – computer-assisted analytical approaches drawing on statistics and information theory – developed further, many research projects conducted during the 1980s aimed at the development of new methods of computer-assisted music analysis. Some projects discovered new possibilities related to using computers to simulate human cognition and perception, drawing on cognitive musicology and Artificial Intelligence, areas that were themselves spurred on by new technical developments and by developments in computer program design. The 1990s ushered in revolutionary methods of music analysis, especially those drawing on Artificial Intelligence research. Some of these approaches started to focus on musical sound, rather than scores. They allowed music analysis to focus on how music is actually perceived. In some approaches, the analysis of music and of music cognition merged. This article provides an overview of computer-assisted music analysis of the 1980s and 1990s, as it relates to music cognition. Selected approaches are being discussed.

  17. Final priority. Rehabilitation Training: Job-Driven Vocational Rehabilitation Technical Assistance Center. Final priority.

    Science.gov (United States)

    2014-08-19

    The Assistant Secretary for Special Education and Rehabilitative Services announces a priority under the Rehabilitation Training program to establish a Job-Driven Vocational Rehabilitation Technical Assistance Center (JDVRTAC). The Assistant Secretary may use this priority for competitions in fiscal year (FY) 2014 and later years. We take this action to focus on training in an area of national need. Specifically, this priority responds to the Presidential Memorandum to Federal agencies directing them to take action to address job-driven training for the Nation's workers. The JDVRTAC will provide technical assistance (TA) to State vocational rehabilitation (VR) agencies to help them develop for individuals with disabilities training and employment opportunities that meet the needs of today's employers.

  18. Who is in charge? The impact of home-based computerized cognitive training on the Cognitive Training Alliance

    DEFF Research Database (Denmark)

    Wilms, Inge Linda

    2017-01-01

    Purpose: This case study observes and analyses how home-based computerized cognitive rehabilitation training impacts the relationship between the patient and home training assistants being either the spouse or paid care takers. The use of computerized cognitive training at home is fairly new...... to the emotional challenges of being a training assistant. A Cognitive Training Alliance model for a cognitive training alliance is proposed which takes into consideration the challenges of delegating training responsibility to computers and home-based assistants. Conclusion: It is important to understand how...... the use of computerized cognitive training in clinics or at home influences the training alliance to avoid or diminish frustration on the part of the patients and assistants....

  19. Cognitive rehabilitation of neuropsychological deficits and mild cognitive impairment: A review of the literature

    Directory of Open Access Journals (Sweden)

    Eliane Correa Miotto

    Full Text Available Abstract Neuropsychological rehabilitation is related to the treatment or optimization of disabilities, handicaps and cognitive deficiencies including emotional, behavioral and personality alterations, aiming at the best cognitive, neurobiological and social re-adaptation. Objective: The main aim of this paper is to review scientific studies published over the last five years on cognitive training with rehabilitation, focusing on elderly subjects with cognitive complaints and patients diagnosed with MCI. Methods: Data were generated from Medline, PsychoInfo and EMBASE including publications from 2002 to 2007 using the search terms "Mild Cognitive Impairment", "Cognitive Complaints", "Rehabilitation" and "Intervention Studies". Data collection criteria were restricted to the quality of evidence Class I. Results: Eight articles out of sixty eight previously selected were chosen because of their randomized studies, including techniques of cognitive rehabilitation in patients with cognitive complaints, MCI and neuropsychological training. Conclusions: The studies showing generalization of rehabilitation techniques to practical real life situations and use of an errorless learning approach were considered more effective in terms of maintaining treatment follow up, although further studies are recommended.

  20. Effects of a multidisciplinar cognitive rehabilitation program for patients with mild Alzheimer's disease

    Directory of Open Access Journals (Sweden)

    Luciane F. Viola

    2011-01-01

    Full Text Available OBJECTIVE: To evaluate the effects of a multidisciplinary rehabilitation program on cognition, quality of life, and neuropsychiatry symptoms in patients with mild Alzheimer's disease. METHOD: The present study was a single-blind, controlled study that was conducted at a university-based day-hospital memory facility. The study included 25 Alzheimer's patients and their caregivers and involved a 12-week stimulation and psychoeducational program. The comparison group consisted of 16 Alzheimer's patients in waiting lists for future intervention. INTERVENTION: Group sessions were provided by a multiprofessional team and included memory training, computer-assisted cognitive stimulation, expressive activities (painting, verbal expression, writing, physiotherapy, and physical training. Treatment was administered twice a week during 6.5-h gatherings. MEASUREMENTS: The assessment battery comprised the following tests: Mini-Mental State Examination, Short Cognitive Test, Quality of Life in Alzheimer's disease, Neuropsychiatric Inventory, and Geriatric Depression Scale. Test scores were evaluated at baseline and the end of the study by raters who were blinded to the group assignments. RESULTS: Measurements of global cognitive function and performance on attention tasks indicated that patients in the experimental group remained stable, whereas controls displayed mild but significant worsening. The intervention was associated with reduced depression symptoms for patients and caregivers and decreased neuropsychiatric symptoms in Alzheimer's subjects. The treatment was also beneficial for the patients' quality of life. CONCLUSION: This multimodal rehabilitation program was associated with cognitive stability and significant improvements in the quality of life for Alzheimer's patients. We also observed a significant decrease in depressive symptoms and caregiver burden. These results support the notion that structured nonpharmacological interventions can yield

  1. Donkey-assisted rehabilitation program for children: a pilot study

    Directory of Open Access Journals (Sweden)

    Paola De Rose

    2011-12-01

    Full Text Available Bonding with animals grants access to the sphere of affectivity and facilitates therapeutic engagement. The methodological approach of donkey-assisted programs is based on mediation, which is characterized by multidirectional relationships (patient-donkey-therapist. The donkey is an excellent facilitator in the motivation-building process, being able to stimulate the child's development by way of active and positive forces that foster psycho-affective and psycho-cognitive development processes. Results of this study, which focused on the child's approach to the donkey, indicate that while communicating with the animal, children rely more on physical expressions than on verbal language. Donkey-assisted rehabilitative sessions can help in identifying children's strong points, on which motivation could be built.

  2. Concomitant Use of Transcranial Direct Current Stimulation and Computer-Assisted Training for the Rehabilitation of Attention in Traumatic Brain Injured Patients: Behavioral and Neuroimaging Results.

    Science.gov (United States)

    Sacco, Katiuscia; Galetto, Valentina; Dimitri, Danilo; Geda, Elisabetta; Perotti, Francesca; Zettin, Marina; Geminiani, Giuliano C

    2016-01-01

    Divided attention (DA), the ability to distribute cognitive resources among two or more simultaneous tasks, may be severely compromised after traumatic brain injury (TBI), resulting in problems with numerous activities involved with daily living. So far, no research has investigated whether the use of non-invasive brain stimulation associated with neuropsychological rehabilitation might contribute to the recovery of such cognitive function. The main purpose of this study was to assess the effectiveness of 10 transcranial direct current stimulation (tDCS) sessions combined with computer-assisted training; it also intended to explore the neural modifications induced by the treatment. Thirty-two patients with severe TBI participated in the study: 16 were part of the experimental group, and 16 part of the control group. The treatment included 20' of tDCS, administered twice a day for 5 days. The electrodes were placed on the dorso-lateral prefrontal cortex. Their location varied across patients and it depended on each participant's specific area of damage. The control group received sham tDCS. After each tDCS session, the patient received computer-assisted cognitive training on DA for 40'. The results showed that the experimental group significantly improved in DA performance between pre- and post-treatment, showing faster reaction times (RTs), and fewer omissions. No improvement was detected between the baseline assessment (i.e., 1 month before treatment) and the pre-training assessment, or within the control group. Functional magnetic resonance imaging (fMRI) data, obtained on the experimental group during a DA task, showed post-treatment lower cerebral activations in the right superior temporal gyrus (BA 42), right and left middle frontal gyrus (BA 6), right postcentral gyrus (BA 3) and left inferior frontal gyrus (BA 9). We interpreted such neural changes as normalization of previously abnormal hyperactivations.

  3. Concomitant use of transcranial Direct Current Stimulation and computer-assisted training for the rehabilitation of attention in traumatic brain injured patients: behavioral and neuroimaging results

    Directory of Open Access Journals (Sweden)

    Katiuscia eSacco

    2016-03-01

    Full Text Available Divided attention, the ability to distribute cognitive resources among two or more simultaneous tasks, may be severely compromised after traumatic brain injury (TBI, resulting in problems with numerous activities involved with daily living. So far, no research has investigated whether the use of non-invasive brain stimulation associated with neuropsychological rehabilitation might contribute to the recovery of such cognitive function. The main purpose of this study was to assess the effectiveness of 10 tDCS sessions combined with computer-assisted training; it also intended to explore the neural modifications induced by the treatment. Thirty-two patients with severe TBI participated in the study: sixteen were part of the experimental group, and sixteen part of the control group. The treatment included 20’ of tDCS, administered twice a day for 5 days. The electrodes were placed on the dorso-lateral prefrontal cortex. Their location varied across patients and it depended on each participant’s specific area of damage. The control group received sham tDCS. After each tDCS session, the patient received computer-assisted cognitive training on divided attention for 40’. The results showed that the experimental group significantly improved in divided attention performance between pre- and post-treatment, showing faster reaction times, and fewer omissions. No improvement was detected between the baseline assessment (i.e., one month before treatment and the pre-training assessment, or within the control group. Functional magnetic resonance imaging data, obtained on the experimental group during a divided attention task, showed post-treatment lower cerebral activations in the right superior temporal gyrus (BA 42, right and left middle frontal gyrus (BA 6, right postcentral gyrus (BA 3 and left inferior frontal gyrus (BA 9. We interpreted such neural changes as normalization of previously abnormal hyperactivations.

  4. [APPLICATION OF COMPUTER-ASSISTED TECHNOLOGY IN ANALYSIS OF REVISION REASON OF UNICOMPARTMENTAL KNEE ARTHROPLASTY].

    Science.gov (United States)

    Jia, Di; Li, Yanlin; Wang, Guoliang; Gao, Huanyu; Yu, Yang

    2016-01-01

    To conclude the revision reason of unicompartmental knee arthroplasty (UKA) using computer-assisted technology so as to provide reference for reducing the revision incidence and improving the level of surgical technique and rehabilitation. The relevant literature on analyzing revision reason of UKA using computer-assisted technology in recent years was extensively reviewed. The revision reasons by computer-assisted technology are fracture of the medial tibial plateau, progressive osteoarthritis of reserved compartment, dislocation of mobile bearing, prosthesis loosening, polyethylene wear, and unexplained persistent pain. Computer-assisted technology can be used to analyze the revision reason of UKA and guide the best operating method and rehabilitation scheme by simulating the operative process and knee joint activities.

  5. Computer-aided cognitive rehabilitation improves cognitive performances and induces brain functional connectivity changes in relapsing remitting multiple sclerosis patients: an exploratory study.

    Science.gov (United States)

    Bonavita, S; Sacco, R; Della Corte, M; Esposito, S; Sparaco, M; d'Ambrosio, A; Docimo, R; Bisecco, A; Lavorgna, L; Corbo, D; Cirillo, S; Gallo, A; Esposito, F; Tedeschi, G

    2015-01-01

    To better understand the effects of short-term computer-based cognitive rehabilitation (cCR) on cognitive performances and default mode network (DMN) intrinsic functional connectivity (FC) in cognitively impaired relapsing remitting (RR) multiple sclerosis (MS) patients. Eighteen cognitively impaired RRMS patients underwent neuropsychological evaluation by the Rao's brief repeatable battery and resting-state functional magnetic resonance imaging to evaluate FC of the DMN before and after a short-term (8 weeks, twice a week) cCR. A control group of 14 cognitively impaired RRMS patients was assigned to an aspecific cognitive training (aCT), and underwent the same study protocol. Correlations between DMN and cognitive performances were also tested. After cCR, there was a significant improvement of the following tests: SDMT (p Color-Word Interference Test and FC in the PCC emerged. After aCT, the control group did not show any significant effect either on FC or neuropsychological tests. No significant differences were found in brain volumes and lesion load in both groups when comparing data acquired at baseline and after cCR or aCT. In cognitively impaired RRMS patients, cCR improves cognitive performances (i.e., processing speed and visual and verbal sustained memory), and increases FC in the PCC and IPC of the DMN. This exploratory study suggests that cCR may induce adaptive cortical reorganization favoring better cognitive performances, thus strengthening the value of cognitive exercise in the general perspective of building either cognitive or brain reserve.

  6. Survey of cognitive rehabilitation practices in the state of Kuwait.

    Science.gov (United States)

    Manee, Fahad S; Nadar, Mohammed Sh; Jassem, Zainab; Chavan, Shashidhar Rao

    2017-03-01

    Background Rehabilitation professionals must be astute at recognizing, assessing, and treating individuals with cognitive deficits. No research is available to examine cognitive rehabilitation practices applied to individuals with neurological conditions in Kuwait. To identify the use of cognitive assessments, the availability of resources, and the barriers to cognitive rehabilitation practices in Kuwait. Methods Face-to-face interviews were conducted with health care professionals working with adult individuals with neurological conditions. These professionals included occupational therapists, speech-language pathologists, psychiatrists, and neurologists. Results The most commonly used cognitive based assessments are MMSE (41%), and MoCA and LOTCA (15.2%). The only clinical assessment used is the Line-Bisection Test (2.2%). The most used occupation-based assessments are FIM (6.5%), COPM (4.3%), the Interest Checklist (2.2%), and the Barthel Index (2.2%). Resources related to cognitive rehabilitation in Kuwait that are unavailable to practitioners include journal clubs (91%), special interest groups (89%), and continuing education programmes (82.6%). Barriers to cognitive rehabilitation practice included lack of sufficient funds for continuing education, lack of time, lack of standardized assessments, and lack of inter-professional teamwork. Conclusion Many adults in Kuwait live with cognitive impairment. There is a need to develop appropriate evidence-based cognitive rehabilitation clinical guidelines in Kuwait.

  7. Cognitive Rehabilitation in Alzheimer's Disease: A Controlled Intervention Trial.

    Science.gov (United States)

    Brueggen, Katharina; Kasper, Elisabeth; Ochmann, Sina; Pfaff, Henrike; Webel, Steffi; Schneider, Wolfgang; Teipel, Stefan

    2017-01-01

    Cognitive Rehabilitation for Alzheimer's disease (AD) is an integrative multimodal intervention. It aims to maintain autonomy and quality of life by enhancing the patients' abilities to compensate for decreased cognitive functioning. We evaluated the feasibility of a group-based Cognitive Rehabilitation approach in mild AD dementia and assessed its effect on activities of daily living (ADL). We included 16 patients with AD dementia in a controlled partial-randomized design. We adapted the manual-guided Cognitive Rehabilitation program (CORDIAL) to a group setting. Over the course of three months, one group received the Cognitive Rehabilitation intervention (n = 8), while the other group received a standardized Cognitive Training as an active control condition (n = 8). ADL-competence was measured as primary outcome. The secondary outcome parameters included cognitive abilities related to daily living, functional cognitive state, and non-cognitive domains, e.g., quality of life. For each scale, we assessed the interaction effect 'intervention by time', i.e., from pre-to post-intervention. We found no significant interaction effect of intervention by time on the primary outcome ADL-competence. The interaction effect was significant for quality of life (Cohen's d: -1.43), showing an increase in the intervention group compared with the control group. Our study demonstrates the feasibility of a group-based Cognitive Rehabilitation program for patients with mild AD dementia. The Cognitive Rehabilitation showed no significant effect on ADL, possibly reflecting a lack of transfer between the therapy setting and real life. However, the group setting enhanced communication skills and coping mechanisms. Effects on ADL may not have reached statistical significance due to a limited sample size. Furthermore, future studies might use an extended duration of the intervention and integrate caregivers to a greater extent to increase transfer to activities of daily living.

  8. National Rehabilitation Hospital Assistive Technology Research Center

    Science.gov (United States)

    1995-10-01

    Shoulder-Arm Orthoses Several years ago, the Rehabilitation Engineering Research Center (RERC) on Rehabilitation Robotics in Delaware1 identified a... exoskeletal applications for persons with disabilities. 2. Create a center of expertise in rehabilitation technology transfer that benefits persons with...AD COOPERATIVE AGREEMENT NUMBER: DAMD17-94-V-4036 TITLE: National Rehabilitation Hospital Assistive Technology- Research Center PRINCIPAL

  9. Technology and its role in rehabilitation for people with cognitive-communication disability following a traumatic brain injury (TBI).

    Science.gov (United States)

    Brunner, Melissa; Hemsley, Bronwyn; Togher, Leanne; Palmer, Stuart

    2017-01-01

    To review the literature on communication technologies in rehabilitation for people with a traumatic brain injury (TBI), and: (a) determine its application to cognitive-communicative rehabilitation, and b) develop a model to guide communication technology use with people after TBI. This integrative literature review of communication technology in TBI rehabilitation and cognitive-communication involved searching nine scientific databases and included 95 studies. Three major types of communication technologies (assistive technology, augmentative and alternative communication technology, and information communication technology) and multiple factors relating to use of technology by or with people after TBI were categorized according to: (i) individual needs, motivations and goals; (ii) individual impairments, activities, participation and environmental factors; and (iii) technologies. While there is substantial research relating to communication technologies and cognitive rehabilitation after TBI, little relates specifically to cognitive-communication rehabilitation. Further investigation is needed into the experiences and views of people with TBI who use communication technologies, to provide the 'user' perspective and influence user-centred design. Research is necessary to investigate the training interventions that address factors fundamental for success, and any impact on communication. The proposed model provides an evidence-based framework for incorporating technology into speech pathology clinical practice and research.

  10. Cognitive rehabilitation: an important tool in disability improvement after brain injuries

    OpenAIRE

    Ioana Stanescu; Gabriela Dogaru

    2016-01-01

    Cognitive rehabilitation is as an important goal of rehabilitation therapy, which aims to help the person with neurological disability to acquire the highest level of cognitive functioning and of functional autonomy. Cognitive impairments in memory, language, judgement, attention, visuo-spatial perception are important blocks in acquiring functional independence. Cognitive rehabilitation therapy is “a systematic, functionally oriented service of therapeutic cognitive activities directed to ...

  11. Residual cognitive disability after completion of inpatient rehabilitation among injured children.

    Science.gov (United States)

    Zonfrillo, Mark R; Durbin, Dennis R; Winston, Flaura K; Zhang, Xuemei; Stineman, Margaret G

    2014-01-01

    To determine the prevalence and nature of residual cognitive disability after inpatient rehabilitation for children aged 7-18 years with traumatic injuries. This retrospective cohort study included children aged 7-18 years in the Uniform Data System for Medical Rehabilitation who underwent inpatient rehabilitation for traumatic injuries in 523 facilities from 2002-2011. Traumatic injuries were identified by standardized Medicare Inpatient Rehabilitation Facility-Patient Assessment Instrument codes. Cognitive outcomes were measured by the Functional Independence Measure instrument. A validated, categorical staging system derived from responses to the items in the cognitive domain of the functional independence measure was used and consisted of clinically relevant levels of cognitive achievement from stage 1 (total cognitive disability) to stage 7 (completely independent cognitive function). There were 13,798 injured children who completed inpatient rehabilitation during the 10-year period. On admission to inpatient rehabilitation, patients with traumatic brain injury (TBI) had more cognitive disability (median stage 2) than those with spinal cord injury or other injuries (median stage 5). Cognitive functioning improved for all patients, but children with TBI still tended to have significant residual cognitive disability (median stage on discharge, 4). Injured children gained cognitive functionality throughout inpatient rehabilitation. Those with TBI had more severe cognitive disability on admission and more residual disability on discharge. This is important not only for patient and family expectation setting but also for resource and service planning, as discharge from inpatient rehabilitation is a critical milestone for reintegration into society for children with serious injury. Copyright © 2014 Mosby, Inc. All rights reserved.

  12. An Innovative Solution Based on Human-Computer Interaction to Support Cognitive Rehabilitation

    Directory of Open Access Journals (Sweden)

    José M. Cogollor

    2014-10-01

    Full Text Available This contribution focuses its objective in describing the design and implementation of an innovative system to provide cognitive rehabilitation. People who will take advantage of this platform suffer from a post-stroke disease called Apraxia and Action Disorganisation Syndrome (AADS. The platform has been integrated at Universidad Politécnica de Madrid and tries to reduce the stay in hospital or rehabilitation center by supporting self-rehabilitation at home. So, the system acts as an intelligent machine which guides patients while executing Activities of Daily Living (ADL, such as preparing a simple tea, by informing them about the errors committed and possible actions to correct them. A short introduction to other works related to stroke, patients to work with, how the system works and how it is implemented are provided in the document. Finally, some relevant information from experiment made with healthy people for technical validation is also shown.

  13. Cognitive rehabilitation for attention deficits following stroke.

    Science.gov (United States)

    Loetscher, Tobias; Lincoln, Nadina B

    2013-05-31

    Many survivors of stroke complain about attentional impairments, such as diminished concentration and mental slowness. However, the effectiveness of cognitive rehabilitation for improving these impairments is uncertain. To determine whether (1) people receiving attentional treatment show better outcomes in their attentional functions than those given no treatment or treatment as usual, and (2) people receiving attentional treatment techniques have a better functional recovery, in terms of independence in activities of daily living, mood and quality of life, than those given no treatment or treatment as usual. We searched the Cochrane Stroke Group Trials Register (October 2012), Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library October 2012), MEDLINE (1948 to October 2012), EMBASE (1947 to October 2012), CINAHL (1981 to October 2012), PsycINFO (1806 to October 2012), PsycBITE and REHABDATA (searched October 2012) and ongoing trials registers. We screened reference lists and tracked citations using Scopus. We included randomised controlled trials (RCTs) of cognitive rehabilitation for impairments of attention for people with stroke. The primary outcome was measures of global attentional functions, and secondary outcomes were measures of attention domains, functional abilities, mood and quality of life. Two review authors independently selected trials, extracted data and assessed trial quality. We included six RCTs with 223 participants. All six RCTs compared cognitive rehabilitation with a usual care control. Meta-analyses demonstrated no statistically significant effect of cognitive rehabilitation for persisting effects on global measures of attention (two studies, 99 participants; standardised mean difference (SMD) 0.16, 95% confidence interval (CI) -0.23 to 0.56; P value = 0.41), standardised attention assessments (two studies, 99 participants; P value ≥ 0.08) or functional outcomes (two studies, 99 participants; P value ≥ 0

  14. Cognitive Rehabilitation for Executive Dysfunction in Parkinson's Disease: Application and Current Directions

    Directory of Open Access Journals (Sweden)

    Jessica Calleo

    2012-01-01

    Full Text Available Cognitive dysfunction in Parkinson's disease contributes to disability, caregiver strain, and diminished quality of life. Cognitive rehabilitation, a behavioral approach to improve cognitive skills, has potential as a treatment option to improve and maintain cognitive skills and increase quality of life for those with Parkinson's disease-related cognitive dysfunction. Four cognitive rehabilitation programs in individuals with PD are identified from the literature. Characteristics of the programs and outcomes are reviewed and critiqued. Current studies on cognitive rehabilitation in PD demonstrate feasibility and acceptability of a cognitive rehabilitation program for patients with PD, but are limited by their small sample size and data regarding generalization of effects over the long term. Because PD involves progressive heterogeneous physical, neurological, and affective difficulties, future cognitive rehabilitation programs should aim for flexibility and individualization, according to each patient's strengths and deficits.

  15. Efficient Vocational Skills Training for People with Cognitive Disabilities: An Exploratory Study Comparing Computer-Assisted Instruction to One-on-One Tutoring.

    Science.gov (United States)

    Larson, James R; Juszczak, Andrew; Engel, Kathryn

    2016-03-01

    This study compared the effectiveness of computer-assisted instruction to that of one-on-one tutoring for teaching people with mild and moderate cognitive disabilities when both training methods are designed to take account of the specific mental deficits most commonly found in cognitive disability populations. Fifteen participants (age 22-71) received either computer-assisted instruction or one-on-one tutoring in three content domains that were of functional and daily relevance to them: behavioural limits, rights and responsibilities (two modules) and alphabetical sorting. Learning was assessed by means of a series of pretests and four learning cycle post-tests. Both instructional conditions maintained time-on-task and teaching material equivalence, and both incorporated a set of best-practices and empirically supported teaching techniques designed to address attentional deficits, stimulus processing inefficiencies and cognitive load limitations. Strong evidence of learning was found in both instructional method conditions. Moreover, in all content domains the two methods yielded approximately equivalent rates of learning and learning attainment. These findings offer tentative evidence that a repetitive, computer-assisted training program can produce learning outcomes in people with mild and moderate cognitive disabilities that are comparable to those achieved by high-quality one-on-one tutoring. © 2015 John Wiley & Sons Ltd.

  16. A Game System for Cognitive Rehabilitation

    Directory of Open Access Journals (Sweden)

    Azrulhizam Shapi’i

    2015-01-01

    Full Text Available Brain injury such as traumatic brain injury (TBI and stroke is the major cause of long-term disabilities in many countries. The increasing rate of brain damaged victims and the heterogeneity of impairments decrease rehabilitation effectiveness and competence resulting in higher cost of rehabilitation treatment. On the other hand, traditional rehabilitation exercises are boring, thus leading patients to neglect the prescribed exercises required for recovery. Therefore, we propose game-based approach to address these problems. This paper presents a rehabilitation gaming system (RGS for cognitive rehabilitation. The RGS is developed based on a proposed conceptual framework which has also been presented in this paper.

  17. Enhanced Cognitive Rehabilitation to Treat Comorbid TBI and PTSD

    Science.gov (United States)

    2017-12-01

    PTSD in which CPT is interwoven with compensatory cognitive rehabilitation principles (CogSMART) to create a hybrid treatment, SMART-CPT. The...symptoms resulting from mild to moderate TBI. These practice standards have been organized into a manualized treatment, Cognitive Symptom Management ...tested a modification of CPT in which CPT was enhanced with compensatory cognitive rehabilitation principles detailed in CogSMART. The enhanced CPT

  18. Assistive and Rehabilitation Robotic System

    Directory of Open Access Journals (Sweden)

    Adrian Abrudean

    2015-06-01

    Full Text Available A short introduction concerning the content of Assistive Technology and Rehabilitation Engineering is followed by a study of robotic systems which combine two or more assistive functions. Based on biomechanical aspects, a complex robotic system is presented, starting with the study of functionality and ending with the practical aspects of the prototype development.

  19. Cognitive rehabilitation in multiple sclerosis: A systematic review.

    Science.gov (United States)

    Mitolo, Micaela; Venneri, Annalena; Wilkinson, Iain D; Sharrack, Basil

    2015-07-15

    Cognitive impairment is a common clinical feature of multiple sclerosis (MS) at both the earlier and later stages of the disease, and has a significant impact on patients' functional status and quality of life. The need to address this deficit should be taken into account in clinical practice and research studies. To conduct an updated systematic review of all published studies of cognitive rehabilitation interventions in people with MS, including studies with methodological shortcomings, to highlight major strengths and weaknesses in the field and to provide directions for future research. We searched electronic databases (PubMed and Web of Science) for articles published in English up until January 2014. The reference lists of all identified articles were also searched to complete the initial list of references. Articles were categorized into outcome measures: cognition, imaging, mood, fatigue, quality of life and self-perceived cognitive deficits. All articles were reviewed independently and assessed according to predetermined criteria. A total of 33 studies met the inclusion criteria of which 4 were of Level II-1 and none was Level I. Although the majority of these studies reported some improvements in cognitive abilities (N=31), the evidence which has been reported in the literature remains inconclusive and no definite conclusions can be drawn about the effect of different types of interventions on cognitive rehabilitation outcomes (recommendation C). This review identified conflicting findings in the published literature about the effectiveness of various forms of cognitive rehabilitation techniques used in patients with MS. Studies with more rigorous methodology are therefore needed to clarify which form of cognitive rehabilitation may lead to greater clinical improvement. Copyright © 2015 Elsevier B.V. All rights reserved.

  20. Home and family in cognitive rehabilitation after brain injury

    DEFF Research Database (Denmark)

    Mogensen, Jesper; Wulf-Andersen, Camilla

    2017-01-01

    The focus of the present article is the home and family environment of patients suffering acquired brain injury. In order to obtain the optimal outcome of posttraumatic cognitive rehabilitation it is important (a) to obtain a sufficient intensity of rehabilitative training, (b) to achieve...... the maximum degree of generalization from formalized training to the daily environment of the patient, and (c) to obtain the best possible utilization of “cognitive reserves” in the form of cognitive abilities and “strategies” acquired pretraumatically. Supplementing the institution-based cognitive training...

  1. A Serious Games Platform for Cognitive Rehabilitation with Preliminary Evaluation.

    Science.gov (United States)

    Rego, Paula Alexandra; Rocha, Rui; Faria, Brígida Mónica; Reis, Luís Paulo; Moreira, Pedro Miguel

    2017-01-01

    In recent years Serious Games have evolved substantially, solving problems in diverse areas. In particular, in Cognitive Rehabilitation, Serious Games assume a relevant role. Traditional cognitive therapies are often considered repetitive and discouraging for patients and Serious Games can be used to create more dynamic rehabilitation processes, holding patients' attention throughout the process and motivating them during their road to recovery. This paper reviews Serious Games and user interfaces in rehabilitation area and details a Serious Games platform for Cognitive Rehabilitation that includes a set of features such as: natural and multimodal user interfaces and social features (competition, collaboration, and handicapping) which can contribute to augment the motivation of patients during the rehabilitation process. The web platform was tested with healthy subjects. Results of this preliminary evaluation show the motivation and the interest of the participants by playing the games.

  2. Cognitive Rehabilitation for Attention and Memory in people with Multiple Sclerosis: study protocol for a randomised controlled trial (CRAMMS).

    Science.gov (United States)

    Lincoln, Nadina B; das Nair, Roshan; Bradshaw, Lucy; Constantinescu, Cris S; Drummond, Avril E R; Erven, Alexandra; Evans, Amy L; Fitzsimmons, Deborah; Montgomery, Alan A; Morgan, Miriam

    2015-12-08

    People with multiple sclerosis have problems with memory and attention. Cognitive rehabilitation is a structured set of therapeutic activities designed to retrain an individual's memory and other cognitive functions. Cognitive rehabilitation may be provided to teach people strategies to cope with these problems, in order to reduce the impact on everyday life. The effectiveness of cognitive rehabilitation for people with multiple sclerosis has not been established. This is a multi-centre, randomised controlled trial investigating the clinical and cost-effectiveness of a group-based cognitive rehabilitation programme for attention and memory problems for people with multiple sclerosis. Four hundred people with multiple sclerosis will be randomised from at least four centres. Participants will be eligible if they have memory problems, are 18 to 69 years of age, are able to travel to attend group sessions and give informed consent. Participants will be randomised in a ratio of 6:5 to the group rehabilitation intervention plus usual care or usual care alone. Intervention groups will receive 10 weekly sessions of a manualised cognitive rehabilitation programme. The intervention will include both restitution strategies to retrain impaired attention and memory functions and compensation strategies to enable participants to cope with their cognitive problems. All participants will receive a follow-up questionnaire and an assessment by a research assistant at 6 and 12 months after randomisation. The primary outcome is the Multiple Sclerosis Impact Scale (MSIS) Psychological subscale at 12 months. Secondary outcomes include the Everyday Memory Questionnaire, General Health Questionnaire-30, EQ-5D and a service use questionnaire from participants, and the Everyday Memory Questionnaire-relative version and Carer Strain Index from a relative or friend. The primary analysis will be based on intention to treat. A mixed-model regression analysis of the MSIS Psychological

  3. Efficacy of a Multimodal Cognitive Rehabilitation Including Psychomotor and Endurance Training in Parkinson's Disease

    Directory of Open Access Journals (Sweden)

    I. Reuter

    2012-01-01

    Full Text Available Mild cognitive impairment, especially executive dysfunction might occur early in the course of Parkinson's disease. Cognitive training is thought to improve cognitive performance. However, transfer of improvements achieved in paper and pencil tests into daily life has been difficult. The aim of the current study was to investigate whether a multimodal cognitive rehabilitation programme including physical exercises might be more successful than cognitive training programmes without motor training. 240 PD-patients were included in the study and randomly allocated to three treatment arms, group A cognitive training, group B cognitive training and transfer training and group C cognitive training, transfer training and psychomotor and endurance training. The primary outcome measure was the ADAS-Cog. The secondary outcome measure was the SCOPA-Cog. Training was conducted for 4 weeks on a rehabilitation unit, followed by 6 months training at home. Caregivers received an education programme. The combination of cognitive training using paper and pencil and the computer, transfer training and physical training seems to have the greatest effect on cognitive function. Thus, patients of group C showed the greatest improvement on the ADAS-Cog and SCOPA-COG and were more likely to continue with the training programme after the study.

  4. Assisting the rehabilitation by hi-tech

    Directory of Open Access Journals (Sweden)

    Mateusz Tomanek

    2017-03-01

    Full Text Available High-tech, which the use is becoming increasingly popular in medicine, media and education has several advantages as increasing the number of persons to whom these services can hit. Example of such activities is the use of videoconference during rehabilitation, where patients perform basic exercises at home, and physiotherapist could control the movement by on-line video. The use of modern technology is only assisting the rehabilitation, rather than a complete replacement. As the purpose of the article was adopted to show the range of possibilities for the use of high-tech in rehabilitation.

  5. From ancient Greece to the cognitive revolution: A comprehensive view of physical rehabilitation sciences.

    Science.gov (United States)

    Martínez-Pernía, David; González-Castán, Óscar; Huepe, David

    2017-02-01

    The development of rehabilitation has traditionally focused on measurements of motor disorders and measurements of the improvements produced during the therapeutic process; however, physical rehabilitation sciences have not focused on understanding the philosophical and scientific principles in clinical intervention and how they are interrelated. The main aim of this paper is to explain the foundation stones of the disciplines of physical therapy, occupational therapy, and speech/language therapy in recovery from motor disorder. To reach our goals, the mechanistic view and how it is integrated into physical rehabilitation will first be explained. Next, a classification into mechanistic therapy based on an old version (automaton model) and a technological version (cyborg model) will be shown. Then, it will be shown how physical rehabilitation sciences found a new perspective in motor recovery, which is based on functionalism, during the cognitive revolution in the 1960s. Through this cognitive theory, physical rehabilitation incorporated into motor recovery of those therapeutic strategies that solicit the activation of the brain and/or symbolic processing; aspects that were not taken into account in mechanistic therapy. In addition, a classification into functionalist rehabilitation based on a computational therapy and a brain therapy will be shown. At the end of the article, the methodological principles in physical rehabilitation sciences will be explained. It will allow us to go deeper into the differences and similarities between therapeutic mechanism and therapeutic functionalism.

  6. The Use of Computer-Assisted Home Exercises to Preserve Physical Function after a Vestibular Rehabilitation Program: A Randomized Controlled Study

    Directory of Open Access Journals (Sweden)

    Michael Smaerup

    2016-01-01

    Full Text Available Objective. The purpose of this study was to evaluate whether elderly patients with vestibular dysfunction are able to preserve physical functional level, reduction in dizziness, and the patient’s quality of life when assistive computer technology is used in comparison with printed instructions. Materials and Methods. Single-blind, randomized, controlled follow-up study. Fifty-seven elderly patients with chronic dizziness were randomly assigned to a computer-assisted home exercise program or to home exercises as described in printed instructions and followed for tree month after discharge from an outpatient clinic. Results. Both groups had maintained their high functional levels three months after finishing the outpatient rehabilitation. No statistically significant difference was found in outcome scores between the two groups. In spite of moderate compliance levels, the patients maintained their high functional level indicating that the elderly should not necessarily exercise for the first three months after termination of the training in the outpatient clinic. Conclusion. Elderly vestibular dysfunction patients exercising at home seem to maintain their functional level, level of dizziness, and quality of life three months following discharge from hospital. In this specific setup, no greater effect was found by introducing a computer-assisted training program, when compared to standard home training guided by printed instructions. This trial is registered with NCT01344408.

  7. Computer-assisted cognitive behavioral therapy for children with epilepsy and anxiety: a pilot study.

    Science.gov (United States)

    Blocher, Jacquelyn B; Fujikawa, Mayu; Sung, Connie; Jackson, Daren C; Jones, Jana E

    2013-04-01

    Anxiety disorders are prevalent in children with epilepsy. The purpose of this study was to evaluate the efficacy, adaptability, and feasibility of a manual-based, computer-assisted cognitive behavioral therapy (CBT) intervention for anxiety disorders in children with epilepsy. Fifteen anxious youth (aged 8-13 years) with epilepsy completed 12 weeks of manualized computer-assisted CBT. The children and parents completed a semi-structured interview at baseline, and questionnaires assessing symptoms of anxiety, depression, and behavior problems were completed prior to treatment, at treatment midpoint, after treatment completion, and at three months posttreatment. There were significant reductions in the symptoms of anxiety and depression reported by the children at completion of the intervention and at the three-month follow-up. Similarly, the parents reported fewer symptoms of anxiety and a reduction in behavior problems. No adverse events were reported. This CBT intervention for children with epilepsy and anxiety disorders appears to be safe, effective, and feasible and should be incorporated into future intervention studies. Copyright © 2012 Elsevier Inc. All rights reserved.

  8. Current status of robotic stroke rehabilitation and opportunities for a cyber-physically assisted upper limb stroke rehabilitation

    NARCIS (Netherlands)

    Li, C.; Rusak, Z.; Horvath, I.; Ji, L.; Hou, Y.

    2014-01-01

    In the last two decades, robotics-assisted stroke reha-bilitation has been wide-spread, in particular for movement rehabilitation of upper limbs. Several studies have reported on the clinical effectiveness of this kind of therapy. The results of these studies show that robot assisted therapy can be

  9. Perspectives for cognitive rehabilitation of patients with diabetes mellitus

    Directory of Open Access Journals (Sweden)

    Mariia Matveeva

    2016-12-01

    Full Text Available Currently, the problem of cognitive dysfunction is becoming increasingly important due to the raising demand for effective intellectual activity in modern society. One of the most significant causes of cognitive dysfunction is dismetabolic nature of the disorder, such as diabetes mellitus, which has recently been gaining prevalence. Much of the resistance of clinical symptoms of diabetic encephalopathy to conventional therapy requires a search for new approaches for solving this problem. Cognitive rehabilitation as a correctional technique has proved a positive effect in terms of the treatment of neurodegenerative diseases of different nature.This review present the ways for correction of cognitive impairment using the method of cognitive rehabilitation in patients with diabetes, its methodology, mechanisms of action and perspectives.

  10. Efficacy of a short cognitive training program in patients with multiple sclerosis

    Directory of Open Access Journals (Sweden)

    Pérez-Martín MY

    2017-02-01

    Full Text Available María Yaiza Pérez-Martín,1 Montserrat González-Platas,1 Pablo Eguía-del Río,2 Cristina Croissier-Elías,1 Alejandro Jiménez Sosa3 1Service of Neurology, Complejo Hospitalario Universitario de Canarias, La Laguna, 2Service of Neurology, Doctor José Molina Orosa Hospital, Arrecife, Lanzarote, 3Unit of Research, Complejo Hospitalario Universitario de Canarias, La Laguna, Spain Background: Cognitive impairment is a common feature in multiple sclerosis (MS and may have a substantial impact on quality of life. Evidence about the effectiveness of neuropsychological rehabilitation is still limited, but current data suggest that computer-assisted cognitive training improves cognitive performance.Objective: The objective of this study was to evaluate the efficacy of combined computer-assisted training supported by home-based neuropsychological training to improve attention, processing speed, memory and executive functions during 3 consecutive months.Methods: In this randomized controlled study blinded for the evaluators, 62 MS patients with clinically stable disease and mild-to-moderate levels of cognitive impairment were randomized to receive a computer-assisted neuropsychological training program (n=30 or no intervention (control group [CG]; n=32. The cognitive assessment included the Brief Repeatable Battery of Neuropsychological Test. Other secondary measures included subjective cognitive impairment, anxiety and depression, fatigue and quality of life measures.Results: The treatment group (TG showed significant improvements in measures of verbal memory, working memory and phonetic fluency after intervention, and repeated measures analysis of covariance revealed a positive effect in most of the functions. The control group (CG did not show changes. The TG showed a significant reduction in anxiety symptoms and significant improvement in quality of life. There were no improvements in fatigue levels and depressive symptoms.Conclusion: Cognitive

  11. Pediatric cognitive rehabilitation: effective treatments in a school-based environment.

    Science.gov (United States)

    Shaw, Dorothy R

    2014-01-01

    Many studies have investigated the impact of pediatric Cognitive Rehabilitation Therapy (CRT) upon intellectual functioning after traumatic brain injury; however, relatively few have identified efficacious treatment in a school setting. The purpose is to present a variety of CRT strategies that would be useful to a teacher or therapist working with students who are learning disabled or who have who have had a traumatic brain injury (TBI). This article investigates the particular challenges in learning which result from impaired cognition, and suggests techniques for improving memory and executive functioning. Students who are learning disabled or who have TBI face social and emotional issues that impact their learning. Special therapeutic interventions are necessary to assist with orienting to their setting, integrating with peers, and coping with distressing emotions. Students with TBI can adapt and flourish in a school based setting provided that therapies and learned strategies are targeted to their specific needs.

  12. Effectiveness of the second-stage rehabilitation in stroke patients with cognitive impairment.

    Science.gov (United States)

    Milinavičienė, Eglė; Rastenytė, Daiva; Kriščiūnas, Aleksandras

    2011-01-01

    The aim of this study was to evaluate the recovery of functional status and effectiveness of the second-stage rehabilitation depending on the degree of cognitive impairment in stroke patients. The study sample comprised 226 stroke patients at the Viršužiglis Hospital of rehabilitation, Hospital of Lithuanian University of Health Sciences. Functional status was evaluated with the Functional Independence Measure, cognitive function with the Mini-Mental Status Examination scale, and severity of neurologic condition with the National Institutes of Health Stroke Scale. The patients were divided into 4 study groups based on cognitive impairment: severe, moderate, mild, or no impairment. More than half (53%) of all cases were found to have cognitive impairment, while patients with different degree of cognitive impairment were equally distributed: mild impairment (18%), moderate impairment (17%), and severe impairment (18%). Improvement of functional status was observed in all study groups (Prehabilitation of stroke patients, functional status as well as cognitive and motor skills were improved both in patients with and without cognitive impairment; however, the patients who were diagnosed with severe or moderate cognitive impairment at the beginning of second-stage rehabilitation showed worse neurological and functional status during the whole second-stage rehabilitation than the patients with mild or no cognitive impairment.

  13. The acceptance of virtual reality devices for cognitive rehabilitation: a report of positive results with schizophrenia.

    Science.gov (United States)

    da Costa, Rosa Maria Esteves Moreira; de Carvalho, Luís Alfredo Vidal

    2004-03-01

    This study presents a process of virtual environment development supported by a cognitive model that is specific to cognitive deficits of diverse disorders or traumatic brain injury, and evaluates the acceptance of computer devices by a group of schizophrenic patients. The subjects that participated in this experiment accepted to work with computers and immersive glasses and demonstrated a high level of interest in the proposed tasks. No problems of illness have been observed. This experiment indicated that further research projects must be carried out to verify the value of virtual reality technology for cognitive rehabilitation of psychiatric patients. The results of the current study represent a small but necessary step in the realization of that potential.

  14. Integrated cognitive remediation and standard rehabilitation therapy in patients of schizophrenia: persistence after 5years.

    Science.gov (United States)

    Buonocore, Mariachiara; Spangaro, Marco; Bechi, Margherita; Baraldi, Maria Alice; Cocchi, Federica; Guglielmino, Carmelo; Bianchi, Laura; Mastromatteo, Antonella; Bosia, Marta; Cavallaro, Roberto

    2018-02-01

    Cognitive remediation, often used in combination with standard rehabilitation programs, represents the best available tool to treat cognitive impairments in patients with schizophrenia. However, there are still open questions about durability of effects and generalization of cognitive improvements to functional outcome. This study aims to investigate the persistence of both cognitive and functional effects of combined cognitive remediation plus standard rehabilitation interventions, 5years after completion of the intervention, also comparing different durations of the standard rehabilitation. Sixty patients diagnosed with schizophrenia and previously treated with a 6months intervention, consisting of standard rehabilitation plus 3-months of cognitive remediation, either followed by another year of standard rehabilitation or routine psychiatric treatment, were reassessed with neuropsychological and functional measures 5years after the intervention. Results show that cognitive abilities remained stable after 5years in both groups, while functional performance significantly decreased in patients treated with the 6months intervention only. Data thus suggest that cognitive effects persist even after 5years, while a longer standard rehabilitation following the cognitive remediation program may be needed to achieve a stable functional gain. Copyright © 2017 Elsevier B.V. All rights reserved.

  15. [User friendliness of computer-based cognitive training for psychogeriatric patients with mild to moderate cognitive impairments].

    Science.gov (United States)

    van der Ploeg, Eva S; Hoorweg, Angela; van der Lee, Jacqueline

    2016-04-01

    Cognitive impairment associated with dementia is characterized by a continuous decline. Cognitive training is a method to train specific brain functions such as memory and attention to prevent or slow down cognitive decline. A small number of studies has shown that cognitive training on a computer has a positive effect on both cognition and mood in people with cognitive impairment. This pilot study tested if serious games could be integrated in a psychogeriatric rehabilitation center. Fourteen psychogeriatric patients participated twice weekly in cognitive training sessions on a computer. Both the participants and the facilitator reported positive interactions and outcomes. However, after five weeks only half of the sample still participated in the training. This was partly because of patient turn-over as well as incorporating this new task in the facilitators' daily work. Fear of failure, physical limitations and rapidly decreasing cognitive function led to drop out according to the facilitator. The engagement of patients in the games and the role of the facilitator seemed essential for success, especially monitoring (and adjusting) the difficulty level of the program for every individual participant.

  16. Investigating therapists’ intention to use serious games for acquired brain injury cognitive rehabilitation

    Directory of Open Access Journals (Sweden)

    Ahmed Mohammed Elaklouk

    2015-04-01

    Full Text Available Acquired brain injury is one cause of long-term disability. Serious games can assist in cognitive rehabilitation. However, therapists’ perception and feedback will determine game adoption. The objective of this study is to investigate therapists’ intention to use serious games for cognitive rehabilitation and identify underlying factors that may affect their acceptance. The respondents are 41 therapists who evaluated a “Ship Game” prototype. Data were collected using survey questionnaire and interview. A seven-point Likert scale was used for items in the questionnaire ranging from (1 “strongly disagree” to (7 “strongly agree”. Results indicate that the game is easy to use (Mean = 5.83, useful (Mean = 5.62, and enjoyable (Mean = 5.90. However intention to use is slightly low (Mean = 4.60. Significant factors that can affect therapists’ intention to use the game were gathered from interviews. Game-based intervention should reflect therapists’ needs in order to achieve various rehabilitation goals, providing suitable and meaningful training. Hence, facilities to tailor the game to the patient’s ability, needs and constraints are important factors that can increase therapists’ intention to use and help to deliver game experience that can motivate patients to undergo the practices needed. Moreover, therapists’ supervision, database functionality and quantitative measures regarding a patient’s progress also represent crucial factors.

  17. Cognitive rehabilitation for elderly people with early-stage Alzheimer?s disease

    OpenAIRE

    Kim, Seyun

    2015-01-01

    [Purpose] The purpose of this study was to investigate the effect of cognitive rehabilitation including tasks of cognitive training on performance of everyday activities in elderly people with early-stage Alzheimer?s disease. [Subjects and Methods] Forty-three elderly people (15 men, 28 women) with a diagnosis of Alzheimer?s disease who had a Mini-Mental State Examination (MMSE) score of 18 or above were randomly assigned to two groups: the cognitive rehabilitation group (experimental) and co...

  18. The feasibility of meta-cognitive strategy training in acute inpatient stroke rehabilitation: case report.

    Science.gov (United States)

    Skidmore, Elizabeth R; Holm, Margo B; Whyte, Ellen M; Dew, Mary Amanda; Dawson, Deirdre; Becker, James T

    2011-04-01

    Meta-cognitive strategy training may be used to augment inpatient rehabilitation to promote active engagement and subsequent benefit for individuals with cognitive impairments after stroke. We examined the feasibility of administering a form of meta-cognitive strategy training, Cognitive Orientation to daily Occupational Performance (CO-OP), during inpatient rehabilitation. We trained an individual with cognitive impairments after right hemisphere stroke to identify performance problems, set self-selected goals, develop plans to address goals, and evaluate performance improvements. To assess feasibility, we examined the number of meta-cognitive training sessions attended, the number of self-selected goals, and changes in goal-related performance. We also examined changes in rehabilitation engagement and disability. The participant used the meta-cognitive strategy to set eight goals addressing physically oriented, instrumental, and work-related activities. Mean improvement in Canadian Occupational Performance Measure Performance Scale scores was 6.1. Pittsburgh Rehabilitation Participation Scale scores (measuring rehabilitation engagement) improved from 3.2 at admission to 4.9 at discharge. Functional Independence Measure scores (measuring disability) improved from 68 at admission, to 97 at discharge. Performance Assessment of Self-Care Skills scores improved from 1.1 at admission to 2.9 at discharge. The results indicate that meta-cognitive strategy training was feasible during inpatient rehabilitation and warrants further evaluation to determine its effectiveness.

  19. Cognitive and social cognitive predictors of change in objective versus subjective quality-of-life in rehabilitation for schizophrenia.

    Science.gov (United States)

    Kurtz, Matthew M; Bronfeld, Melanie; Rose, Jennifer

    2012-12-30

    A small but growing body of work has studied the role of cognitive skills in predicting response to integrated programs of rehabilitation in schizophrenia. No studies however, have directly compared the roles and interrelationships of cognition, social cognition and other disease factors in predicting improvements in the separate domains of objective quality-of-life (QOL) and subjective satisfaction with life (SWL) in response to rehabilitation in schizophrenia. Forty-four outpatients with schizophrenia were administered measures of cognition, social cognition, and symptoms at entry to a psychosocial and cognitive rehabilitation program. Change in objective QOL and subjective SWL before and after treatment were measured as outcome variables. Cognitive measures of verbal memory and social cognitive measures of facial affect recognition were linked to improvements in objective QOL, while verbal memory and crystallized verbal skill was linked to improvements in SWL. Facial affect recognition partially mediated the relationship between verbal memory and improvements in objective QOL. The implications of these findings for understanding interrelationships between cognition and social cognition and their role in predicting change in different domains of outcome as a function of behavioral treatment are discussed. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  20. Combination benefit of cognitive rehabilitation plus donepezil for Alzheimer's disease patients.

    Science.gov (United States)

    Matsuzono, Kosuke; Hishikawa, Nozomi; Takao, Yoshiki; Wakutani, Yosuke; Yamashita, Toru; Deguchi, Kentaro; Abe, Koji

    2016-02-01

    Alzheimer's disease (AD) is one of the most important diseases in aging society, and non-drug therapy might be an alternative therapeutic approach. Thus, we evaluated the add-on effect of cognitive rehabilitation on AD patients under donepezil treatment. We retrospectively analyzed 55 AD patients with a Mini-Mental State Examination score of 15-25, dividing them into two groups depending on whether they were receiving ambulatory cognitive rehabilitation (group D + R, n = 32) or not (group D, n = 23) in Kurashiki Heisei Hospital over 1 year. The present cognitive rehabilitation included physical therapy, occupational therapy and speech therapy for 1-2 h once or twice a week. Between group D and group D + R, there was no significant difference in baseline data, such as age, Mini-Mental State Examination score, periventricular hyperintensity on magnetic resonance imaging, deep white matter hyperintensity on magnetic resonance imaging or donepezil dose (4.1 mg/day). At 1 year later, however, the Mini-Mental State Examination score improved only in group D + R from 21.7 to 24.0 (**P cognitive rehabilitation plus a choline esterase inhibitor donepezil showed a better effect for the cognitive function of AD patients than drug only therapy at 1 year. © 2015 Japan Geriatrics Society.

  1. Computer- and Suggestion-based Cognitive Rehabilitation following Acquired Brain Injury

    DEFF Research Database (Denmark)

    Lindeløv, Jonas Kristoffer

    . That is, training does not cause cognitive transfer and thus does not constitute “brain training” or “brain exercise” of any clinical relevance. A larger study found more promising results for a suggestion-based treatment in a hypnotic procedure. Patients improved to above population average in a matter...... of 4-8 hours, making this by far the most effective treatment compared to computer-based training, physical exercise, phamaceuticals, meditation, and attention process training. The contrast between computer-based methods and the hypnotic suggestion treatment may be reflect a more general discrepancy...

  2. Basal ganglia and beyond: The interplay between motor and cognitive aspects in Parkinson's disease rehabilitation.

    Science.gov (United States)

    Ferrazzoli, Davide; Ortelli, Paola; Madeo, Graziella; Giladi, Nir; Petzinger, Giselle M; Frazzitta, Giuseppe

    2018-07-01

    Parkinson's disease (PD) is characterized by motor and cognitive dysfunctions, affecting the motor behaviour. We summarize evidence that the interplay between motor and cognitive approaches is crucial in PD rehabilitation. Rehabilitation is complementary to pharmacological therapy and effective in reducing the PD disturbances, probably acting by inducing neuroplastic effects. The motor behaviour results from a complex integration between cortical and subcortical areas, underlying the motor, cognitive and motivational aspects of movement. The close interplay amongst these areas makes possible to learn, control and express habitual-automatic actions, which are dysfunctional in PD. The physiopathology of PD could be considered the base for the development of effective rehabilitation treatments. As the volitional action control is spared in early-medium stages of disease, rehabilitative approaches engaging cognition permit to achieve motor benefits and appear to be the most effective for PD. We will point out data supporting the relevance of targeting both motor and cognitive aspects in PD rehabilitation. Finally, we will discuss the role of cognitive engagement in motor rehabilitation for PD. Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

  3. Cognitive rehabilitation of attention and memory in depression

    OpenAIRE

    Richa Priyamvada; Rupesh Ranjan; Suprakash Chaudhury

    2015-01-01

    Background: Cognitive deficits are an important component of depression and may remain impaired after recovery from depression. Objectives: To evaluate the efficacy of cognitive rehabilitation in depression on cognitive dysfunction in the area of attention and memory. Materials and Methods: The study was hospital based pre- and post-intervention with follow-up assessment design. Selection of the depressive patients was by purposive sampling. The sample size consists of 30 intervention depress...

  4. Cognitive rehabilitation in neuro-oncological patients: three case reports

    Directory of Open Access Journals (Sweden)

    Chiara Zucchella

    2012-06-01

    Full Text Available Cognitive impairment is one of the most common neurological disorders in neuro-oncological patients, linked with morbidity, disability, and poor quality of life. As pharmacologic interventions have not yet proven effective in the treatment of cognitive deficits, cognitive rehabilitation could represent an alternative approach. This paper presents three case studies, describing the cognitive intervention and discussing its effectiveness in the light of current evidence.

  5. Family and home in cognitive rehabilitation after brain injury

    DEFF Research Database (Denmark)

    Wulf-Andersen, Camilla; Mogensen, Jesper

    2017-01-01

    Acquired brain injury (ABI) severely affects both the injured patient and her/his family. This fact alone calls for a therapeutic approach addressing not only the individual victim of ABI but also her/his family. Additionally, the optimal outcome of posttraumatic cognitive rehabilitation may...... be best obtained by supplementing the institution-based cognitive training with home-based training. Moving cognitive training and other therapeutic interventions into the home environment does, however, constitute an additional challenge to the family structure and psychological wellbeing of all family...... members. We presently argue in favour of an increased utilization of family-based intervention programs for the families of brain injured patients – in general and especially in case of utilization of home-based rehabilitative training....

  6. A feasibility study of group cognitive rehabilitation for cancer survivors: enhancing cognitive function and quality of life.

    Science.gov (United States)

    Schuurs, Alana; Green, Heather J

    2013-05-01

    This research aimed to address the gap in evidence-based treatment available for cancer survivors who are experiencing cognitive dysfunction, through piloting a novel treatment intervention. The overall research question was whether a group cognitive rehabilitation intervention would be feasible for improving cognitive function and quality of life for people who have completed cancer treatment. Three groups of adults were recruited as follows: an intervention group of 23 cancer survivors who completed a 4-week group cognitive rehabilitation treatment, a comparison group of nine cancer survivors, and a community sample of 23 adults who had never experienced cancer. Measures of objective and subjective cognitive function, quality of life, psychosocial distress, and illness perceptions were used. The research design was non-randomised. The results indicated that the intervention was effective in improving overall cognitive function, visuospatial/constructional performance, immediate memory, and delayed memory beyond practice effects alone. It was helpful in reducing participants' perceptions of cognitive impairment and psychosocial distress, as well as promoting social functioning and understanding of cognition. The improvements were maintained at 3 months after the intervention. Participants reported a high level of satisfaction with the treatment. The results provided evidence for the feasibility of a brief group-based cognitive rehabilitation intervention to treat cognitive problems experienced by cancer survivors. Copyright © 2012 John Wiley & Sons, Ltd.

  7. Final priority; Rehabilitation Services Administration--Assistive Technology Alternative Financing Program. Final priority.

    Science.gov (United States)

    2014-08-14

    The Assistant Secretary for Special Education and Rehabilitative Services announces a priority under the Assistive Technology Alternative Financing Program administered by the Rehabilitation Services Administration (RSA). The Assistant Secretary may use this priority for competitions in fiscal year (FY) 2014 and later years. This priority is designed to ensure that the Department funds high-quality assistive technology (AT) alternative financing programs (AFPs) that meet rigorous standards in order to enable individuals with disabilities to access and acquire assistive technology devices and services necessary to achieve education, community living, and employment goals.

  8. Virtual reality and cognitive rehabilitation: a review of current outcome research.

    Science.gov (United States)

    Larson, Eric B; Feigon, Maia; Gagliardo, Pablo; Dvorkin, Assaf Y

    2014-01-01

    Recent advancement in the technology of virtual reality (VR) has allowed improved applications for cognitive rehabilitation. The aim of this review is to facilitate comparisons of therapeutic efficacy of different VR interventions. A systematic approach for the review of VR cognitive rehabilitation outcome research addressed the nature of each sample, treatment apparatus, experimental treatment protocol, control treatment protocol, statistical analysis and results. Using this approach, studies that provide valid evidence of efficacy of VR applications are summarized. Applications that have not yet undergone controlled outcome study but which have promise are introduced. Seventeen studies conducted over the past eight years are reviewed. The few randomized controlled trials that have been completed show that some applications are effective in treating cognitive deficits in people with neurological diagnoses although further study is needed. Innovations requiring further study include the use of enriched virtual environments that provide haptic sensory input in addition to visual and auditory inputs and the use of commercially available gaming systems to provide tele-rehabilitation services. Recommendations are offered to improve efficacy of rehabilitation, to improve scientific rigor of rehabilitation research and to broaden access to the evidence-based treatments that this research has identified.

  9. Goal-orientated cognitive rehabilitation for dementias associated with Parkinson's disease-A pilot randomised controlled trial.

    Science.gov (United States)

    Hindle, John V; Watermeyer, Tamlyn J; Roberts, Julie; Brand, Andrew; Hoare, Zoe; Martyr, Anthony; Clare, Linda

    2018-05-01

    To examine the appropriateness and feasibility of cognitive rehabilitation for people with dementias associated with Parkinson's in a pilot randomised controlled study. This was a single-blind pilot randomised controlled trial of goal-oriented cognitive rehabilitation for dementias associated with Parkinson's. After goal setting, participants were randomised to cognitive rehabilitation (n = 10), relaxation therapy (n = 10), or treatment-as-usual (n = 9). Primary outcomes were ratings of goal attainment and satisfaction with goal attainment. Secondary outcomes included quality of life, mood, cognition, health status, everyday functioning, and carers' ratings of goal attainment and their own quality of life and stress levels. Assessments were at 2 and 6 months following randomisation. At 2 months, cognitive rehabilitation was superior to treatment-as-usual and relaxation therapy for the primary outcomes of self-rated goal attainment (d = 1.63 and d = 1.82, respectively) and self-rated satisfaction with goal attainment (d = 2.04 and d = 1.84). At 6 months, cognitive rehabilitation remained superior to treatment-as-usual (d = 1.36) and relaxation therapy (d = 1.77) for self-rated goal attainment. Cognitive rehabilitation was superior to treatment as usual and/or relaxation therapy in a number of secondary outcomes at 2 months (mood, self-efficacy, social domain of quality of life, carers' ratings of participants' goal attainment) and at 6 months (delayed recall, health status, quality of life, carer ratings of participants' goal attainment). Carers receiving cognitive rehabilitation reported better quality of life, health status, and lower stress than those allocated to treatment-as-usual. Cognitive rehabilitation is feasible and potentially effective for dementias associated with Parkinson's disease. Copyright © 2018 John Wiley & Sons, Ltd.

  10. Rehabilitation for improved cognition in patients with stress-related exhaustion disorder

    DEFF Research Database (Denmark)

    Malmberg Gavelin, Hanna; Eskilsson, Therese; Boraxbekk, Carl-Johan

    2018-01-01

    Stress-related exhaustion has been associated with selective and enduring cognitive impairments. However, little is known about how to address cognitive deficits in stress rehabilitation and how this influences stress recovery over time. The aim of this open-label, parallel randomized controlled...... trial (ClinicalTrials.gov: NCT03073772) was to investigate the long-term effects of 12 weeks cognitive or aerobic training on cognitive function, psychological health, and work ability for patients diagnosed with exhaustion disorder (ED). One-hundred-and-thirty-two patients (111 women) participating...... in multimodal stress rehabilitation were randomized to receive additional cognitive training (n = 44), additional aerobic training (n = 47), or no additional training (n = 41). Treatment effects were assessed before, immediately after and one-year post intervention. The primary outcome was global cognitive...

  11. Effect of virtual reality on cognitive dysfunction in patients with brain tumor.

    Science.gov (United States)

    Yang, Seoyon; Chun, Min Ho; Son, Yu Ri

    2014-12-01

    To investigate whether virtual reality (VR) training will help the recovery of cognitive function in brain tumor patients. Thirty-eight brain tumor patients (19 men and 19 women) with cognitive impairment recruited for this study were assigned to either VR group (n=19, IREX system) or control group (n=19). Both VR training (30 minutes a day for 3 times a week) and computer-based cognitive rehabilitation program (30 minutes a day for 2 times) for 4 weeks were given to the VR group. The control group was given only the computer-based cognitive rehabilitation program (30 minutes a day for 5 days a week) for 4 weeks. Computerized neuropsychological tests (CNTs), Korean version of Mini-Mental Status Examination (K-MMSE), and Korean version of Modified Barthel Index (K-MBI) were used to evaluate cognitive function and functional status. The VR group showed improvements in the K-MMSE, visual and auditory continuous performance tests (CPTs), forward and backward digit span tests (DSTs), forward and backward visual span test (VSTs), visual and verbal learning tests, Trail Making Test type A (TMT-A), and K-MBI. The VR group showed significantly (p<0.05) better improvements than the control group in visual and auditory CPTs, backward DST and VST, and TMT-A after treatment. VR training can have beneficial effects on cognitive improvement when it is combined with computer-assisted cognitive rehabilitation. Further randomized controlled studies with large samples according to brain tumor type and location are needed to investigate how VR training improves cognitive impairment.

  12. Effectiveness of cognitive behavioural therapy in a community-based pulmonary rehabilitation programme: A controlled clinical trial.

    Science.gov (United States)

    Luk, Edwin K; Gorelik, Alexandra; Irving, Louis; Khan, Fary

    2017-03-06

    To investigate whether the use of cognitive behavioural therapy in pulmonary rehabilitation addresses the depression and anxiety burden and thereby improves rehabilitation outcomes. Prospective controlled clinical trial. A total of 70 patients with chronic obstructive pulmonary disease who were referred to a community centre for pulmonary rehabilitation. Patients were allocated to either the control group, consisting of pulmonary rehabilitation alone, or to the treatment group, receiving pulmonary rehabilitation and an additional 6 sessions of group-based cognitive behavioural therapy. Assessments consisting of questionnaires and walk tests were conducted pre- and post-pulmonary rehabilitation. A total of 28 patients were enrolled. The cognitive behavioural therapy group had significant improvements in exercise capacity following pulmonary rehabilitation (mean change 32.9 m, p = 0.043), which was maintained at 3 months post-pulmonary rehabilitation (mean change 23.4 m, p = 0.045). Patients in the cognitive behavioural therapy group showed significant short-term improvements in fatigue, stress and depression (mean change 2.4, p = 0.016, 3.9, p = 0.024 and 4.3, p = 0.047, respectively) and a 3-month post-pulmonary rehabilitation improvement in anxiety score (mean change 3.1, p = 0.01). No significant changes were seen in the control group. The addition of cognitive behavioural therapy improved patients' physical, psychological and quality of life results. Cognitive behavioural therapy should be considered for inclusion in a pulmonary rehabilitation programme to enhance outcomes.

  13. Symbiotic Cognitive Computing

    OpenAIRE

    Farrell, Robert G.; Lenchner, Jonathan; Kephjart, Jeffrey O.; Webb, Alan M.; Muller, MIchael J.; Erikson, Thomas D.; Melville, David O.; Bellamy, Rachel K.E.; Gruen, Daniel M.; Connell, Jonathan H.; Soroker, Danny; Aaron, Andy; Trewin, Shari M.; Ashoori, Maryam; Ellis, Jason B.

    2016-01-01

    IBM Research is engaged in a research program in symbiotic cognitive computing to investigate how to embed cognitive computing in physical spaces. This article proposes 5 key principles of symbiotic cognitive computing.  We describe how these principles are applied in a particular symbiotic cognitive computing environment and in an illustrative application.  

  14. Efficacy of a short cognitive training program in patients with multiple sclerosis

    Science.gov (United States)

    Pérez-Martín, María Yaiza; González-Platas, Montserrat; Eguía-del Río, Pablo; Croissier-Elías, Cristina; Jiménez Sosa, Alejandro

    2017-01-01

    Background Cognitive impairment is a common feature in multiple sclerosis (MS) and may have a substantial impact on quality of life. Evidence about the effectiveness of neuropsychological rehabilitation is still limited, but current data suggest that computer-assisted cognitive training improves cognitive performance. Objective The objective of this study was to evaluate the efficacy of combined computer-assisted training supported by home-based neuropsychological training to improve attention, processing speed, memory and executive functions during 3 consecutive months. Methods In this randomized controlled study blinded for the evaluators, 62 MS patients with clinically stable disease and mild-to-moderate levels of cognitive impairment were randomized to receive a computer-assisted neuropsychological training program (n=30) or no intervention (control group [CG]; n=32). The cognitive assessment included the Brief Repeatable Battery of Neuropsychological Test. Other secondary measures included subjective cognitive impairment, anxiety and depression, fatigue and quality of life measures. Results The treatment group (TG) showed significant improvements in measures of verbal memory, working memory and phonetic fluency after intervention, and repeated measures analysis of covariance revealed a positive effect in most of the functions. The control group (CG) did not show changes. The TG showed a significant reduction in anxiety symptoms and significant improvement in quality of life. There were no improvements in fatigue levels and depressive symptoms. Conclusion Cognitive intervention with a computer-assisted training supported by home training between face-to-face sessions is a useful tool to treat patients with MS and improve functions such as verbal memory, working memory and phonetic fluency. PMID:28223806

  15. A description of a cognitive rehabilitation programme evaluated in brain tumour patients with mild to moderate cognitive deficits

    NARCIS (Netherlands)

    Gehring, K.; Aaronson, N.K.; Taphoorn, M.J.B.; Sitskoorn, M.M.

    2011-01-01

    This series of articles for rehabilitation in practice aims to cover a knowledge element of the rehabilitation medicine curriculum. Nevertheless they are intended to be of interest to a multidisciplinary audience. The competency addressed in this article is cognitive rehabilitation.Background: There

  16. Content analysis to locate assistive technology in Queensland's motor injury insurance rehabilitation legislation and guidelines.

    Science.gov (United States)

    Steel, Emily J

    2018-06-08

    Reforms to Australia's disability and rehabilitation sectors have espoused the potential of assistive technology as an enabler. As new insurance systems are being developed it is timely to examine the structure of existing systems. This exploratory study examined the policies guiding assistive technology provision in the motor accident insurance sector of one Australian state. Policy documents were analyzed iteratively with set of qualitative questions to understand the intent and interpretation of policies guiding assistive technology provision. Content analysis identified relevant sections and meaningful terminology, and context analysis explored the dominant perspectives informing policy. The concepts and language of assistive technology are not part of the policy frameworks guiding rehabilitation practice in Queensland's motor accident insurance sector. The definition of rehabilitation in the legislation is consistent contemporary international interpretations that focus on optimizing functioning in interaction with the environment. However, the supporting documents are focused on recovery from injuries where decisions are guided by clinical need and affordability. The policies frame rehabilitation in a medical model that assistive technology provision from the rehabilitation plan. The legislative framework provides opportunities to develop and improve assistive technology provision as part of an integrated approach to rehabilitation.

  17. Perceptions of a cognitive rehabilitation group by older people living with cognitive impairment and their caregivers: A qualitative interview study.

    Science.gov (United States)

    Moebs, Isabelle; Gee, Susan; Miyahara, Motohide; Paton, Helen; Croucher, Matthew

    2017-05-01

    Cognitive rehabilitation has been developed to improve quality of life, activities of daily living and mood for people with cognitive impairment, but the voice of people with cognitive impairment has been underrepresented. This study aimed to understand the experience of people living with cognitive impairment, as well as their caregivers who took part in a cognitive rehabilitation intervention programme. Twelve individuals with cognitive impairment and 15 caregivers participated in individual qualitative interviews. The interview data were analysed in three steps: 1) familiarisation of the transcripts; 2) identification of themes; 3) re-interpretation, refinement and integration of themes with methodological auditors. Both participants living with cognitive impairment and caregivers valued the comfortable environment with friendly, caring and supportive group leaders who taught practical tips and strategies. The participants living with cognitive impairment enjoyed socialising with like others. Caregivers benefited from learning about memory problems and sharing their challenges with other caregivers. The participants living with cognitive impairment emphasised the benefits of relational and practical aspects, whereas the caregivers valued the informational and emotional support. In conclusion, both participants living with cognitive impairment and caregivers found the cognitive rehabilitation group useful.

  18. Cognitive rehabilitation training in patients with brain tumor-related epilepsy and cognitive deficits: a pilot study.

    Science.gov (United States)

    Maschio, Marta; Dinapoli, Loredana; Fabi, Alessandra; Giannarelli, Diana; Cantelmi, Tonino

    2015-11-01

    The aim of this pilot observational study was to evaluate effect of cognitive rehabilitation training (RehabTr) on cognitive performances in patients with brain tumor-related epilepsy (BTRE) and cognitive disturbances. Medical inclusion criteria: patients (M/F) ≥ 18 years ≤ 75 with symptomatic seizures due to primary brain tumors or brain metastases in stable treatment with antiepileptic drugs; previous surgical resection or biopsy; >70 Karnofsky Performance Status; stable oncological disease. Eligible patients recruited from 100 consecutive patients with BTRE at first visit to our Center from 2011 to 2012. All recruited patients were administered battery of neuropsychological tests exploring various cognitive domains. Patients considered to have a neuropsychological deficit were those with at least one test score for a given domain indicative of impairment. Thirty patients out of 100 showed cognitive deficits, and were offered participation in RehabTr, of which 16 accepted (5 low grade glioma, 4 high grade glioma, 2 glioblastoma, 2 meningioma and 3 metastases) and 14 declined for various reasons. The RehabTr consisted of one weekly individual session of 1 h, for a total of 10 weeks, carried out by a trained psychologist. The functions trained were: memory, attention, visuo-spatial functions, language and reasoning by means of Training NeuroPsicologico (TNP(®)) software. To evaluate the effect of the RehabTr, the same battery of tests was administered directly after cognitive rehabilitation (T1), and at six-month follow-up (T2). Statistical analysis with Student T test for paired data showed that short-term verbal memory, episodic memory, fluency and long term visuo-spatial memory improved immediately after the T1 and remained stable at T2. At final follow-up all patients showed an improvement in at least one domain that had been lower than normal at baseline. Our results demonstrated a positive effect of rehabilitative training at different times, and, for

  19. Exploring Music-Based Rehabilitation for Parkinsonism through Embodied Cognitive Science

    Science.gov (United States)

    Schiavio, Andrea; Altenmüller, Eckart

    2015-01-01

    Recent embodied approaches in cognitive sciences emphasize the constitutive roles of bodies and environment in driving cognitive processes. Cognition is thus seen as a distributed system based on the continuous interaction of bodies, brains, and environment. These categories, moreover, do not relate only causally, through a sequential input–output network of computations; rather, they are dynamically enfolded in each other, being mutually implemented by the concrete patterns of actions adopted by the cognitive system. However, while this claim has been widely discussed across various disciplines, its relevance and potential beneficial applications for music therapy remain largely unexplored. With this in mind, we provide here an overview of the embodied approaches to cognition, discussing their main tenets through the lenses of music therapy. In doing so, we question established methodological and theoretical paradigms and identify possible novel strategies for intervention. In particular, we refer to the music-based rehabilitative protocols adopted for Parkinson’s disease patients. Indeed, in this context, it has recently been observed that music therapy not only affects movement-related skills but that it also contributes to stabilizing physiological functions and improving socio-affective behaviors. We argue that these phenomena involve previously unconsidered aspects of cognition and (motor) behavior, which are rooted in the action-perception cycle characterizing the whole living system. PMID:26539155

  20. Exploring Music-Based Rehabilitation for Parkinsonism through Embodied Cognitive Science

    Directory of Open Access Journals (Sweden)

    Andrea eSchiavio

    2015-10-01

    Full Text Available Recent embodied approaches in cognitive sciences emphasise the constitutive roles of bodies and environment in driving cognitive processes. Cognition is thus seen as a distributed system based on the continuous interaction of bodies, brains, and environment. These categories, moreover, do not relate only causally, through a sequential input-output network of computations; rather, they are dynamically enfolded in each other, being mutually implemented by the concrete patterns of actions adopted by the cognitive system. However, while this claim has been widely discussed across various disciplines, its relevance and potential beneficial applications for music therapy remain largely unexplored. With this in mind, we provide here an overview of the embodied approaches to cognition, discussing their main tenets through the lenses of music therapy. In doing so we question established methodological and theoretical paradigms and identify possible novel strategies for intervention. In particular, we refer to the music-based rehabilitative protocols adopted for Parkinson’s Disease (PD patients. Indeed, in this context it has recently been observed that music therapy not only affects movement-related skills but that it also contributes to stabilising physiological functions and improving socio-affective behaviours. We argue that these phenomena involve previously unconsidered aspects of cognition and (motor behaviour, which are rooted in the action-perception cycle characterising the whole living system.

  1. Cognitive and affective benefits of combination therapy with galantamine plus cognitive rehabilitation for Alzheimer's disease.

    Science.gov (United States)

    Tokuchi, Ryo; Hishikawa, Nozomi; Matsuzono, Kosuke; Takao, Yoshiki; Wakutani, Yosuke; Sato, Kota; Kono, Syoichiro; Ohta, Yasuyuki; Deguchi, Kentaro; Yamashita, Toru; Abe, Koji

    2016-04-01

    The aim of the present study was to compare the effects of a galantamine only therapy and a combination therapy with galantamine plus ambulatory cognitive rehabilitation for Alzheimer's disease patients. For this retrospective cohort study, we enrolled 86 patients with Alzheimer's disease, dividing them into two groups - a galantamine only group (group G, n = 45) and a combination with galantamine plus ambulatory rehabilitation group (group G + R, n = 41). The present cognitive rehabilitation included a set of physical therapy, occupational therapy and speech therapy for 1-2 h once or twice a week. We compared the Mini-Mental State Examination and Frontal Assessment Battery for cognitive assessment, and Geriatric Depression Scale, Apathy Scale, and Abe's Behavioral and Psychological Symptoms of Dementia score for affective assessment in two groups over 6 months. The baseline Mini-Mental State Examination score was 20.2 and 18.7 in groups G and G + R, respectively. Other baseline data (Frontal Assessment Battery, Geriatric Depression Scale, Apathy Scale, and Abe's Behavioral and Psychological Symptoms of Dementia) were not different between the two groups. Although group G kept all the scores stable until 6 months of the treatment, the Apathy Scale score showed a significant improvement in group G + R as early as 3 months, followed by the Mini-Mental State Examination and Frontal Assessment Battery improvements at 6 months (*P = 0.04 and *P = 0.02, respectively). The Geriatric Depression Scale and Abe's Behavioral and Psychological Symptoms of Dementia did not show any changes. The combination therapy of galantamine plus ambulatory cognitive rehabilitation showed a superior benefit both on cognitive and affective functions than galantamine only therapy in Alzheimer's disease patients. © 2015 Japan Geriatrics Society.

  2. Changes in cognitive functioning in sick-listed participants in occupational rehabilitation: A feasibility study.

    Science.gov (United States)

    Johansen, Thomas; Skjerve, Arvid; Jensen, Chris; Dittrich, Winand H; Øyeflaten, Irene

    2016-11-01

    Individuals on long-term sick leave attending occupational rehabilitation often complain about impairments in cognitive functions such as memory and attention. Knowledge of cognitive functioning in these individuals is limited. Such knowledge is clinically relevant for improving occupational rehabilitation programmes. The aims of this feasibility study were to assess the methodological design and to investigate changes in memory and attention on participants during occupational rehabilitation. Individuals attending occupational rehabilitation (n = 28) and individuals working full time (n = 25) matched for age, gender, and education participated. The two groups were administered cognitive tests targeting memory and attention and self-reported questionnaires at pre-test and post-test. Outcome measures were speed and accuracy of responses on the cognitive tests and self-reported work ability, subjective health complaints, and symptoms of depression and anxiety. In total, 35% of all invited participants agreed to take part and 93% of these also completed the second test. The mean gain scores in the intervention group were significantly higher than in the control group in response latency on simple and choice reaction time and errors in spatial working memory. The results of this study indicate that the motivation of participants to complete testing was high. Improvements in memory and attention were evident in rehabilitation participants indicating that rehabilitation may have an effect on cognitive functions.

  3. "The feasibility of implementing cognitive remediation for work in community based psychiatric rehabilitation programs": Correction to McGurk et al. (2017).

    Science.gov (United States)

    2017-06-01

    Reports an error in "The feasibility of implementing cognitive remediation for work in community based psychiatric rehabilitation programs" by Susan R. McGurk, Kim T. Mueser, Melanie A. Watkins, Carline M. Dalton and Heather Deutsch ( Psychiatric Rehabilitation Journal , 2017[Mar], Vol 40[1], 79-86). In the article, the author order was incorrect due to a printer error. The online version of this article has been corrected. (The following abstract of the original article appeared in record 2017-13255-004.) Objective: Adding cognitive remediation to vocational rehabilitation services improves cognitive and work functioning in people with serious mental illness, but despite interest, the uptake of cognitive programs into community services has been slow. This study evaluated the feasibility of implementing an empirically supported cognitive remediation program in routine rehabilitation services at 2 sites. The Thinking Skills for Work (TSW) program was adapted for implementation at 2 sites of a large psychiatric rehabilitation agency providing prevocational services, but not community-based vocational services, which were provided off-site. Agency staff were trained to deliver TSW to clients with work or educational goals. Cognitive assessments were conducted at baseline and posttreatment, with work and school activity tracked for 2 years. Eighty-three participants enrolled in TSW, of whom 79.5% completed at least 6 of the 24 computer cognitive exercise sessions (M = 16.7) over an average of 18 weeks. Participants improved significantly from baseline to posttreatment in verbal learning and memory, speed of processing, and overall cognitive functioning. Over the follow-up, 25.3% of participants worked and 47.0% were involved in work or school activity. Higher work rates were observed at the site where participants had easier access to vocational services. The results support the feasibility of implementing the TSW program by frontline staff in agencies providing

  4. Choice of Human-Computer Interaction Mode in Stroke Rehabilitation.

    Science.gov (United States)

    Mousavi Hondori, Hossein; Khademi, Maryam; Dodakian, Lucy; McKenzie, Alison; Lopes, Cristina V; Cramer, Steven C

    2016-03-01

    Advances in technology are providing new forms of human-computer interaction. The current study examined one form of human-computer interaction, augmented reality (AR), whereby subjects train in the real-world workspace with virtual objects projected by the computer. Motor performances were compared with those obtained while subjects used a traditional human-computer interaction, that is, a personal computer (PC) with a mouse. Patients used goal-directed arm movements to play AR and PC versions of the Fruit Ninja video game. The 2 versions required the same arm movements to control the game but had different cognitive demands. With AR, the game was projected onto the desktop, where subjects viewed the game plus their arm movements simultaneously, in the same visual coordinate space. In the PC version, subjects used the same arm movements but viewed the game by looking up at a computer monitor. Among 18 patients with chronic hemiparesis after stroke, the AR game was associated with 21% higher game scores (P = .0001), 19% faster reaching times (P = .0001), and 15% less movement variability (P = .0068), as compared to the PC game. Correlations between game score and arm motor status were stronger with the AR version. Motor performances during the AR game were superior to those during the PC game. This result is due in part to the greater cognitive demands imposed by the PC game, a feature problematic for some patients but clinically useful for others. Mode of human-computer interface influences rehabilitation therapy demands and can be individualized for patients. © The Author(s) 2015.

  5. A Case Report Examining the Feasibility of Meta-Cognitive Strategy Training in Acute Inpatient Stroke Rehabilitation

    Science.gov (United States)

    Skidmore, Elizabeth R.; Holm, Margo B.; Whyte, Ellen M.; Dew, Mary Amanda; Dawson, Deirdre; Becker, James T.

    2011-01-01

    Meta-cognitive strategy training may be used to augment inpatient rehabilitation to promote active engagement and subsequent benefit for individuals with cognitive impairments after stroke. We examined the feasibility of administering a form of meta-cognitive strategy training, Cognitive Orientation to daily Occupational Performance, during inpatient rehabilitation. We trained an individual with cognitive impairments after right hemisphere stroke to identify performance problems, set self-selected goals, develop plans to address goals, and evaluate performance improvements. To assess feasibility, we examined the number of meta-cognitive training sessions attended, the number of self-selected goals, and changes in goal-related performance. We also examined changes in rehabilitation engagement and disability. The participant used the meta-cognitive strategy to set 8 goals addressing physically-oriented, instrumental, and work-related activities. Mean improvement in Canadian Occupational Performance Measure Performance Scale scores was 6.1. Pittsburgh Rehabilitation Participation Scale scores (measuring rehabilitation engagement) improved from 3.2 at admission to 4.9 at discharge. Functional Independence Measure scores (measuring disability) improved from 68 at admission, to 97 at discharge. Performance Assessment of Self-care Skills scores improved from 1.1 at admission to 2.9 at discharge. The results indicate that meta-cognitive strategy training was feasible during inpatient rehabilitation and warrants further evaluation to determine its effectiveness. PMID:21391121

  6. Virtual reality in cognitive and motor rehabilitation: facts, fiction and fallacies.

    Science.gov (United States)

    Tieri, Gaetano; Morone, Giovanni; Paolucci, Stefano; Iosa, Marco

    2018-02-01

    Over recent decades many researchers and clinicians have started to use Virtual Reality (VR) as a new technology for implementing innovative rehabilitation treatments in cognitive and motor domains. However, the expression 'VR' has often also been improperly used to refer to video games. Further, VR efficacy, often confused with that of video-game exercises, is still debated. Areas covered: In this review, we provide the scientific rationale for the advantages of using VR systems in rehabilitation and investigate whether the VR could really be a promising technique for the future of rehabilitation of patients, or if it is just an entertainment for scientists. In addition, we describe some of the most used devices in VR with their potential advantages for research and provide an overview of the recent evidence and meta-analyses in rehabilitation. Expert commentary: We highlight the efficacy and fallacies of VR in neurorehabilitation and discuss the important factors emerging from the use of VR, including the sense of presence and the embodiment over a virtual avatar, in developing future applications in cognitive and motor rehabilitation.

  7. Increased brain connectivity and activation after cognitive rehabilitation in Parkinson's disease: a randomized controlled trial.

    Science.gov (United States)

    Díez-Cirarda, María; Ojeda, Natalia; Peña, Javier; Cabrera-Zubizarreta, Alberto; Lucas-Jiménez, Olaia; Gómez-Esteban, Juan Carlos; Gómez-Beldarrain, Maria Ángeles; Ibarretxe-Bilbao, Naroa

    2017-12-01

    Cognitive rehabilitation programs have demonstrated efficacy in improving cognitive functions in Parkinson's disease (PD), but little is known about cerebral changes associated with an integrative cognitive rehabilitation in PD. To assess structural and functional cerebral changes in PD patients, after attending a three-month integrative cognitive rehabilitation program (REHACOP). Forty-four PD patients were randomly divided into REHACOP group (cognitive rehabilitation) and a control group (occupational therapy). T1-weighted, diffusion weighted and functional magnetic resonance images (fMRI) during resting-state and during a memory paradigm (with learning and recognition tasks) were acquired at pre-treatment and post-treatment. Cerebral changes were assessed with repeated measures ANOVA 2 × 2 for group x time interaction. During resting-state fMRI, the REHACOP group showed significantly increased brain connectivity between the left inferior temporal lobe and the bilateral dorsolateral prefrontal cortex compared to the control group. Moreover, during the recognition fMRI task, the REHACOP group showed significantly increased brain activation in the left middle temporal area compared to the control group. During the learning fMRI task, the REHACOP group showed increased brain activation in the left inferior frontal lobe at post-treatment compared to pre-treatment. No significant structural changes were found between pre- and post-treatment. Finally, the REHACOP group showed significant and positive correlations between the brain connectivity and activation and the cognitive performance at post-treatment. This randomized controlled trial suggests that an integrative cognitive rehabilitation program can produce significant functional cerebral changes in PD patients and adds evidence to the efficacy of cognitive rehabilitation programs in the therapeutic approach for PD.

  8. Perspectives on neurocognitive rehabilitation as an adjunct treatment for addictive disorders: From cognitive improvement to relapse prevention.

    Science.gov (United States)

    Rezapour, Tara; DeVito, Elise E; Sofuoglu, Mehmet; Ekhtiari, Hamed

    2016-01-01

    Addiction, as a brain disorder, can be defined with two distinct but interacting components: drug dependency and neurocognitive deficits. Most of the therapeutic interventions in addiction medicine, including pharmacological or psychosocial therapies, that are in clinical use have been mainly focused on directly addressing addictive behaviors, especially drug use and urges to use drugs. In the field of addiction treatment, it is often presumed that drug users' neurocognitive deficits will reverse following abstinence. However, in many cases, neurocognitive deficits are not fully ameliorated following sustained abstinence, and neurocognitive function may further deteriorate in early abstinence. It can be argued that many cognitive functions, such as sustained attention and executive control, are essential for full recovery and long-term abstinence from addiction. Recent advances in cognitive neuroscience have provided scientific foundations for neurocognitive rehabilitation as a means of facilitating recovery from drug addiction. Neurocognitive rehabilitation for drug addicted individuals could be implemented as part of addiction treatment, with highly flexible delivery methods including traditional "paper and pencil" testing, or computer-based technology via laptops, web-based, or smartphones in inpatient and outpatient settings. Despite this promise, there has been limited research into the potential efficacy of neurocognitive rehabilitation as a treatment for drug addiction. Further, many questions including the optimum treatment length, session duration, and necessary treatment adherence for treatment efficacy remain to be addressed. In this chapter, we first introduce cognitive rehabilitation as one of the potential areas to bridge the gap between cognitive neuroscience and addiction medicine, followed by an overview of current challenges and future directions. © 2016 Elsevier B.V. All rights reserved.

  9. A pilot single-blind multicentre randomized controlled trial to evaluate the potential benefits of computer-assisted arm rehabilitation gaming technology on the arm function of children with spastic cerebral palsy.

    Science.gov (United States)

    Preston, Nick; Weightman, Andrew; Gallagher, Justin; Levesley, Martin; Mon-Williams, Mark; Clarke, Mike; O'Connor, Rory J

    2016-10-01

    To evaluate the potential benefits of computer-assisted arm rehabilitation gaming technology on arm function of children with spastic cerebral palsy. A single-blind randomized controlled trial design. Power calculations indicated that 58 children would be required to demonstrate a clinically important difference. Intervention was home-based; recruitment took place in regional spasticity clinics. A total of 15 children with cerebral palsy aged five to 12 years were recruited; eight to the device group. Both study groups received 'usual follow-up treatment' following spasticity treatment with botulinum toxin; the intervention group also received a rehabilitation gaming device. ABILHAND-kids and Canadian Occupational Performance Measure were performed by blinded assessors at baseline, six and 12 weeks. An analysis of covariance showed no group differences in mean ABILHAND-kids scores between time points. A non-parametric analysis of variance on Canadian Occupational Performance Measure scores showed a statistically significant improvement across time points (χ 2 (2,15) = 6.778, p = 0.031), but this improvement did not reach minimal clinically important difference. Mean daily device use was seven minutes. Recruitment did not reach target owing to unanticipated staff shortages in clinical services. Feedback from children and their families indicated that the games were not sufficiently engaging to promote sufficient use that was likely to result in functional benefits. This study suggests that computer-assisted arm rehabilitation gaming does not benefit arm function, but a Type II error cannot be ruled out. © The Author(s) 2015.

  10. 75 FR 9189 - Office of Special Education and Rehabilitative Services; Overview Information; Assistive...

    Science.gov (United States)

    2010-03-01

    ... DEPARTMENT OF EDUCATION Office of Special Education and Rehabilitative Services; Overview... single budget period of 12 months. The Assistant Secretary for Special Education and Rehabilitative... Secretary for Special Education and Rehabilitative Services may change the maximum project period through a...

  11. 75 FR 9193 - Office of Special Education and Rehabilitative Services; Overview Information; Assistive...

    Science.gov (United States)

    2010-03-01

    ... DEPARTMENT OF EDUCATION Office of Special Education and Rehabilitative Services; Overview... budget period of 12 months. The Assistant Secretary for Special Education and Rehabilitative Services may... for Special Education and Rehabilitative Services may change the maximum project period through a...

  12. The Effect of Occupation-based Cognitive Rehabilitation for Traumatic Brain Injury: A Meta-analysis of Randomized Controlled Trials.

    Science.gov (United States)

    Park, Hae Yean; Maitra, Kinsuk; Martinez, Kristina Marie

    2015-06-01

    Traumatic brain injury (TBI) is the leading cause of death and disability among people younger than 35 years in the United States. Cognitive difficulty is a common consequence of TBI. To address cognitive deficits of patients with TBI, various cognitive rehabilitation approaches have been used for the clinical setting. The purpose of this study was to investigate the overall effect of occupation-based cognitive rehabilitation on patients' improvement in cognitive performance components, activity of daily living (ADL) performance, and values, beliefs and spirituality functions of patients with TBI. The papers used in this study were retrieved from the Cochrane Database, EBSCO (CINAHL), PsycINFO, PubMed and Web of Science published between 1997 and 2014. The keywords for searching were cognitive, rehabilitation, occupation, memory, attention, problem-solving, executive function, ADL, values, beliefs, spirituality, randomized controlled trials and TBI. For the meta-analysis, we examined 60 effect sizes from nine studies that are related to the occupation-based cognitive rehabilitation on persons with TBI. In persons with TBI, overall mental functions, ADL, and values, beliefs and spirituality were significantly improved in the groups that received occupation-based cognitive rehabilitation compared with comparison groups (mean d = 0.19, p cognitive rehabilitation would be beneficial for individuals with TBI for improving daily functioning and positively be able to affect their psychosocial functions. Collecting many outcome measures in studies with relatively few participants and the final data are less reliable than the whole instrument itself. Future research should evaluate the effectiveness of specific occupation-based cognitive rehabilitations programmes in order to improve consistency among rehabilitation providers. Copyright © 2015 John Wiley & Sons, Ltd.

  13. Computer-Aided Design/Computer-Assisted Manufacture Monolithic Restorations for Severely Worn Dentition: A Case History Report.

    Science.gov (United States)

    Abou-Ayash, Samir; Boldt, Johannes; Vuck, Alexander

    Full-arch rehabilitation of patients with severe tooth wear due to parafunctional behavior is a challenge for dentists and dental technicians, especially when a highly esthetic outcome is desired. A variety of different treatment options and prosthetic materials are available for such a clinical undertaking. The ongoing progress of computer-aided design/computer-assisted manufacture technologies in combination with all-ceramic materials provides a predictable workflow for these complex cases. This case history report describes a comprehensive, step-by-step treatment protocol leading to an optimally predictable treatment outcome for an esthetically compromised patient.

  14. HapHop-Physio: a computer game to support cognitive therapies in children

    Directory of Open Access Journals (Sweden)

    Rico-Olarte C

    2017-07-01

    Full Text Available Carolina Rico-Olarte,1 Diego M López,1 Santiago Narváez,1 Charic D Farinango,1 Peter S Pharow2 1Faculty of Electronics and Telecommunications Engineering, Universidad del Cauca, Telematics Engineering Research Group, Popayán, Colombia; 2Fraunhofer Institute of Digital Media and Technology IDMT, Ilmenau, Germany Background: Care and support of children with physical or mental disabilities are accompanied with serious concerns for parents, families, healthcare institutions, schools, and their communities. Recent studies and technological innovations have demonstrated the feasibility of providing therapy and rehabilitation services to children supported by computer games. Objective: The aim of this paper is to present HapHop-Physio, an innovative computer game that combines exercise with fun and learning, developed to support cognitive therapies in children. Methods: Conventional software engineering methods such as the Scrum methodology, a functionality test and a related usability test, were part of the comprehensive methodology adapted to develop HapHop-Physio. Results: The game supports visual and auditory attention therapies, as well as visual and auditory memory activities. The game was developed by a multidisciplinary team, which was based on the Hopscotch® platform provided by Fraunhofer Institute for Digital Media Technology IDMT Institute in Germany, and designed in collaboration with a rehabilitation clinic in Colombia. HapHop-Physio was tested and evaluated to probe its functionality and user satisfaction. Conclusion: The results show the development of an easy-to-use and funny game by a multidisciplinary team using state-of-the-art videogame technologies and software methodologies. Children testing the game concluded that they would like to play again while undergoing rehabilitation therapies. Keywords: computer game, exer-games, cognitive therapies, rehabilitation

  15. User-centered virtual environment assessment and design for cognitive rehabilitation applications

    Science.gov (United States)

    Fidopiastis, Cali Michael

    Virtual environment (VE) design for cognitive rehabilitation necessitates a new methodology to ensure the validity of the resulting rehabilitation assessment. We propose that benchmarking the VE system technology utilizing a user-centered approach should precede the VE construction. Further, user performance baselines should be measured throughout testing as a control for adaptive effects that may confound the metrics chosen to evaluate the rehabilitation treatment. To support these claims we present data obtained from two modules of a user-centered head-mounted display (HMD) assessment battery, specifically resolution visual acuity and stereoacuity. Resolution visual acuity and stereoacuity assessments provide information about the image quality achieved by an HMD based upon its unique system parameters. When applying a user-centered approach, we were able to quantify limitations in the VE system components (e.g., low microdisplay resolution) and separately point to user characteristics (e.g., changes in dark focus) that may introduce error in the evaluation of VE based rehabilitation protocols. Based on these results, we provide guidelines for calibrating and benchmarking HMDs. In addition, we discuss potential extensions of the assessment to address higher level usability issues. We intend to test the proposed framework within the Human Experience Modeler (HEM), a testbed created at the University of Central Florida to evaluate technologies that may enhance cognitive rehabilitation effectiveness. Preliminary results of a feasibility pilot study conducted with a memory impaired participant showed that the HEM provides the control and repeatability needed to conduct such technology comparisons. Further, the HEM affords the opportunity to integrate new brain imaging technologies (i.e., functional Near Infrared Imaging) to evaluate brain plasticity associated with VE based cognitive rehabilitation.

  16. Modelling Ecological Cognitive Rehabilitation Therapies for Building Virtual Environments in Brain Injury.

    Science.gov (United States)

    Martínez-Moreno, J M; Sánchez-González, P; Luna, M; Roig, T; Tormos, J M; Gómez, E J

    2016-01-01

    Brain Injury (BI) has become one of the most common causes of neurological disability in developed countries. Cognitive disorders result in a loss of independence and patients' quality of life. Cognitive rehabilitation aims to promote patients' skills to achieve their highest degree of personal autonomy. New technologies such as virtual reality or interactive video allow developing rehabilitation therapies based on reproducible Activities of Daily Living (ADLs), increasing the ecological validity of the therapy. However, the lack of frameworks to formalize and represent the definition of this kind of therapies can be a barrier for widespread use of interactive virtual environments in clinical routine. To provide neuropsychologists with a methodology and an instrument to design and evaluate cognitive rehabilitation therapeutic interventions strategies based on ADLs performed in interactive virtual environments. The proposed methodology is used to model therapeutic interventions during virtual ADLs considering cognitive deficit, expected abnormal interactions and therapeutic hypotheses. It allows identifying abnormal behavioural patterns and designing interventions strategies in order to achieve errorless-based rehabilitation. An ADL case study ('buying bread') is defined according to the guidelines established by the ADL intervention model. This case study is developed, as a proof of principle, using interactive video technology and is used to assess the feasibility of the proposed methodology in the definition of therapeutic intervention procedures. The proposed methodology provides neuropsychologists with an instrument to design and evaluate ADL-based therapeutic intervention strategies, attending to solve actual limitation of virtual scenarios, to be use for ecological rehabilitation of cognitive deficit in daily clinical practice. The developed case study proves the potential of the methodology to design therapeutic interventions strategies; however our current

  17. Evidenced-Based Cognitive Rehabilitation for Persons With Multiple Sclerosis: An Updated Review of the Literature From 2007 to 2016.

    Science.gov (United States)

    Goverover, Yael; Chiaravalloti, Nancy D; O'Brien, Amanda R; DeLuca, John

    2018-02-01

    To update the clinical recommendations for cognitive rehabilitation of people with multiple sclerosis (MS), based on a systematic review of the literature from 2007 through 2016. Searches of MEDLINE, PsycINFO, and CINAHL were conducted with a combination of the following terms: attention, awareness, cognition, cognitive, communication, executive, executive function, language, learning, memory, perception, problem solving, reasoning, rehabilitation, remediation, training, processing speed, and working memory. One hundred twenty-nine articles were identified and underwent initial screening. Fifty-nine articles were selected for inclusion after initial screening. Nineteen studies were excluded after further detailed review. Forty studies were fully reviewed and evaluated. Articles were assigned to 1 of 6 categories: attention, learning and memory, processing speed and working memory, executive functioning, metacognition, or nonspecified/combined cognitive domains. Articles were abstracted and levels of evidence were decided using specific criteria. The current review yielded 6 class I studies, 10 class II studies, and 24 class III studies. One intervention in the area of verbal learning and memory received support for a practice standard, 2 computer programs received support as practice guidelines (in the area of attention and multicognitive domains), and several studies provided support for 5 practice options in the domains of attention and learning and memory. Substantial progress has been made since our previous review regarding the identification of effective treatments for cognitive impairments in persons with MS. However, much work remains to be done to optimize rehabilitation potential by applying the most methodologically rigorous research designs to provide class I evidence in support of a given treatment strategy. Copyright © 2017 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  18. Rehabilitation of executive function and social cognition impairments after brain injury.

    Science.gov (United States)

    Manly, Tom; Murphy, Fionnuala C

    2012-12-01

    Brain injury is a major cause of long-term disability. Executive and social cognition sequelae are associated with poor outcome. This review examines recent evidence on the efficacy of rehabilitation in these areas. Accumulating evidence shows that interventions that work with patients on developing insight and strategies to offset executive impairments can produce significant benefits. Training of specific capacities, such as working memory, holds some promise, but more needs to be known about effect generalization. Evidence on social cognition rehabilitation following brain injury is sparse. Although there are some encouraging early results, more information on the clinical significance of change for everyday function is required. Rehabilitation in these areas is inherently difficult but vital if outcomes are to improve. Significant gains have been reported, and further work applying appropriate methods is urgently required.

  19. Volumetric analysis of day of injury computed tomography is associated with rehabilitation outcomes after traumatic brain injury

    Science.gov (United States)

    Majercik, Sarah; Bledsoe, Joseph; Ryser, David; Hopkins, Ramona O.; Fair, Joseph E.; Frost, R. Brock; MacDonald, Joel; Barrett, Ryan; Horn, Susan; Pisani, David; Bigler, Erin D.; Gardner, Scott; Stevens, Mark; Larson, Michael J.

    2016-01-01

    Introduction Day-of-injury (DOI) brain lesion volumes in traumatic brain injury (TBI) patients are rarely used to predict long-term outcomes in the acute setting. The purpose of this study was to investigate the relationship between acute brain injury lesion volume and rehabilitation outcomes in patients with TBI at a Level One Trauma Center. Methods Patients with TBI who were admitted to our rehabilitation unit after the acute care trauma service from February 2009-July 2011 were eligible for the study. Demographic data and outcome variables including cognitive and motor FIM scores, length of stay (LOS) in the rehabilitation unit, and ability to return to home were obtained. DOI quantitative injury lesion volumes and degree of midline shift were obtained from day-of-injury (DOI) brain computed tomography (CT) scans. A multiple step-wise regression model including 13 independent variables was created. This model was used to predict post-rehabilitation outcomes, including FIM scores and ability to return to home. PInjury Severity Score 24.7±9.9, and head Abbreviated Injury Scale score 3.73±0.97. Acute hospital length of stay (LOS) was 12.3±8.9 days and rehabilitation LOS was 15.9±9.3 days. Day-of-injury TBI lesion volumes were inversely associated with cognitive FIM scores at rehabilitation admission (p=0.004) and discharge (p=0.004) and inversely associated with ability to be discharged to home after rehabilitation (p=0.006). Conclusion In a cohort of patients with moderate to severe TBI requiring a rehabilitation unit stay after the acute care hospital stay, DOI brain injury lesion volumes are associated with worse cognitive FIM scores at the time of rehabilitation admission and discharge. Smaller injury volumes were associated with eventual discharge to home. Volumetric neuroimaging in the acute injury phase may improve surgeons’ ultimate outcome predictions in TBI patients. Level of Evidence/Study Type Level V, case series, Prognostic/Epidemiological PMID

  20. Spatial cognitive rehabilitation and motor recovery after stroke

    Science.gov (United States)

    Barrett, A.M.; Muzaffar, Tufail

    2014-01-01

    Purpose of review Stroke rehabilitation needs to take major steps forward to reduce functional disability for survivors. In this article, we suggest that spatial retraining might greatly increase the efficiency and efficacy of motor rehabilitation, directly addressing the burden and cost of paralysis after stroke. Recent findings Combining motor and cognitive treatment may be practical, as well as addressing needs after moderate–to-severe stroke. Spatial neglect could suppress motor recovery and reduce motor learning, even when patients receive appropriate rehabilitation to build strength, dexterity, and endurance. Spatial neglect rehabilitation acts to promote motor as well as visual-perceptual recovery. These findings, and previous underemphasized studies, make a strong case for combining spatial neglect treatment with traditional exercise training. Spatial neglect therapies might also help people who cannot participate in intensive movement therapies because of limited strength and endurance after stroke. Summary Spatial retraining, currently used selectively after right brain stroke, may be broadly useful after stroke to promote rapid motor recovery. PMID:25364954

  1. Computer assisted radiology

    International Nuclear Information System (INIS)

    Lemke, H.U.; Jaffe, C.C.; Felix, R.

    1993-01-01

    The proceedings of the CAR'93 symposium present the 126 oral papers and the 58 posters contributed to the four Technical Sessions entitled: (1) Image Management, (2) Medical Workstations, (3) Digital Image Generation - DIG, and (4) Application Systems - AS. Topics discussed in Session (1) are: picture archiving and communication systems, teleradiology, hospital information systems and radiological information systems, technology assessment and implications, standards, and data bases. Session (2) deals with computer vision, computer graphics, design and application, man computer interaction. Session (3) goes into the details of the diagnostic examination methods such as digital radiography, MRI, CT, nuclear medicine, ultrasound, digital angiography, and multimodality imaging. Session (4) is devoted to computer-assisted techniques, as there are: computer assisted radiological diagnosis, knowledge based systems, computer assisted radiation therapy and computer assisted surgical planning. (UWA). 266 figs [de

  2. Cognitive and emotional consequences of TBI: intervention strategies for vocational rehabilitation.

    Science.gov (United States)

    Mateer, Catherine A; Sira, Claire S

    2006-01-01

    The effects of a traumatic brain injury on vocational outcome can be predicted on the basis of several factors. Environmental factors such as a supportive work environment, and person specific factors, including the client's age, premorbid occupation, injury variables, level of awareness, psychosocial adjustment, coping skills, and cognitive deficits have all been found to predict return to work following a traumatic brain injury. Some of these factors are amenable to treatment, and clinicians can impact clients' likelihood of returning to work by intervening in various ways. Through case studies and a literature review on the effectiveness of cognitive rehabilitation interventions, we have outlined specific strategies and recommendations for interventions. Cognitive rehabilitation strategies that address attention, memory and executive deficits can improve clients' abilities to manage workplace tasks and demands. Many clients continue to experience problems with social and emotional adjustment following a brain injury that impact return to work. Cognitive behavioural therapy is well suited for improving coping skills, helping clients to manage cognitive difficulties, and addressing more generalized anxiety and depression in the context of a brain injury.

  3. Home-based tele-assisted robotic rehabilitation of joint impairments in children with cerebral palsy.

    Science.gov (United States)

    Chen, Kai; Ren, Yupeng; Gaebler-Spira, Deborah; Zhang, Li-Qun

    2014-01-01

    A portable rehabilitation robot incorporating intelligent stretching, robot-guided voluntary movement training with motivating games and tele-rehabilitation was developed to provide convenient and cost-effective rehabilitation to children with cerebral palsy (CP) and extend rehabilitation care beyond hospital. Clinicians interact with the patients remotely for periodic evaluations and updated guidance. The tele-assisted stretching and active movement training was done over 6-week 18 sessions on the impaired ankle of 23 children with CP in their home setting. Treatment effectiveness was evaluated using biomechanical measures and clinical outcome measures. After the tele-assisted home robotic rehabilitation intervention, there were significant increases in the ankle passive and active range of motion, muscle strength, a decrease in spasticity, and increases in balance and selective control assessment of lower-extremity.

  4. Humanoid assessing rehabilitative exercises.

    Science.gov (United States)

    Simonov, M; Delconte, G

    2015-01-01

    This article is part of the Focus Theme of Methods of Information in Medicine on "New Methodologies for Patients Rehabilitation". The article presents the approach in which the rehabilitative exercise prepared by healthcare professional is encoded as formal knowledge and used by humanoid robot to assist patients without involving other care actors. The main objective is the use of humanoids in rehabilitative care. An example is pulmonary rehabilitation in COPD patients. Another goal is the automated judgment functionality to determine how the rehabilitation exercise matches the pre-programmed correct sequence. We use the Aldebaran Robotics' NAO humanoid to set up artificial cognitive application. Pre-programmed NAO induces elderly patient to undertake humanoid-driven rehabilitation exercise, but needs to evaluate the human actions against the correct template. Patient is observed using NAO's eyes. We use the Microsoft Kinect SDK to extract motion path from the humanoid's recorded video. We compare human- and humanoid-operated process sequences by using the Dynamic Time Warping (DTW) and test the prototype. This artificial cognitive software showcases the use of DTW algorithm to enable humanoids to judge in near real-time about the correctness of rehabilitative exercises performed by patients following the robot's indications. One could enable better sustainable rehabilitative care services in remote residential settings by combining intelligent applications piloting humanoids with the DTW pattern matching algorithm applied at run time to compare humanoid- and human-operated process sequences. In turn, it will lower the need of human care.

  5. Subjective cognitive dysfunction in rehabilitation outpatients with musculoskeletal disorders or chronic pain

    NARCIS (Netherlands)

    Schrier, Ernst; Geertzen, Jan H.; Dijkstra, Pieter U.

    BACKGROUND: Rehabilitation patients, without brain damage, sometimes complain about poor concentration and problems with their memory. The magnitude and associations, of this cognitive dysfunction, with different factors is unclear. AIM: To determine the magnitude of cognitive dysfunction in

  6. Cognitive rehabilitation in epilepsy: An evidence-based review.

    Science.gov (United States)

    Farina, Elisabetta; Raglio, Alfredo; Giovagnoli, Anna Rita

    2015-01-01

    To review the modalities of cognitive rehabilitation (CR), outcome endpoints, and the levels of evidence of efficacy of different interventions. A systematic research in Pubmed, Psychinfo, and SCOPUS was performed assessing the articles written in the entire period covered by these databases till December 2013. Articles in English, Spanish or French were evaluated. A manual research evaluated the references of all of the articles. The experimental studies were classified according to the level of evidence of efficacy, using a standardized Italian method (SPREAD, 2007), adopting the criteria reported by Cicerone et al. (2000, 2011). Eighteen papers were classified into two reviews, four papers dealing with the principles and efficacy of CR in epilepsy, a methodological paper, a single-case report, a multiple-case report, and nine experimental papers. Most studies involved patients with temporal lobe epilepsy. Different types of CR were used to treat patients with epilepsy. A holistic rehabilitation approach was more useful than selective interventions to treat memory and attention disturbances. CR may be a useful tool to treat cognitive impairment in patients with epilepsy. However, the modalities of treatment and outcome endpoints are important concerns of clinical care and research. Controlled studies are needed to determine the efficacy of rehabilitation in well-defined groups of patients with epilepsy. Copyright © 2014 Elsevier B.V. All rights reserved.

  7. Successful neuropsychological rehabilitation in a patient with Cerebellar Cognitive Affective Syndrome.

    Science.gov (United States)

    Ruffieux, N; Colombo, F; Gentaz, E; Annoni, J-M; Chouiter, L; Roulin Hefti, S; Ruffieux, A; Bihl, T

    2017-01-01

    The objective of this case study was to describe the neuropsychological rehabilitation of a 16-year-old patient who presented a Cerebellar Cognitive Affective Syndrome (CCAS) following a bilateral cerebellar hemorrhage. The patient presented severe and diffuse cognitive deficits, massive behavioral disorders, and emotion regulation difficulties. The cognitive rehabilitation was performed in the chronic phase (one year after the onset of the hemorrhage) using a transdisciplinary neurobehavioral approach based on the patient's favorite interest (soccer). A significant behavioral and cognitive improvement was observed. The patient became progressively independent in all activities of daily living and was discharged home. The Functional Independence Measure at discharge was 124/126 (vs. 37/126 at entry). The patient was able to complete his schooling despite the mild cognitive and behavioral sequelae. This first description of the use of neurobehavioral therapy in a case of chronic CCAS suggests that (a) major clinical improvement can occur more than one year after the onset of the CCAS, showing the importance of long-term and intensive neurorehabilitation; and (b) when the cerebellum cannot properly play its regulator role in cognition, neuropsychological intervention through a behavioral and cognitive approach can be of great help by acting as an external modulator to help the patient regain control over himself.

  8. Computer-Assisted Training as a Complement in Rehabilitation of Patients With Chronic Vestibular Dizziness-A Randomized Controlled Trial

    DEFF Research Database (Denmark)

    Brandt, Michael Smærup; Gro¨nvall, Erik; Larsen, Simon B.

    2015-01-01

    Objective To compare a computer exercise program with conservative home-training following printed instructions in the rehabilitation of elderly patients with vestibular dysfunction. Design Single-blind, randomized, controlled trial. Setting Geriatric Department, Aarhus University Hospital...

  9. Computer-Assisted Visual Search/Decision Aids as a Training Tool for Mammography

    National Research Council Canada - National Science Library

    Nodine, Calvin

    1999-01-01

    The primary goal of the project is to develop a computer-assisted visual search (CAVS) mammography training tool that will improve the perceptual and cognitive skills of trainees leading to mammographic expertise...

  10. Computer-Assisted Visual Search/Decision Aids as a Training Tool for Mammography

    National Research Council Canada - National Science Library

    Nodine, Calvin

    1998-01-01

    The primary goal of the project is to develop a computer-assisted visual search (CAVS) mammography training tool that will improve the perceptual and cognitive skills of trainees leading to mammographic expertise...

  11. Computer-Assisted Visual Search/Decision Aids as a Training Tool for Mammography

    National Research Council Canada - National Science Library

    Nodine, Calvin

    2000-01-01

    The primary goal of the project is to develop a computer-assisted visual search (CAVS) mammography training tool that will improve the perceptual and cognitive skills of trainees leading to mammographic expertise...

  12. Upper limb stroke rehabilitation: the effectiveness of Stimulation Assistance through Iterative Learning (SAIL).

    Science.gov (United States)

    Meadmore, Katie L; Cai, Zhonglun; Tong, Daisy; Hughes, Ann-Marie; Freeman, Chris T; Rogers, Eric; Burridge, Jane H

    2011-01-01

    A novel system has been developed which combines robotic therapy with electrical stimulation (ES) for upper limb stroke rehabilitation. This technology, termed SAIL: Stimulation Assistance through Iterative Learning, employs advanced model-based iterative learning control (ILC) algorithms to precisely assist participant's completion of 3D tracking tasks with their impaired arm. Data is reported from a preliminary study with unimpaired participants, and also from a single hemiparetic stroke participant with reduced upper limb function who has used the system in a clinical trial. All participants completed tasks which involved moving their (impaired) arm to follow an image of a slowing moving sphere along a trajectory. The participants' arm was supported by a robot and ES was applied to the triceps brachii and anterior deltoid muscles. During each task, the same tracking trajectory was repeated 6 times and ILC was used to compute the stimulation signals to be applied on the next iteration. Unimpaired participants took part in a single, one hour training session and the stroke participant undertook 18, 1 hour treatment sessions composed of tracking tasks varying in length, orientation and speed. The results reported describe changes in tracking ability and demonstrate feasibility of the SAIL system for upper limb rehabilitation. © 2011 IEEE

  13. Effect of virtual reality on cognition in stroke patients.

    Science.gov (United States)

    Kim, Bo Ryun; Chun, Min Ho; Kim, Lee Suk; Park, Ji Young

    2011-08-01

    To investigate the effect of virtual reality on the recovery of cognitive impairment in stroke patients. Twenty-eight patients (11 males and 17 females, mean age 64.2) with cognitive impairment following stroke were recruited for this study. All patients were randomly assigned to one of two groups, the virtual reality (VR) group (n=15) or the control group (n=13). The VR group received both virtual reality training and computer-based cognitive rehabilitation, whereas the control group received only computer-based cognitive rehabilitation. To measure, activity of daily living cognitive and motor functions, the following assessment tools were used: computerized neuropsychological test and the Tower of London (TOL) test for cognitive function assessment, Korean-Modified Barthel index (K-MBI) for functional status evaluation, and the motricity index (MI) for motor function assessment. All recruited patients underwent these evaluations before rehabilitation and four weeks after rehabilitation. The VR group showed significant improvement in the K-MMSE, visual and auditory continuous performance tests (CPT), forward digit span test (DST), forward and backward visual span tests (VST), visual and verbal learning tests, TOL, K-MBI, and MI scores, while the control group showed significant improvement in the K-MMSE, forward DST, visual and verbal learning tests, trail-making test-type A, TOL, K-MBI, and MI scores after rehabilitation. The changes in the visual CPT and backward VST in the VR group after rehabilitation were significantly higher than those in the control group. Our findings suggest that virtual reality training combined with computer-based cognitive rehabilitation may be of additional benefit for treating cognitive impairment in stroke patients.

  14. Change in cognitive performance is associated with functional recovery during post-acute stroke rehabilitation: a multi-centric study from intermediate care geriatric rehabilitation units of Catalonia.

    Science.gov (United States)

    Pérez, Laura Mónica; Inzitari, Marco; Roqué, Marta; Duarte, Esther; Vallés, Elisabeth; Rodó, Montserrat; Gallofré, Miquel

    2015-10-01

    Recovery after a stroke is determined by a broad range of neurological, functional and psychosocial factors. Evidence regarding these factors is not well established, in particular influence of cognition changes during rehabilitation. We aimed to investigate whether selective characteristics, including cognitive performance and its change over time, modulate functional recovery with home discharge in stroke survivors admitted to post-acute rehabilitation units. We undertook a multicenter cohort study, including all patients discharged from acute wards to any geriatric rehabilitation unit in Catalonia-Spain during 2008. Patients were assessed for demographics, clinical and functional variables using Conjunt Mínim Bàsic de Dades dels Recursos Sociosanitaris (CMBD-RSS), which adapts the Minimum Data Set tool used in America's nursing homes. Baseline-to-discharge change in cognition was calculated on repeated assessments using the Cognitive Performance Scale (CPS, range 0-6, best-worst cognition). The multivariable effect of these factors was analyzed in relation to the outcome. 879 post-stroke patients were included (mean age 77.48 ± 10.18 years, 52.6% women). A worse initial CPS [OR (95% CI) = 0.851 (0.774-0.935)] and prevalent fecal incontinence [OR (95% CI) = 0.560 (0.454-0.691)] reduced the likelihood of returning home with functional improvement; whereas improvement of CPS, baseline to discharge, [OR (95% CI) = 1.348 (1.144-1.588)], more rehabilitation days within the first 2 weeks [OR (95% CI) = 1.011 (1.006-1.015)] and a longer hospital stay [OR (95% CI) = 1.011 (1.006-1.015)] were associated with the outcome. In our sample, different clinical characteristics, including cognitive function and its improvement over time, are associated with functional improvement in stroke patients undergoing rehabilitation. Our results might provide information to further studies aimed at exploring the influence of cognition changes during rehabilitation.

  15. Computer assisted roentgenology

    International Nuclear Information System (INIS)

    Trajkova, N.; Velkova, K.

    1999-01-01

    This is a report on the potentials and superiorities of computer tomography (CT), assumed as an up-to-date imaging examination method in medicine. The current trend in the development of computer assisted roentgenology consists in the implementation of new computer and communication systems promoting diagnostic and therapeutic activities. CT-study application is discussed with special reference to diagnosis and treatment of brain, lung, mediastinal and abdominal diseases. The new trends in the particular implementation of CT are presented, namely: CT-assisted biopsy, CT-assisted abscess drainage, drug administration under CT control, as well as the wide use of CT in orthopaedic surgery, otorinolaryngology etc. Also emphasis is laid on the important role played by three-dimensional technologies in computer-assisted surgery, leading to qualitatively new stage in the surgical therapeutic approach to patients

  16. Cognitive rehabilitation of episodic memory disorders: from theory to practice

    OpenAIRE

    Radek Ptak; Radek Ptak; Martial Van Der Linden; Armin Schnider; Armin Schnider

    2010-01-01

    Memory disorders are among the most frequent and most debilitating cognitive impairments following acquired brain damage. Cognitive remediation strategies attempt to restore lost memory capacity, provide compensatory techniques or teach the use of external memory aids. Memory rehabilitation has strongly been influenced by memory theory, and the interaction between both has stimulated the development of techniques such as spaced retrieval, vanishing cues or errorless learning. These techniques...

  17. Cognitive Rehabilitation of Episodic Memory Disorders: From Theory to Practice

    OpenAIRE

    Ptak, Radek; der Linden, Martial Van; Schnider, Armin

    2010-01-01

    Memory disorders are among the most frequent and most debilitating cognitive impairments following acquired brain damage. Cognitive remediation strategies attempt to restore lost memory capacity, provide compensatory techniques or teach the use of external memory aids. Memory rehabilitation has strongly been influenced by memory theory, and the interaction between both has stimulated the development of techniques such as spaced retrieval, vanishing cues or errorless learning. These techniques...

  18. Evidenced-based cognitive rehabilitation for persons with multiple sclerosis: a review of the literature.

    Science.gov (United States)

    O'Brien, Amanda R; Chiaravalloti, Nancy; Goverover, Yael; Deluca, John

    2008-04-01

    To conduct evidence-based review of cognitive rehabilitation intervention research conducted in persons with multiple sclerosis (MS), to classify level of evidence, and to generate recommendations for interventions in this area. An open (no year limits set) search of Medline, PsychInfo, and CINAHL (eliminating repetitions) using combinations of the following terms: attention, awareness, cognition, cognitive, communication, executive, executive function, language, learning, memory, perception, problem solving, reasoning, rehabilitation, remediation, training, and working memory. Reference sections of articles found through the sites were also searched. Studies were chosen based on criteria from previous evidence-based reviews such that articles are excluded from the review if (1) the study was not an intervention, (2) it was a theoretic article, (3) it was a review article, (4) detail was lacking to fully evaluate the intervention, (5) it was not MS-specific, (6) it included a pediatric sample, (7) it was a case report without empirical data to evaluate outcomes, (8) it was not peer-reviewed (also excludes book chapters), (9) it was a pharmacologic intervention, or (10) it was not available for review in English. Articles were categorized into interventions for attention, learning and memory, executive functioning, or nonspecified/combined cognitive domains. There were 4 reviewers in the current study. All articles were reviewed independently by at least 2 persons and abstracted according to predetermined criteria. There was a final total of 16 articles, which underwent a full review and classification of a level of evidence based on previously published peer-reviewed methodology used for evidence-based reviews. The current review yielded 16 studies of cognitive rehabilitation for persons with MS, including 4 class I studies, 5 class II studies, 2 class III studies, and 5 class IV studies. Two intervention methodologies in the area of verbal learning and memory

  19. Cognitive and physical rehabilitation of intensive care unit survivors: results of the RETURN randomized controlled pilot investigation.

    Science.gov (United States)

    Jackson, James C; Ely, E Wesley; Morey, Miriam C; Anderson, Venice M; Denne, Laural B; Clune, Jennifer; Siebert, Carol S; Archer, Kristin R; Torres, Renee; Janz, David; Schiro, Elena; Jones, Julie; Shintani, Ayumi K; Levine, Brian; Pun, Brenda T; Thompson, Jennifer; Brummel, Nathan E; Hoenig, Helen

    2012-04-01

    Millions of patients who survive medical and surgical general intensive care unit care every year experience newly acquired long-term cognitive impairment and profound physical and functional disabilities. To overcome the current reality in which patients receive inadequate rehabilitation, we devised a multifaceted, in-home, telerehabilitation program implemented using social workers and psychology technicians with the goal of improving cognitive and functional outcomes. This was a single-site, feasibility, pilot, randomized trial of 21 general medical/surgical intensive care unit survivors (8 controls and 13 intervention patients) with either cognitive or functional impairment at hospital discharge. After discharge, study controls received usual care (sporadic rehabilitation), whereas intervention patients received a combination of in-home cognitive, physical, and functional rehabilitation over a 3-month period via a social worker or master's level psychology technician utilizing telemedicine to allow specialized multidisciplinary treatment. Interventions over 12 wks included six in-person visits for cognitive rehabilitation and six televisits for physical/functional rehabilitation. Outcomes were measured at the completion of the rehabilitation program (i.e., at 3 months), with cognitive functioning as the primary outcome. Analyses were conducted using linear regression to examine differences in 3-month outcomes between treatment groups while adjusting for baseline scores. Patients tolerated the program with only one adverse event reported. At baseline both groups were well-matched. At 3-month follow-up, intervention group patients demonstrated significantly improved cognitive executive functioning on the widely used and well-normed Tower test (for planning and strategic thinking) vs. controls (median [interquartile range], 13.0 [11.5-14.0] vs. 7.5 [4.0-8.5]; adjusted p improving cognitive performance and functional outcomes in just 3 months. Future investigations

  20. Cognitive rehabilitation treatment for mental slowness in conversion disorder : A case report

    NARCIS (Netherlands)

    De Vroege, L.; Khasho, D.; Foruz, A.; Van Der Feltz-cornelis, C.M.; Walla, P.

    2017-01-01

    Cognitive rehabilitation treatment (CRT) has been described in patients with brain injury, but it has not been attempted in cases of cognitive dysfunction without organic cause. This case report describes CRT of neurocognitive impairment in a 54-year-old female patient with conversion disorder (CD).

  1. COMPUTER-ASSISTED ACCOUNTING

    Directory of Open Access Journals (Sweden)

    SORIN-CIPRIAN TEIUŞAN

    2009-01-01

    Full Text Available What is computer-assisted accounting? Where is the place and what is the role of the computer in the financial-accounting activity? What is the position and importance of the computer in the accountant’s activity? All these are questions that require scientific research in order to find the answers. The paper approaches the issue of the support granted to the accountant to organize and manage the accounting activity by the computer. Starting from the notions of accounting and computer, the concept of computer-assisted accounting is introduced, it has a general character and it refers to the accounting performed with the help of the computer or using the computer to automate the procedures performed by the person who is doing the accounting activity; this is a concept used to define the computer applications of the accounting activity. The arguments regarding the use of the computer to assist accounting targets the accounting informatization, the automating of the financial-accounting activities and the endowment with modern technology of the contemporary accounting.

  2. Volumetric analysis of day of injury computed tomography is associated with rehabilitation outcomes after traumatic brain injury.

    Science.gov (United States)

    Majercik, Sarah; Bledsoe, Joseph; Ryser, David; Hopkins, Ramona O; Fair, Joseph E; Brock Frost, R; MacDonald, Joel; Barrett, Ryan; Horn, Susan; Pisani, David; Bigler, Erin D; Gardner, Scott; Stevens, Mark; Larson, Michael J

    2017-01-01

    Day-of-injury (DOI) brain lesion volumes in traumatic brain injury (TBI) patients are rarely used to predict long-term outcomes in the acute setting. The purpose of this study was to investigate the relationship between acute brain injury lesion volume and rehabilitation outcomes in patients with TBI at a level one trauma center. Patients with TBI who were admitted to our rehabilitation unit after the acute care trauma service from February 2009-July 2011 were eligible for the study. Demographic data and outcome variables including cognitive and motor Functional Independence Measure (FIM) scores, length of stay (LOS) in the rehabilitation unit, and ability to return to home were obtained. The DOI quantitative injury lesion volumes and degree of midline shift were obtained from DOI brain computed tomography scans. A multiple stepwise regression model including 13 independent variables was created. This model was used to predict postrehabilitation outcomes, including FIM scores and ability to return to home. A p value less than 0.05 was considered significant. Ninety-six patients were enrolled in the study. Mean age was 43 ± 21 years, admission Glasgow Coma Score was 8.4 ± 4.8, Injury Severity Score was 24.7 ± 9.9, and head Abbreviated Injury Scale score was 3.73 ± 0.97. Acute hospital LOS was 12.3 ± 8.9 days, and rehabilitation LOS was 15.9 ± 9.3 days. Day-of-injury TBI lesion volumes were inversely associated with cognitive FIM scores at rehabilitation admission (p = 0.004) and discharge (p = 0.004) and inversely associated with ability to be discharged to home after rehabilitation (p = 0.006). In a cohort of patients with moderate to severe TBI requiring a rehabilitation unit stay after the acute care hospital stay, DOI brain injury lesion volumes are associated with worse cognitive FIM scores at the time of rehabilitation admission and discharge. Smaller-injury volumes were associated with eventual discharge to home. Volumetric neuroimaging in the acute

  3. Validation of a mechanism to balance exercise difficulty in robot-assisted upper-extremity rehabilitation after stroke

    Directory of Open Access Journals (Sweden)

    Zimmerli Lukas

    2012-02-01

    Full Text Available Abstract Background The motivation of patients during robot-assisted rehabilitation after neurological disorders that lead to impairments of motor functions is of great importance. Due to the increasing number of patients, increasing medical costs and limited therapeutic resources, clinicians in the future may want patients to practice their movements at home or with reduced supervision during their stay in the clinic. Since people only engage in an activity and are motivated to practice if the outcome matches the effort at which they perform, an augmented feedback application for rehabilitation should take the cognitive and physical deficits of patients into account and incorporate a mechanism that is capable of balancing i.e. adjusting the difficulty of an exercise in an augmented feedback application to the patient's capabilities. Methods We propose a computational mechanism based on Fitts' Law that balances i.e. adjusts the difficulty of an exercise for upper-extremity rehabilitation. The proposed mechanism was implemented into an augmented feedback application consisting of three difficulty conditions (easy, balanced, hard. The task of the exercise was to reach random targets on the screen from a starting point within a specified time window. The available time was decreased with increasing condition difficulty. Ten subacute stroke patients were recruited to validate the mechanism through a study. Cognitive and motor functions of patients were assessed using the upper extremity section of the Fugl-Meyer Assessment, the modified Ashworth scale as well as the Addenbrookes cognitive examination-revised. Handedness of patients was obtained using the Edinburgh handedness inventory. Patients' performance during the execution of the exercises was measured twice, once for the paretic and once for the non-paretic arm. Results were compared using a two-way ANOVA. Post hoc analysis was performed using a Tukey HSD with a significance level of p Results

  4. Control strategies for effective robot assisted gait rehabilitation: the state of art and future prospects.

    Science.gov (United States)

    Cao, Jinghui; Xie, Sheng Quan; Das, Raj; Zhu, Guo L

    2014-12-01

    A large number of gait rehabilitation robots, together with a variety of control strategies, have been developed and evaluated during the last decade. Initially, control strategies applied to rehabilitation robots were adapted from those applied to traditional industrial robots. However, these strategies cannot optimise effectiveness of gait rehabilitation. As a result, researchers have been investigating control strategies tailored for the needs of rehabilitation. Among these control strategies, assisted-as-needed (AAN) control is one of the most popular research topics in this field. AAN training strategies have gained the theoretical and practical evidence based backup from motor learning principles and clinical studies. Various approaches to AAN training have been proposed and investigated by research groups all around the world. This article presents a review on control algorithms of gait rehabilitation robots to summarise related knowledge and investigate potential trends of development. There are existing review papers on control strategies of rehabilitation robots. The review by Marchal-Crespo and Reinkensmeyer (2009) had a broad cover of control strategies of all kinds of rehabilitation robots. Hussain et al. (2011) had specifically focused on treadmill gait training robots and covered a limited number of control implementations on them. This review article encompasses more detailed information on control strategies for robot assisted gait rehabilitation, but is not limited to treadmill based training. It also investigates the potential to further develop assist-as-needed gait training based on assessments of patients' ability. In this paper, control strategies are generally divided into the trajectory tracking control and AAN control. The review covers these two basic categories, as well as other control algorithm and technologies derived from them, such as biofeedback control. Assessments on human gait ability are also included to investigate how to

  5. Computational Architecture of a Robot Coach for Physical Exercises in Kinesthetic Rehabilitation

    OpenAIRE

    Nguyen , Sao Mai; Tanguy , Philippe; Rémy-Néris , Olivier

    2016-01-01

    International audience; The rising number of the elderly incurs growing concern about healthcare, and in particular rehabilitation healthcare. Assistive technology and and assistive robotics in particular may help to improve this process. We develop a robot coach capable of demonstrating rehabilitation exercises to patients, watch a patient carry out the exercises and give him feedback so as to improve his performance and encourage him. We propose a general software architecture for our robot...

  6. Envisioning future cognitive telerehabilitation technologies: a co-design process with clinicians.

    Science.gov (United States)

    How, Tuck-Voon; Hwang, Amy S; Green, Robin E A; Mihailidis, Alex

    2017-04-01

    Purpose Cognitive telerehabilitation is the concept of delivering cognitive assessment, feedback, or therapeutic intervention at a distance through technology. With the increase of mobile devices, wearable sensors, and novel human-computer interfaces, new possibilities are emerging to expand the cognitive telerehabilitation paradigm. This research aims to: (1) explore design opportunities and considerations when applying emergent pervasive computing technologies to cognitive telerehabilitation and (2) develop a generative co-design process for use with rehabilitation clinicians. Methods We conducted a custom co-design process that used design cards, probes, and design sessions with traumatic brain injury (TBI) clinicians. All field notes and transcripts were analyzed qualitatively. Results Potential opportunities for TBI cognitive telerehabilitation exist in the areas of communication competency, executive functioning, emotional regulation, energy management, assessment, and skill training. Designers of TBI cognitive telerehabilitation technologies should consider how technologies are adapted to a patient's physical/cognitive/emotional state, their changing rehabilitation trajectory, and their surrounding life context (e.g. social considerations). Clinicians were receptive to our co-design approach. Conclusion Pervasive computing offers new opportunities for life-situated cognitive telerehabilitation. Convivial design methods, such as this co-design process, are a helpful way to explore new design opportunities and an important space for further methodological development. Implications for Rehabilitation Designers of rehabilitation technologies should consider how to extend current design methods in order to facilitate the creative contribution of rehabilitation stakeholders. This co-design approach enables a fuller participation from rehabilitation clinicians at the front-end of design. Pervasive computing has the potential to: extend the duration and intensity of

  7. Information-Processing Correlates of Computer-Assisted Word Learning by Mentally Retarded Students.

    Science.gov (United States)

    Conners, Frances A.; Detterman, Douglas K.

    1987-01-01

    Nineteen moderately/severely retarded students (ages 9-22) completed ten 15-minute computer-assisted instruction sessions and seven basic cognitive tasks measuring simple learning, choice reaction time, relearning, probed recall, stimulus discrimination, tachictoscopic threshold, and recognition memory. Stimulus discrimination, probed recall, and…

  8. Information processing, computation, and cognition.

    Science.gov (United States)

    Piccinini, Gualtiero; Scarantino, Andrea

    2011-01-01

    Computation and information processing are among the most fundamental notions in cognitive science. They are also among the most imprecisely discussed. Many cognitive scientists take it for granted that cognition involves computation, information processing, or both - although others disagree vehemently. Yet different cognitive scientists use 'computation' and 'information processing' to mean different things, sometimes without realizing that they do. In addition, computation and information processing are surrounded by several myths; first and foremost, that they are the same thing. In this paper, we address this unsatisfactory state of affairs by presenting a general and theory-neutral account of computation and information processing. We also apply our framework by analyzing the relations between computation and information processing on one hand and classicism, connectionism, and computational neuroscience on the other. We defend the relevance to cognitive science of both computation, at least in a generic sense, and information processing, in three important senses of the term. Our account advances several foundational debates in cognitive science by untangling some of their conceptual knots in a theory-neutral way. By leveling the playing field, we pave the way for the future resolution of the debates' empirical aspects.

  9. COGNITIVE DIALOG GAMES AS COGNITIVE ASSISTANTS: TRACKING AND ADAPTING KNOWLEDGE AND INTERACTIONS IN STUDENT’S DIALOGS

    Directory of Open Access Journals (Sweden)

    Adem Karahoca

    2018-04-01

    Full Text Available This study introduces a system design in a form of cognitive dialog game (DiaCog to support pedagogical factors and student learning model ideas. The purpose of the study is to describe how such a design achieves tracking and adapting students’ knowledge and mastery learning levels as a cognitive assistant. Also, this study shows alternative ways for supporting intelligent personal learning, tutoring systems, and MOOCS. This paper explains method called DiaCog that uses structure for students` thinking in an online dialog by tracking student`s level of learning/knowledge status. The methodology of computing is the semantic that match between students` interactions in a dialog. By this way it informs DiaCog’s learner model to inform the pedagogical model. Semantic fingerprint matching method of DiaCog allows making comparisons with expert knowledge to detect students` mastery levels in learning. The paper concludes with the DiaCog tool and methodologies that used for intelligent cognitive assistant design to implement pedagogical and learner model to track and adapt students’ learning. Finally, this paper discusses future improvements and planned experimental set up to advance the techniques introduced in DiaCog design.

  10. Cognitive assisted living ambient system: a survey

    Directory of Open Access Journals (Sweden)

    Ruijiao Li

    2015-11-01

    Full Text Available The demographic change towards an aging population is creating a significant impact and introducing drastic challenges to our society. We therefore need to find ways to assist older people to stay independently and prevent social isolation of these population. Information and Communication Technologies (ICT provide various solutions to help older adults to improve their quality of life, stay healthier, and live independently for a time. Ambient Assisted Living (AAL is a field to investigate innovative technologies to provide assistance as well as healthcare and rehabilitation to impaired seniors. The paper provides a review of research background and technologies of AAL.

  11. Internet-Assisted Cognitive Behavioral Therapy.

    Science.gov (United States)

    Andersson, Gerhard; Carlbring, Per

    2017-12-01

    Internet-assisted cognitive-behavioral therapy (ICBT) is a way to deliver cognitive-behavioral therapy (CBT) that has been found to generate similar effects as face-to-face CBT in some studies. Results have been replicated by different research groups. This article presents the treatment format and reviews evidence for mood and anxiety disorders. Future developments are discussed, including the lack of theories specific for the treatment format and ways to handle comorbidity. Although some programs have been implemented there is a need for further studies in clinical settings. Overall, clinician-assisted ICBT is becoming one of the most evidence-based forms of psychological treatment. Copyright © 2017 Elsevier Inc. All rights reserved.

  12. A comparison of the effectiveness of problem solving training and of cognitive-emotional rehabilitation on neurocognition, social cognition and social functioning in people with schizophrenia.

    Science.gov (United States)

    Veltro, Franco; Mazza, Monica; Vendittelli, Nicola; Alberti, Mirella; Casacchia, Massimo; Roncone, Rita

    2011-01-01

    Social cognition and Problem Solving (PS) impairments are common characteristics in patients with schizophrenia. Experimental neuropsychological findings support the hypothesis that schizophrenia is characterized by a broad range of heterogeneous cognitive impairments. Since that time Problem Solving Training has been employed as a core strategy in a wide variety of therapeutic settings. Renewed interest in cognitive functioning, including social Problem Solving skills and social cognition in schizophrenia, has led us to reconsider the potential value of metacognitive strategy as a rehabilitation strategy. The present study reports the results obtained by 24 persons with schizophrenia who were randomly assigned to one of two training session groups: Cognitive-Emotional Rehabilitation (REC) vs Problem Solving Training (PST). Both treatments were administered to small groups composed of subjects suffering from schizophrenic disorders over a 12 months period: primary measures of clinical, social outcomes and secondary measures of cognitive and Problem Solving functions were conducted at 0, and 12 months. Results showed that both training methods were found to be effective in psychopathological measures and in social functioning. On cognitive function improvements were specific to the rehabilitative approach. PST are mainly improved capacities for planning and memory, while the REC improved measures such as social cognition Theory of mind and emotion recognition. The results confirmed that it is no necessary to divide the rehabilitation training in treatments directed to specific domains. The conceptualization and applicability of PST and REC its implications for persons with schizophrenia, and future studies in this research area have also been discussed.

  13. The Effect of Preoperative Cognitive Behavior and Exercise Therapy for a Patient With an Implanted Left Ventricular Assist Device in Korea.

    Science.gov (United States)

    Seo, Yong Gon; Park, Won Hah; Jeon, Eun Seok; Sung, Ji Dong; Jang, Mi Ja

    2017-10-01

    Left ventricular assist devices (LVADs) are used in patients with progressive heart failure symptoms to provide circulatory support. Patients with LVADs are referred to inpatient cardiac rehabilitation to prevent postoperative complications and improve aerobic capacity and quality of life. Preoperative exercise therapy for cardiac patients is an emerging treatment modality, and several studies have reported that it improves postoperative outcomes, such as length of hospital stay and postoperative complications. This case report describes the benefits of preoperative cognitive behavioral and exercise therapy in a Korean patient undergoing LVAD implantation. V. Copyright © 2017 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

  14. Evidence-based cognitive rehabilitation: updated review of the literature from 2003 through 2008.

    Science.gov (United States)

    Cicerone, Keith D; Langenbahn, Donna M; Braden, Cynthia; Malec, James F; Kalmar, Kathleen; Fraas, Michael; Felicetti, Thomas; Laatsch, Linda; Harley, J Preston; Bergquist, Thomas; Azulay, Joanne; Cantor, Joshua; Ashman, Teresa

    2011-04-01

    To update our clinical recommendations for cognitive rehabilitation of people with traumatic brain injury (TBI) and stroke, based on a systematic review of the literature from 2003 through 2008. PubMed and Infotrieve literature searches were conducted using the terms attention, awareness, cognitive, communication, executive, language, memory, perception, problem solving, and/or reasoning combined with each of the following terms: rehabilitation, remediation, and training for articles published between 2003 and 2008. The task force initially identified citations for 198 published articles. One hundred forty-one articles were selected for inclusion after our initial screening. Twenty-nine studies were excluded after further detailed review. Excluded articles included 4 descriptive studies without data, 6 nontreatment studies, 7 experimental manipulations, 6 reviews, 1 single case study not related to TBI or stroke, 2 articles where the intervention was provided to caretakers, 1 article redacted by the journal, and 2 reanalyses of prior publications. We fully reviewed and evaluated 112 studies. Articles were assigned to 1 of 6 categories reflecting the primary area of intervention: attention; vision and visuospatial functioning; language and communication skills; memory; executive functioning, problem solving and awareness; and comprehensive-holistic cognitive rehabilitation. Articles were abstracted and levels of evidence determined using specific criteria. Of the 112 studies, 14 were rated as class I, 5 as class Ia, 11 as class II, and 82 as class III. Evidence within each area of intervention was synthesized and recommendations for Practice Standards, Practice Guidelines, and Practice Options were made. There is substantial evidence to support interventions for attention, memory, social communication skills, executive function, and for comprehensive-holistic neuropsychologic rehabilitation after TBI. Evidence supports visuospatial rehabilitation after right

  15. [The rehabilitation treatment of patients with motor and cognitive disorders after stroke].

    Science.gov (United States)

    Sakharov, V Iu; Isanova, V A

    2014-01-01

    Objective. To study the possibility of using the rehabilitative pneumatic suit "Atlant" in stroke outpatients. Material and methods. We studied 11 stroke patients who wore the pneumatic suit in the early rehabilitation period. A comparison group included 13 patients. The high effectiveness of complex treatment with using the suit "Atlant" was shown. The motor activity was improved in 71.4% of patients, the recovery of speech was found in 33.3% patients. Conclusion. Continuity of rehabilitation in outpatients with stroke promotes the recovery of functional activity, motor, cognitive and speech functions and positively impacts on the emotional state of the patient.

  16. A Cognitive Computing Approach for Classification of Complaints in the Insurance Industry

    Science.gov (United States)

    Forster, J.; Entrup, B.

    2017-10-01

    In this paper we present and evaluate a cognitive computing approach for classification of dissatisfaction and four complaint specific complaint classes in correspondence documents between insurance clients and an insurance company. A cognitive computing approach includes the combination classical natural language processing methods, machine learning algorithms and the evaluation of hypothesis. The approach combines a MaxEnt machine learning algorithm with language modelling, tf-idf and sentiment analytics to create a multi-label text classification model. The result is trained and tested with a set of 2500 original insurance communication documents written in German, which have been manually annotated by the partnering insurance company. With a F1-Score of 0.9, a reliable text classification component has been implemented and evaluated. A final outlook towards a cognitive computing insurance assistant is given in the end.

  17. HapHop-Physio: a computer game to support cognitive therapies in children.

    Science.gov (United States)

    Rico-Olarte, Carolina; López, Diego M; Narváez, Santiago; Farinango, Charic D; Pharow, Peter S

    2017-01-01

    Care and support of children with physical or mental disabilities are accompanied with serious concerns for parents, families, healthcare institutions, schools, and their communities. Recent studies and technological innovations have demonstrated the feasibility of providing therapy and rehabilitation services to children supported by computer games. The aim of this paper is to present HapHop-Physio, an innovative computer game that combines exercise with fun and learning, developed to support cognitive therapies in children. Conventional software engineering methods such as the Scrum methodology, a functionality test and a related usability test, were part of the comprehensive methodology adapted to develop HapHop-Physio. The game supports visual and auditory attention therapies, as well as visual and auditory memory activities. The game was developed by a multidisciplinary team, which was based on the Hopscotch ® platform provided by Fraunhofer Institute for Digital Media Technology IDMT Institute in Germany, and designed in collaboration with a rehabilitation clinic in Colombia. HapHop-Physio was tested and evaluated to probe its functionality and user satisfaction. The results show the development of an easy-to-use and funny game by a multidisciplinary team using state-of-the-art videogame technologies and software methodologies. Children testing the game concluded that they would like to play again while undergoing rehabilitation therapies.

  18. Rehabilitation after traumatic brain injury.

    Science.gov (United States)

    Barnes, M P

    1999-01-01

    Head injury is a common disabling condition but regrettably facilities for rehabilitation are sparse. There is now increasing evidence of the efficacy of a comprehensive multidisciplinary rehabilitation team compared to natural recovery following brain injury. This chapter outlines some basic concepts of rehabilitation and emphasises the importance of valid and reliable outcome measures. The evidence of the efficacy of a rehabilitation programme is discussed in some detail. A number of specific rehabilitation problems are outlined including the management of spasticity, nutrition, pressure sores and urinary continence. The increasingly important role of assistive technology is illustrated, particularly in terms of communication aids and environmental control equipment. However, the major long-term difficulties after head injury focus around the cognitive, intellectual, behavioural and emotional problems. The complex management of these disorders is briefly addressed and the evidence of the efficacy of some techniques discussed. The importance of recognition of the vegetative stage and avoidance of misdiagnosis is emphasised. Finally, the important, but often neglected, area of employment rehabilitation is covered.

  19. Effect of Cognitive Rehabilitation on Executive Functions in Adolescent Survivors of Leukemia: A Randomized and Controlled Clinical Trial

    Directory of Open Access Journals (Sweden)

    Omid Amani

    2017-06-01

    Conclusion The results of this study have shown that the effect of cognitive rehabilitation on executive functions reaps significant dividends with regard to the promotion of hope in adolescents who survived leukemia and have been under the chemotherapy. The promotion of hope in participants belonging to the intervention group was more than in the participants of the wait list group. Given the fact that, today, one of the main goals of treatment of chronic diseases such as cancer is to enhance the quality of mental health of the surviving patients, the use of inexpensive and accessible programs like cognitive rehabilitation would be very effective. Consequently, healthcare professionals could attempt to reduce the side effects caused by chemotherapy and radiation, in addition to improving the cognitive issues of affected individuals, by placing emphasis on hope among the concerned patients. Therefore, it is recommended to conduct further research by considering the results of this work in order to develop effective cognitive rehabilitation interventions, thereby, enhancing the coping strategies, quality of life, and mental health of patients who are afflicted with cancer and those who survived cancer. Cognitive rehabilitation services should also be considered for post-treatment follow-up projects. 

  20. Hybrid Assistive Limb (HAL) Rehabilitation in Patients with Acute Hemorrhagic Stroke.

    Science.gov (United States)

    Ogata, Toshiyasu; Abe, Hiroshi; Samura, Kazuhiro; Hamada, Omi; Nonaka, Masani; Iwaasa, Mitsutoshi; Higashi, Toshio; Fukuda, Hiroyuki; Shiota, Etsuji; Tsuboi, Yoshio; Inoue, Tooru

    2015-01-01

    The efficacy of hybrid assistive limb (HAL) rehabilitation in the acute phase of stroke remains unclear. The purpose of this study was to evaluate the outcomes of patients with acute intracranial hemorrhage (ICH) who were treated with or without HAL rehabilitation. Among 270 patients with acute ICH from 2009 to 2014, 91 patients with supratentorial ICH were included in this retrospective study. Of these, 14 patients (HAL group) received HAL rehabilitation at approximately 1 week after ICH occurrence, while the remaining 77 patients received usual rehabilitation without HAL (N-HAL group). We obtained various patient data from the hospitals where the patients were moved to for further rehabilitation. Statistical comparisons were performed for the characteristics of the ICH patients, and outcomes between the HAL and N-HAL groups. There were no differences in outcomes between the HAL and N-HAL groups. However, patients with right ICH in the HAL group exhibited a significant association with a functional independence measure (FIM) score of ≥ 110 compared with patients in the N-HAL group (HAL group: 81.8%, N-HAL group: 43.9%, P = 0.04). In patients with right ICH, HAL rehabilitation was associated with improved outcomes as evaluated by the FIM score. Thus, HAL rehabilitation may improve outcomes of acute ICH in appropriately selected patients.

  1. [Impact of animal-assisted intervention on rehabilitation of patients with spinal cord injury].

    Science.gov (United States)

    Zsoldos, Amanda; Sátori, Agnes; Zana, Agnes

    2014-09-28

    The animal-assisted programs represent an interdisciplinary approach. They can be integrated into preventive, therapeutic and rehabilitative processes as complementary methods. The aim of the study was to promote the psychological adaptation and social reintegration of patients who suffered spinal cord injury, as well as reducing depression and feelings of isolation caused by the long hospitalization. The hypothesis of the authors was that the animal-assisted intervention method can be effectively inserted into the rehabilitation process of individuals with spinal cord injury as complementary therapy. 15 adults with spinal cord injury participated in the five-week program, twice a week. Participants first filled out a questionnaire on socio-demographics, and after completion of the program they participated in a short, directed interview with open questions. During the field-work, after observing the participants, qualitative data analysis was performed. The results suggest that the therapeutic animal induced a positive effect on the emotional state of the patients. Participants acquired new skills and knowledge, socialization and group cohesion had been improved. The authors conclude that the animal-assisted activity complemented by therapeutic elements can be beneficial in patients undergoing spinal cord injury rehabilitation and that knowledge obtained from the study can be helpful in the development of a future animal-assisted therapy program for spinal cord injury patients.

  2. Effect of Cognitive Rehabilitation on Improving Cognitive Function and Activities of Daily Living among Elderly Patients with Stroke at Assiut University Hospital

    Science.gov (United States)

    Abd-Elaziz, Saieda Abd-Elhameed; Khedr, Eman M.; Ahmed, Hanaa Abd Elhakiem; Ibrahim, Hoda Diab Fahmy

    2015-01-01

    Cognitive impairment is a frequent consequence of stroke. The study aimed to measure the effect of cognitive rehabilitation of elderly patients with stroke on their cognitive function and activities of daily living. Quasi experimental research design were used in this study. This study was conducted at neuropsychiatric, physical medicine and…

  3. Physical computation and cognitive science

    CERN Document Server

    Fresco, Nir

    2014-01-01

    This book presents a study of digital computation in contemporary cognitive science. Digital computation is a highly ambiguous concept, as there is no common core definition for it in cognitive science. Since this concept plays a central role in cognitive theory, an adequate cognitive explanation requires an explicit account of digital computation. More specifically, it requires an account of how digital computation is implemented in physical systems. The main challenge is to deliver an account encompassing the multiple types of existing models of computation without ending up in pancomputationalism, that is, the view that every physical system is a digital computing system. This book shows that only two accounts, among the ones examined by the author, are adequate for explaining physical computation. One of them is the instructional information processing account, which is developed here for the first time.   “This book provides a thorough and timely analysis of differing accounts of computation while adv...

  4. A Soft-Inflatable Exosuit for Knee Rehabilitation: Assisting Swing Phase During Walking

    Directory of Open Access Journals (Sweden)

    Saivimal Sridar

    2018-05-01

    Full Text Available In this paper, we present a soft-inflatable exosuit to assist knee extension during gait training for stroke rehabilitation. The soft exosuit is designed to provide 25% of the knee moment required during the swing phase of the gait cycle and is integrated with inertial measurement units (IMUs and smart shoe insole sensors to improve gait phase detection and controller design. The stiffness of the knee joint during level walking is computed using inverse dynamics. The soft-inflatable actuators, with an I cross-section, are mechanically characterized at varying angles to enable generation of the required stiffness outputs. A linear relation between the inflatable actuator stiffness and internal pressure as a function of the knee angle is obtained, and a two-layer stiffness controller is implemented to assist the knee joint by providing appropriate stiffness during the swing phase. Finally, to evaluate the ability of the exosuit to assist in swing motion, surface-electromyography (sEMG sensors are placed on the three muscle groups of the quadriceps and two groups of the hamstrings, on three healthy participants. A reduction in muscle activity of the rectus femoris, vastus lateralis, and vastus medialis is observed, which demonstrates feasibility of operation and potential future usage of the soft inflatable exosuit by impaired users.

  5. A Human-Robot Interaction Perspective on Assistive and Rehabilitation Robotics.

    Science.gov (United States)

    Beckerle, Philipp; Salvietti, Gionata; Unal, Ramazan; Prattichizzo, Domenico; Rossi, Simone; Castellini, Claudio; Hirche, Sandra; Endo, Satoshi; Amor, Heni Ben; Ciocarlie, Matei; Mastrogiovanni, Fulvio; Argall, Brenna D; Bianchi, Matteo

    2017-01-01

    Assistive and rehabilitation devices are a promising and challenging field of recent robotics research. Motivated by societal needs such as aging populations, such devices can support motor functionality and subject training. The design, control, sensing, and assessment of the devices become more sophisticated due to a human in the loop. This paper gives a human-robot interaction perspective on current issues and opportunities in the field. On the topic of control and machine learning, approaches that support but do not distract subjects are reviewed. Options to provide sensory user feedback that are currently missing from robotic devices are outlined. Parallels between device acceptance and affective computing are made. Furthermore, requirements for functional assessment protocols that relate to real-world tasks are discussed. In all topic areas, the design of human-oriented frameworks and methods is dominated by challenges related to the close interaction between the human and robotic device. This paper discusses the aforementioned aspects in order to open up new perspectives for future robotic solutions.

  6. Cognitive training in Parkinson disease: cognition-specific vs nonspecific computer training.

    Science.gov (United States)

    Zimmermann, Ronan; Gschwandtner, Ute; Benz, Nina; Hatz, Florian; Schindler, Christian; Taub, Ethan; Fuhr, Peter

    2014-04-08

    In this study, we compared a cognition-specific computer-based cognitive training program with a motion-controlled computer sports game that is not cognition-specific for their ability to enhance cognitive performance in various cognitive domains in patients with Parkinson disease (PD). Patients with PD were trained with either a computer program designed to enhance cognition (CogniPlus, 19 patients) or a computer sports game with motion-capturing controllers (Nintendo Wii, 20 patients). The effect of training in 5 cognitive domains was measured by neuropsychological testing at baseline and after training. Group differences over all variables were assessed with multivariate analysis of variance, and group differences in single variables were assessed with 95% confidence intervals of mean difference. The groups were similar regarding age, sex, and educational level. Patients with PD who were trained with Wii for 4 weeks performed better in attention (95% confidence interval: -1.49 to -0.11) than patients trained with CogniPlus. In our study, patients with PD derived at least the same degree of cognitive benefit from non-cognition-specific training involving movement as from cognition-specific computerized training. For patients with PD, game consoles may be a less expensive and more entertaining alternative to computer programs specifically designed for cognitive training. This study provides Class III evidence that, in patients with PD, cognition-specific computer-based training is not superior to a motion-controlled computer game in improving cognitive performance.

  7. Parkinson's patients' executive profile and goals they set for improvement: Why is cognitive rehabilitation not common practice?

    Science.gov (United States)

    Vlagsma, T T; Koerts, J; Fasotti, L; Tucha, O; van Laar, T; Dijkstra, H; Spikman, J M

    2016-01-01

    Impairments in executive functions (EF) are the core cognitive impairment in patients with Parkinson's disease (PD). Surprisingly, cognitive rehabilitation is not routinely offered to patients with PD. However, in patients with acquired brain injury (ABI), cognitive rehabilitation, in particular strategic executive training, is common practice and has been shown to be effective. In this study, we determined whether PD patients have different needs and aims with regard to strategic executive training than ABI patients, and whether possible differences might be a reason for not offering this kind of cognitive rehabilitation programme to patients with PD. Patients' needs and aims were operationalised by individually set goals, which were classified into domains of EF and daily life. In addition, patients with PD and ABI were compared on their cognitive, in particular EF, profile. Overall, PD patients' goals and cognitive profile were similar to those of patients with ABI. Therefore, based on the findings of this study, there is no reason to assume that strategic executive training cannot be part of standard therapy in PD. However, when strategic executive training is applied in clinical practice, disease-specific characteristics need to be taken into account.

  8. Social cognitive or learning theory use to improve self-efficacy in musculoskeletal rehabilitation: A systematic review and meta-analysis.

    Science.gov (United States)

    Ghazi, Cameron; Nyland, John; Whaley, Rumeal; Rogers, Thomas; Wera, Jeff; Henzman, Cameron

    2018-07-01

    To review the rehabilitation research methodological quality and intervention effectiveness of studies that used social cognitive or learning theory principles to improve self-efficacy in patients with orthopedic or musculoskeletal conditions. A systematic literature review and meta-analysis of peer reviewed studies published in English was performed using the OVID and SPORTDiscus databases. Initial search terms were "social cognitive theory" or "social learning theory" combined with "rehabilitation". From the 25 total studies that contributed to this review, 23 contributed patient outcome information and 20 contributed to effect size determination. Of 1947 total study participants, most (n = 1537, 78.9%) were women. Participants were primarily late middle-age (64.8 ± 17 years). Studies included participants with hip or knee osteoarthritis (OA) or who were post-hip or knee arthroplasty (11/25, 44%), post-femur or tibia fracture (6/25, 24%), adults in assisted living or inpatient rehabilitation facilities (2/25, 8%), independent community dwelling older adults (2/25, 8%), college-age recreational athletes post-sports injury (2/25, 8%), older women with osteoporosis risk (1/25, 4%) or middle-aged adults post-traumatic hand injury (1/25, 4%). For the 20 studies that contributed to effect size determination, a large overall mean effect size (Cohen's d = 0.98, 95% CI 0.42-1.86) was observed. Studies that used social cognitive or learning theory principles to improve self-efficacy in patients with orthopedic or musculoskeletal conditions generally displayed moderate to large effect sizes supporting this intervention. Sound research methodological quality and low risk of intervention-related injury or other adverse events were also generally observed. Findings suggest that these interventions may also benefit individuals with conditions that have not progressed to end-stage salvage surgery such as younger, more athletically active individuals for knee OA

  9. Assist-as-Needed Control of a Robotic Orthosis Actuated by Pneumatic Artificial Muscle for Gait Rehabilitation

    Directory of Open Access Journals (Sweden)

    Quy-Thinh Dao

    2018-03-01

    Full Text Available Rehabilitation robots are designed to help patients improve their recovery from injury by supporting them to perform repetitive and systematic training sessions. These robots are not only able to guide the subjects’ lower-limb to a designate trajectory, but also estimate their disability and adapt the compliance accordingly. In this research, a new control strategy for a high compliant lower-limb rehabilitation orthosis system named AIRGAIT is developed. The AIRGAIT orthosis is powered by pneumatic artificial muscle actuators. The trajectory tracking controller based on a modified computed torque control which employs a fractional derivative is proposed for the tracking purpose. In addition, a new method is proposed for compliance control of the robotic orthosis which results in the successful implementation of the assist-as-needed training strategy. Finally, various subject-based experiments are carried out to verify the effectiveness of the developed control system.

  10. Cognitive engineering in mental health computing

    NARCIS (Netherlands)

    Brinkman, W.P.

    2011-01-01

    Computer applications in support of mental health care and rehabilitation are becoming more widely used. They include technologies such as virtual reality, electronic diaries, multimedia, brain computing and computer games. Research in this area is emerging, and focussing on a variety of issues,

  11. Rehabilitation for post-stroke cognitive impairment: an overview of recommendations arising from systematic reviews of current evidence.

    Science.gov (United States)

    Gillespie, David C; Bowen, Audrey; Chung, Charlie S; Cockburn, Janet; Knapp, Peter; Pollock, Alex

    2015-02-01

    Although cognitive impairments are common following stroke, there is considerable uncertainty about the types of interventions that can reduce activity restrictions and improve quality of life. Indeed, a recent project to identify priorities for research into life after stroke determined that the top priority for patients, carers and health professionals was how to improve cognitive impairments. To provide an overview of the evidence for the effectiveness of cognitive rehabilitation for patients with stroke and to determine the main gaps in the current evidence base. Evidence was synthesised for the six Cochrane reviews relating to rehabilitation for post-stroke cognitive impairment and any subsequently published randomized controlled trials to February 2012. Data arising from 44 trials involving over 1500 patients was identified. Though there was support for the effectiveness of cognitive rehabilitation for some cognitive impairments, significant gaps were found in the current evidence base. All of the Cochrane reviews identified major limitations within the evidence they identified. There is currently insufficient research evidence, or evidence of insufficient quality, to support clear recommendations for clinical practice. Recommendations are made as to the research required to strengthen the evidence base, and so facilitate the delivery of effective interventions to individuals with cognitive impairment after stroke. © The Author(s) 2014.

  12. Performance, Cognitive Load, and Behaviour of Technology-Assisted English Listening Learning: From CALL to MALL

    Science.gov (United States)

    Chang, Chi-Cheng; Warden, Clyde A.; Liang, Chaoyun; Chou, Pao-Nan

    2018-01-01

    This study examines differences in English listening comprehension, cognitive load, and learning behaviour between outdoor ubiquitous learning and indoor computer-assisted learning. An experimental design, employing a pretest-posttest control group is employed. Randomly assigned foreign language university majors joined either the experimental…

  13. The Integration of Cognitive Remediation Therapy into the Whole Psychosocial Rehabilitation Process: An Evidence-Based and Person-Centered Approach

    Directory of Open Access Journals (Sweden)

    Rafael Penadés

    2012-01-01

    Full Text Available Cognitive remediation therapies seem to ameliorate cognitive impairments in patients with schizophrenia. Interestingly, some improvement in daily functioning can also be expected as a result. However, to achieve these results it is necessary that cognitive remediation is carried out in the context of broader psychosocial rehabilitation involving the learning of other communication, social, and self-control skills. Unfortunately, little is known about how to integrate these different rehabilitation tools in broader rehabilitation programs. Based on both the neurocognitive behavioral approach and the action theory framework, a hierarchical flowchart is represented in this paper to integrate CRT with other evidence-based psychological therapies in outpatient settings. Finally, some evidence is provided in which cognitive abilities need to be targeted in remediation programs to improve functioning. In summary, to improve daily functioning, according to these studies, cognitive remediation needs to include the teaching of some cognitive strategies that target executive skills.

  14. [Cognitive rehabilitation in early stage Alzheimer's disease].

    Science.gov (United States)

    Kasper, E; Thöne-Otto, A; Bürger, K; Schröder, S G; Hoffmann, W; Schneider, W; Teipel, S

    2016-07-01

    Dementia impairs the coping with routine daily tasks and social relationships due to an increasing degeneration of cognitive abilities. An appropriate treatment must adequately consider the effects of declined cognitive abilities on patients and their environment. Therefore, in recent times, integrative procedures for cognitive rehabilitation (CR) have become increasingly important for the therapy of patients with mild cognitive impairment (MCI) and mild dementia (MD). CR approaches provide compensatory possibilities for clearly defined routine challenges and the individual needs of those affected. This overview article in the form of a selective review elaborates factors for the effectiveness of CR on the basis of the currently available literature: 1) individuality - consideration of personal needs and targets, 2) compensation - mediation of skills and strategies to compensate for cognitive impairments, 3) interaction - inclusion of relatives and environmental conditions and 4) integration - integration of various therapeutic disciplines and methods. On the basis of this assessment with regards to the content, a critical analysis of the methods of short and long-term therapeutic effects on MCD and MD was carried out. Although the resulting factors were of high long-term relevance for the improvement of depression and quality of life, effects on cognition were more pronounced for MCI than for MD, which emphasizes the importance of beginning therapy as early as possible. The results show that future studies on effectiveness must employ endpoints relevant for routine daily life, and that the possibility of an implementation of therapeutic concepts in a healthcare system should be considered as an essential criterion.

  15. Efficacy of memory rehabilitation therapy: a meta-analysis of TBI and stroke cognitive rehabilitation literature.

    Science.gov (United States)

    Elliott, Madison; Parente, Frederick

    2014-01-01

    To examine the efficacy of cognitive rehabilitation strategies specifically designed to improve memory after traumatic brain injury (TBI) and stroke vs. memory improvement with the passage of time. A meta-analysis was performed on 26 studies of memory retraining and recovery that were published between the years of 1985 and 2013. Effect sizes (ESs) from each study were calculated and converted to Pearson's r and then analysed to assess the overall effect size and the relationship among the ESs, patient demographics and treatment interventions. RESULTS indicated a significant average ES (r = 0.51) in the treatment intervention conditions, as well as a significant average ES (r = 0.31) in the control conditions, in which participants did not receive any treatment. The largest ESs occurred in studies of stroke patients and studies concerning working memory rehabilitation. RESULTS showed that memory rehabilitation was an effective therapeutic intervention, especially for stroke patients and for working memory as a treatment domain. However, the results also indicated that significant memory improvement occurred spontaneously over time.

  16. Clinical effectiveness of combined virtual reality and robot assisted fine hand motion rehabilitation in subacute stroke patients.

    Science.gov (United States)

    Huang, Xianwei; Naghdy, Fazel; Naghdy, Golshah; Du, Haiping

    2017-07-01

    Robot-assisted therapy is regarded as an effective and reliable method for the delivery of highly repetitive rehabilitation training in restoring motor skills after a stroke. This study focuses on the rehabilitation of fine hand motion skills due to their vital role in performing delicate activities of daily living (ADL) tasks. The proposed rehabilitation system combines an adaptive assist-as-needed (AAN) control algorithm and a Virtual Reality (VR) based rehabilitation gaming system (RGS). The developed system is described and its effectiveness is validated through clinical trials on a group of eight subacute stroke patients for a period of six weeks. The impact of the training is verified through standard clinical evaluation methods and measuring key kinematic parameters. A comparison of the pre- and post-training results indicates that the method proposed in this study can improve fine hand motion rehabilitation training effectiveness.

  17. Manual-based cognitive behavioral and cognitive rehabilitation therapy for young-onset dementia: a case report.

    Science.gov (United States)

    Tonga, Johanne Bjoernstad; Arnevik, Espen Ajo; Werheid, Katja; Ulstein, Ingun Dina

    2016-03-01

    There is a growing attention worldwide to young-onset dementia (YOD) and this group's special challenges and needs. The literature on psychosocial interventions for this population is scarce, and little is known about the specific challenges and benefits of working therapeutically with this group of patients. The aim of this study was to explore if a manual-based structured cognitive behavioral/cognitive rehabilitation program would be beneficial for these patients. One case, a 63-year-old woman with YOD, is presented to illustrate how this intervention can be applied to individual patients to manage depressive symptoms in YOD.

  18. Computer-assisted radiology

    International Nuclear Information System (INIS)

    Lemke, H.U.

    1988-01-01

    New digital imaging modalities and more sophisticated image processing systems will have a profound effect on those areas of medicine concerned with imaging. This mainly means computer-assisted radiology (CAR) and implies a transition from analog film systems to digital imaging systems, integration of digital imaging modalities through picture archiving and communication systems (PACS) and the graduated employment of image-oriented medical work stations (MWS) for computer-assisted representation, communication, diagnosis, and therapy planning. (orig.) [de

  19. Computer versus Compensatory Calendar Training in Individuals with Mild Cognitive Impairment: Functional Impact in a Pilot Study.

    Science.gov (United States)

    Chandler, Melanie J; Locke, Dona E C; Duncan, Noah L; Hanna, Sherrie M; Cuc, Andrea V; Fields, Julie A; Hoffman Snyder, Charlene R; Lunde, Angela M; Smith, Glenn E

    2017-09-06

    This pilot study examined the functional impact of computerized versus compensatory calendar training in cognitive rehabilitation participants with mild cognitive impairment (MCI). Fifty-seven participants with amnestic MCI completed randomly assigned calendar or computer training. A standard care control group was used for comparison. Measures of adherence, memory-based activities of daily living (mADLs), and self-efficacy were completed. The calendar training group demonstrated significant improvement in mADLs compared to controls, while the computer training group did not. Calendar training may be more effective in improving mADLs than computerized intervention. However, this study highlights how behavioral trials with fewer than 30-50 participants per arm are likely underpowered, resulting in seemingly null findings.

  20. [Development of an integrative cognitive rehabilitation program for brain injured patients in the post-acute stage].

    Science.gov (United States)

    Oh, Hyun Soo; Kim, Young Ran; Seo, Wha Sook; Seo, Yeon Ok

    2005-04-01

    This study was conducted to develop a comprehensive cognitive rehabilitation program that can be easily applied to brain injured patients by family members or nurses in community or hospital settings. A Systemic literature review design was used. Thirty-three related studies were reviewed. Based on the results of the literature review, the training tasks for attention were designated to enhancing 4 hierarchical areas, i.e., focused, selective, alternating, and divided attention. On the other hand, the memory rehabilitation tasks mainly consisted of mnemonic skills, such as the association method which helps patients memorize given information by linking together common attributes, the visual imagery method, and self-instruction method. The problem solving rehabilitation program included a task of games or plays which stimulated the patients' curiosity and interest. The training tasks for problem solving were to encourage the process of deriving reasonable solutions for a problematic situation resembling real problems that the patients were faced with in their everyday life. It is expected that the cognitive rehabilitation program developed from this study could help patients having difficulty in their every day life, due to a reduced cognitive ability resulting from brain injury, to effectively adapt to every day life.

  1. Effectiveness of Assistive Technologies for Low Vision Rehabilitation: A Systematic Review

    Science.gov (United States)

    Jutai, Jeffrey W.; Strong, J. Graham; Russell-Minda, Elizabeth

    2009-01-01

    "Low vision" describes any condition of diminished vision that is uncorrectable by standard eyeglasses, contact lenses, medication, or surgery that disrupts a person's ability to perform common age-appropriate visual tasks. Examples of assistive technologies for vision rehabilitation include handheld magnifiers; electronic vision-enhancement…

  2. Cognitive engineering for technology in mental health care and rehabilitation

    NARCIS (Netherlands)

    Brinkman, W.P.; Doherty, G.; Gorini, A.; Gaggioli, A.; Neerincx, M.

    2010-01-01

    The use of technology, such as virtual reality, electronic diaries, multimedia, brain computing and computer games, to support the care and rehabilitation of patients affected by mental disorders is a relatively new and advancing research area. In this workshop, researchers, developers and mental

  3. Potential of a suite of robot/computer-assisted motivating systems for personalized, home-based, stroke rehabilitation

    Directory of Open Access Journals (Sweden)

    Feng Xin

    2007-03-01

    Full Text Available Abstract Background There is a need to improve semi-autonomous stroke therapy in home environments often characterized by low supervision of clinical experts and low extrinsic motivation. Our distributed device approach to this problem consists of an integrated suite of low-cost robotic/computer-assistive technologies driven by a novel universal access software framework called UniTherapy. Our design strategy for personalizing the therapy, providing extrinsic motivation and outcome assessment is presented and evaluated. Methods Three studies were conducted to evaluate the potential of the suite. A conventional force-reflecting joystick, a modified joystick therapy platform (TheraJoy, and a steering wheel platform (TheraDrive were tested separately with the UniTherapy software. Stroke subjects with hemiparesis and able-bodied subjects completed tracking activities with the devices in different positions. We quantify motor performance across subject groups and across device platforms and muscle activation across devices at two positions in the arm workspace. Results Trends in the assessment metrics were consistent across devices with able-bodied and high functioning strokes subjects being significantly more accurate and quicker in their motor performance than low functioning subjects. Muscle activation patterns were different for shoulder and elbow across different devices and locations. Conclusion The Robot/CAMR suite has potential for stroke rehabilitation. By manipulating hardware and software variables, we can create personalized therapy environments that engage patients, address their therapy need, and track their progress. A larger longitudinal study is still needed to evaluate these systems in under-supervised environments such as the home.

  4. Potential role of a cognitive rehabilitation program following left temporal lobe epilepsy surgery

    Directory of Open Access Journals (Sweden)

    Camila de Vasconcelos Geraldi

    Full Text Available ABSTRACT Research into memory and epilepsy has focused on measuring problems and exploring causes with limited attention directed at the role of neuropsychological rehabilitation in alleviating post-operative memory difficulties. Objectives To assess the effects of a memory rehabilitation program in patients with left temporal lobe epilepsy following surgery. Methods Twenty-four patients agreed to participate and 18 completed the study; nine received memory rehabilitation while nine had no input and were designated as controls. Verbal learning efficiency, naming abilities, memory subjective ratings, ecological activity measures and a language fMRI paradigm were used as outcome measures. Results Improved verbal learning and naming test performance, increase in memory strategy use and improved self-perception were observed following the rehabilitation. Changes in fMRI activation patterns were seen in the rehabilitation group over the long term. Conclusion The findings support the potential role of a cognitive rehabilitation program following left temporal lobe surgery.

  5. Family and home in cognitive rehabilitation after brain injury: The importance of family oriented interventions.

    Science.gov (United States)

    Wulf-Andersen, Camilla; Mogensen, Jesper

    2017-01-01

    Acquired brain injury (ABI) severely affects both the injured patient and her/his family. This fact alone calls for a therapeutic approach addressing not only the individual victim of ABI but also her/his family. Additionally, the optimal outcome of posttraumatic cognitive rehabilitation may be best obtained by supplementing the institution-based cognitive training with home-based training. Moving cognitive training and other therapeutic interventions into the home environment does, however, constitute an additional challenge to the family structure and psychological wellbeing of all family members. We presently argue in favour of an increased utilization of family-based intervention programs for the families of brain injured patients - in general and especially in case of utilization of home-based rehabilitative training.

  6. Human computer confluence applied in healthcare and rehabilitation.

    Science.gov (United States)

    Viaud-Delmon, Isabelle; Gaggioli, Andrea; Ferscha, Alois; Dunne, Stephen

    2012-01-01

    Human computer confluence (HCC) is an ambitious research program studying how the emerging symbiotic relation between humans and computing devices can enable radically new forms of sensing, perception, interaction, and understanding. It is an interdisciplinary field, bringing together researches from horizons as various as pervasive computing, bio-signals processing, neuroscience, electronics, robotics, virtual & augmented reality, and provides an amazing potential for applications in medicine and rehabilitation.

  7. Computer-assisted instruction

    NARCIS (Netherlands)

    Voogt, J.; Fisser, P.; Wright, J.D.

    2015-01-01

    Since the early days of computer technology in education in the 1960s, it was claimed that computers can assist instructional practice and hence improve student learning. Since then computer technology has developed, and its potential for education has increased. In this article, we first discuss

  8. Back home after an acquired brain injury: building a "low-cost" team to provide theory-driven cognitive rehabilitation after routine interventions.

    Science.gov (United States)

    Pierini, Davide; Hoerold, Doreen

    2014-01-01

    Individuals with Acquired Brain Injury (ABI) could benefit from further cognitive rehabilitation, after they have returned home. However, a lack of specialist services to provide such rehabilitation often prevents this. This leads to reduced reintegration of patients, increased social disadvantages and ultimately, higher economic costs. 10 months post-stroke, a 69 year-old woman was discharged from an inpatient rehabilitation program and returned home with severe cognitive impairments. We describe a pilot project which provided an individualised, low cost rehabilitation program, supervised and trained by a neuropsychologist. Progress was monitored every 3 months in order to decide on continuation of the program, based on the achieved results and predicted costs. Post intervention, despite severe initial impairment, cognitive and most notably daily functioning had improved. Although the financial investment was moderately high for the family, the intervention was still considered cost-effective when compared with the required costs of care in a local non-specialist care home. Moreover, the pilot experience was used to build a "local expert team" available for other individuals requiring rehabilitation. These results encourage the development of similar local "low cost" teams in the community, to provide scientifically-grounded cognitive rehabilitation for ABI patients returning home.

  9. Cognitive activity limitations one year post-trauma in patients admitted to sub-acute rehabilitation after severe traumatic brain injury

    DEFF Research Database (Denmark)

    Sommer, Jens Bak; Norup, Anne; Poulsen, Ingrid

    2013-01-01

    Objective: To examine cognitive activity limitations and predictors of outcome 1 year post-trauma in patients admitted to sub-acute rehabilitation after severe traumatic brain injury. Subjects: The study included 119 patients with severe traumatic brain injury admitted to centralized sub-acute re......Objective: To examine cognitive activity limitations and predictors of outcome 1 year post-trauma in patients admitted to sub-acute rehabilitation after severe traumatic brain injury. Subjects: The study included 119 patients with severe traumatic brain injury admitted to centralized sub......-acute rehabilitation in the Eastern part of Denmark during a 5-year period from 2005 to 2009. Methods: Level of consciousness was assessed consecutively during rehabilitation and at 1 year post-trauma. Severity of traumatic brain injury was classified according to duration of post-traumatic amnesia. The cognitive...... subscale of Functional Independence MeasureTM (Cog-FIM) was used to assess cognitive activity limitations. Multivariate logistic regression analyses were performed to identify predictors of an independent level of functioning. Results: The majority of patients progressed to a post-confusional level...

  10. Exoskeleton Technology in Rehabilitation: Towards an EMG-Based Orthosis System for Upper Limb Neuromotor Rehabilitation

    Directory of Open Access Journals (Sweden)

    Luis Manuel Vaca Benitez

    2013-01-01

    Full Text Available The rehabilitation of patients should not only be limited to the first phases during intense hospital care but also support and therapy should be guaranteed in later stages, especially during daily life activities if the patient’s state requires this. However, aid should only be given to the patient if needed and as much as it is required. To allow this, automatic self-initiated movement support and patient-cooperative control strategies have to be developed and integrated into assistive systems. In this work, we first give an overview of different kinds of neuromuscular diseases, review different forms of therapy, and explain possible fields of rehabilitation and benefits of robotic aided rehabilitation. Next, the mechanical design and control scheme of an upper limb orthosis for rehabilitation are presented. Two control models for the orthosis are explained which compute the triggering function and the level of assistance provided by the device. As input to the model fused sensor data from the orthosis and physiology data in terms of electromyography (EMG signals are used.

  11. Cognitive spectrum of the social mission of the rehabilitation park

    Directory of Open Access Journals (Sweden)

    E. G. Pozdnyakova-Kirbyateva

    2017-08-01

    It is emphasized that reflection on these requests exceeds the social rehabilitation of the park’s mission within cognitive umbrellas. Six peaks of logically combining achieve the same number of subjects or groups of the latter. Continuous and dashed bar side, combining the top chimney in the middle to form eight triangles. Four of the past, for example, continuous parties combine discipline with which to achieve the main objectives of the study. This position caused the author to include rationale for the creation and operation of the pilot facility for Ukraine as rehabilitation park scientific and practical achievements of social, medical, educational, architectural, psychological disciplines and ethics. Accordingly, the principles of anthropocentrism, humanism, behaviorism conceptual definition of the publication.

  12. Neural computation and the computational theory of cognition.

    Science.gov (United States)

    Piccinini, Gualtiero; Bahar, Sonya

    2013-04-01

    We begin by distinguishing computationalism from a number of other theses that are sometimes conflated with it. We also distinguish between several important kinds of computation: computation in a generic sense, digital computation, and analog computation. Then, we defend a weak version of computationalism-neural processes are computations in the generic sense. After that, we reject on empirical grounds the common assimilation of neural computation to either analog or digital computation, concluding that neural computation is sui generis. Analog computation requires continuous signals; digital computation requires strings of digits. But current neuroscientific evidence indicates that typical neural signals, such as spike trains, are graded like continuous signals but are constituted by discrete functional elements (spikes); thus, typical neural signals are neither continuous signals nor strings of digits. It follows that neural computation is sui generis. Finally, we highlight three important consequences of a proper understanding of neural computation for the theory of cognition. First, understanding neural computation requires a specially designed mathematical theory (or theories) rather than the mathematical theories of analog or digital computation. Second, several popular views about neural computation turn out to be incorrect. Third, computational theories of cognition that rely on non-neural notions of computation ought to be replaced or reinterpreted in terms of neural computation. Copyright © 2012 Cognitive Science Society, Inc.

  13. Brief Report: Is Cognitive Rehabilitation Needed in Verbal Adults with Autism? Insights from Initial Enrollment in a Trial of Cognitive Enhancement Therapy

    Science.gov (United States)

    Eack, Shaun M.; Bahorik, Amber L.; Hogarty, Susan S.; Greenwald, Deborah P.; Litschge, Maralee Y.; Mazefsky, Carla A.; Minshew, Nancy J.

    2013-01-01

    Cognitive rehabilitation is an emerging set of potentially effective interventions for the treatment of autism spectrum disorder, yet the applicability of these approaches for "high functioning" adults who have normative levels of intelligence remains unexplored. This study examined the initial cognitive performance characteristics of 40…

  14. Selective visual attention to drive cognitive brain machine interfaces: from concepts to neurofeedback and rehabilitation applications

    Directory of Open Access Journals (Sweden)

    Elaine eAstrand

    2014-08-01

    Full Text Available Brain Machine Interfaces (BMI using motor cortical activity to drive an external effector like a screen cursor or a robotic arm have seen enormous success and proven their great rehabilitation potential. An emerging parallel effort is now directed to BMIs controlled by endogenous cognitive activity, also called cognitive BMIs. While more challenging, this approach opens new dimensions to the rehabilitation of cognitive disorders. In the present work, we focus on BMIs driven by visuospatial attention signals and we provide a critical review of these studies in the light of the accumulated knowledge about the psychophysics, anatomy and neurophysiology of visual spatial attention. Importantly, we provide a unique comparative overview of the several studies, ranging from noninvasive to invasive human and non-human primates studies, that decode attention-related information from ongoing neuronal activity. We discuss these studies in the light of the challenges attention-driven cognitive BMIs have to face. In a second part of the review, we discuss past and current attention-based neurofeedback studies, describing both the covert effects of neurofeedback onto neuronal activity and its overt behavioral effects. Importantly, we compare neurofeedback studies based on the amplitude of cortical activity to studies based on the enhancement of cortical information content. Last, we discuss several lines of future research and applications for attention-driven cognitive BCIs, including the rehabilitation of cognitive deficits, restored communication in locked-in patients, and open-field applications for enhanced cognition in normal subjects. The core motivation of this work is the key idea that the improvement of current cognitive BMIs for therapeutic and open field applications needs to be grounded in a proper interdisciplinary understanding of the physiology of the cognitive function of interest, be it spatial attention, working memory or any other

  15. Animal-assisted interventions in internal and rehabilitation medicine: a review of the recent literature.

    Science.gov (United States)

    Muñoz Lasa, S; Ferriero, G; Brigatti, E; Valero, R; Franchignoni, F

    2011-06-01

    While conventional wisdom has always affirmed the value of animals in promoting human well-being, only recently has their therapeutic role in medicine become the focus of dedicated research. Therapeutic modalities that use animals as a tool for improving the physical, emotional, cognitive and/or social functioning of humans are called animal-assisted interventions (AAI), and are classified into: animal-assisted activities (AAA); animal-assisted therapy (AAT); and service animal programs (SAP). The aim of this review is to analyze the papers published between 2001 and 2010 in the most influential medical journals dealing with AAI, and discuss their findings in the light of what may be of interest for internal medicine and rehabilitation. A total of 35 articles met the strict inclusion criteria for this review: 18 papers dealing with AAA, 8 with AAT, and 9 with SAP. The therapeutic outcomes associated with AAA are: enhancement of socialization; reduction of stress, anxiety and loneliness; improvement in mood and general well-being; and development of leisure/recreation skills. Regarding AAT, horses are often used as a complementary strategy to facilitate the normalization of muscle tone and improve motor skills in children with cerebral palsy and persons with lower limb spasticity. Finally, most SAP utilize dogs, that assist people with various disabilities in performing everyday activities, thus reducing their dependence on other persons. Further studies are needed to better define the fields and programs for the therapeutic use of animals and to increase their utilization in medicine, as a promising, complementary and natural means to improve both functional autonomy and quality of life.

  16. Virtual rehabilitation--benefits and challenges.

    Science.gov (United States)

    Burdea, G C

    2003-01-01

    To discuss the advantages and disadvantages of rehabilitation applications of virtual reality. VR can be used as an enhancement to conventional therapy for patients with conditions ranging from musculoskeletal problems, to stroke-induced paralysis, to cognitive deficits. This approach is called "VR-augmented rehabilitation." Alternately, VR can replace conventional interventions altogether, in which case the rehabilitation is "VR-based." If the intervention is done at a distance, then it is called "telerehabilitation." Simulation exercises for post-stroke patients have been developed using a "teacher object" approach or a video game approach. Simulations for musculo-skeletal patients use virtual replicas of rehabilitation devices (such as rubber ball, power putty, peg board). Phobia-inducing virtual environments are prescribed for patients with cognitive deficits. VR-augmented rehabilitation has been shown effective for stroke patients in the chronic phase of the disease. VR-based rehabilitation has been improving patients with fear of flying, Vietnam syndrome, fear of heights, and chronic stroke patients. Telerehabilitation interventions using VR have improved musculo-skeletal and post-stroke patients, however less data is available at this time. Virtual reality presents significant advantages when applied to rehabilitation of patients with varied conditions. These advantages include patient motivation, adaptability and variability based on patient baseline, transparent data storage, online remote data access, economy of scale, reduced medical costs. Challenges in VR use for rehabilitation relate to lack of computer skills on the part of therapists, lack of support infrastructure, expensive equipment (initially), inadequate communication infrastructure (for telerehabilitation in rural areas), and patient safety concerns.

  17. Benefits of virtual reality based cognitive rehabilitation through simulated activities of daily living: a randomized controlled trial with stroke patients.

    Science.gov (United States)

    Faria, Ana Lúcia; Andrade, Andreia; Soares, Luísa; I Badia, Sergi Bermúdez

    2016-11-02

    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. 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 post-intervention 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). 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

  18. Cognitive-communication disorder following right hemisphere stroke: exploring rehabilitation access and outcomes.

    Science.gov (United States)

    Hewetson, Ronelle; Cornwell, Petrea; Shum, David

    2017-07-01

    Rehabilitation positively influences return to activities and social roles in people with aphasia. The cognitive-communication disorder (CCD) found following a right hemisphere stroke has been less extensively researched with rehabilitation access and outcomes yet to be determined. To document rehabilitation access and outcomes for people with CCD post-stroke; and compare outcomes based on presence (viz CCD; aphasia) or absence of communication impairment. A retrospective chart audit was completed for patients with first onset unilateral stroke, with a hospital length of stay (LOS) of at least two days and a communication assessment by a speech pathologist. Data extracted included presence and severity of communication impairment, access to and LOS in a rehabilitation unit, and functional outcome measures recorded at rehabilitation discharge. The majority of the 115 patients who met inclusion criteria were living independently (n = 112, 97.4%) at the time of stroke. CCD (66%) was diagnosed with similar frequency to aphasia (68%). The presence of communication impairment did not result in significant differences in rehabilitation LOS and discharge destination when compared to hemispheric strokes without communication impairment. Severity of CCD was an independent predictor of functional gain by rehabilitation discharge. People with CCD require comparable access to rehabilitation as people with aphasia, and severity of CCD should be considered in determining rehabilitation LOS. A large number of people are discharged with ongoing CCD which warrants exploration of potential participation restrictions created by the communication impairment.

  19. THE USE OF A COMPLEX “BRAIN-COMPUTER INTERFACE AND EXO-SKELETON” AND MOVEMENT IMAGINATION TECHNIQUE FOR POST-STROKE REHABILITATION

    Directory of Open Access Journals (Sweden)

    S. V. Kotov

    2015-01-01

    Full Text Available Background: Efficacy of physical exercise and movement imagination for restoration of motor dysfunction after a stroke is seen as proven. However, the use of movement imagination is complicated by impossibility of objective and subjective control over  the exercise, as well as by the absence of their motor support. The brain-computer interface based on electroencephalography is a technique that enables a feedback during movement imagination.Materials and methods: We assessed 10 patients (6 men and 4 women aged from 30 to 66 years (mean age, 47 ± 7.7 years with an ischemic (n = 9 and hemorrhagic (n = 1 stroke during the last 2 months to 4 years. Online recognition of movement imagination was done by a classifier with a brain computer interface. An exo-skeleton supported passive movements in a paretic hand managed by the brain-computer interface. During 2 weeks the patients had 10 sessions of 45–90 minute duration each. For control, we used data from 5 stroke patients who, in addition to their standard treatment, underwent an imitation of rehabilitation procedures without movement imagination and feedback. To assess efficacy of treatment, we used a modified Ashworth scale, Fugl-Meyer scale, test for evaluation of hand functions ARAT, British scale for assessment of muscle force MRC-SS. Level of everyday activity and working ability was measured with a modified Rankin scale and Bartel index. Cognitive functions were assessed with Schulte tables.Results: Online recognition of movement imagination according to desynchronization of μ rhythm was registered in 50–75% of patients. All patients reported a subjective improvement of motor functions and working ability. Positive results for at least one parameter were observed in all patients; however, there were no significant difference between the parameters before and after rehabilitation procedures, excluding cognitive functions (degree of warming-up, p < 0.02.Conclusion: In post stroke patients

  20. Effectiveness of Animal Assisted Therapy after brain injury: A bridge to improved outcomes in CRT.

    Science.gov (United States)

    Stapleton, Mary

    2016-06-18

    Animal Assisted Therapy (AAT) has been widely used as a complementary therapy in mental health treatment especially to remediate social skill deficits. The goal of AAT is to improve social, emotional, and cognitive functioning. The purpose of this article is to draw upon the literature on AAT and explore specific applications to cognitive rehabilitation therapy (CRT) and social skills training. This study provides a systematic review of most of the available literature on ATT and assesses that potential uses of ATT for brain injury rehabilitation. Although the efficacy of AAT is not currently well documented by rigorous research, (Kazin, 2010) anecdotal evidence suggests that brain injury survivors may benefit from the combination of AAT and cognitive rehabilitation techniques. Acquired Brain Injury (ABI) survivors with cognitive impairments can benefit from AAT as part of a comprehensive and holistic rehabilitation treatment plan.

  1. Cognitive rehabilitation of episodic memory disorders: from theory to practice

    Directory of Open Access Journals (Sweden)

    Radek Ptak

    2010-07-01

    Full Text Available Memory disorders are among the most frequent and most debilitating cognitive impairments following acquired brain damage. Cognitive remediation strategies attempt to restore lost memory capacity, provide compensatory techniques or teach the use of external memory aids. Memory rehabilitation has strongly been influenced by memory theory, and the interaction between both has stimulated the development of techniques such as spaced retrieval, vanishing cues or errorless learning. These techniques partly rely on implicit memory and therefore enable even patients with dense amnesia to acquire new information. However, knowledge acquired in this way is often strongly domain-specific and inflexible. In addition, individual patients with amnesia respond differently to distinct interventions. The factors underlying these differences have not yet been identified. Behavioural management of memory failures therefore often relies on a careful description of environmental factors and measurement of associated behavioural disorders such as unawareness of memory failures. The current evidence suggests that patients with less severe disorders benefit from self-management techniques and mnemonics whereas rehabilitation of severely amnesic patients should focus on behaviour management, the transmission of domain-specific knowledge through implicit memory processes and the compensation for memory deficits with memory aids.

  2. New Framework for Rehabilitation - Fusion of Cognitive and Physical Rehabilitation: The Hope for Dancing

    Directory of Open Access Journals (Sweden)

    Prabhjot eDhami

    2015-01-01

    Full Text Available Neurorehabilitation programs are commonly employed with the goal to help restore functionality in patients. However, many of these therapies report only having a small impact. In response to the need for more effective and innovative approaches, rehabilitative methods that take advantage of the neuroplastic properties of the brain have been used to aid with both physical and cognitive impairments. Following this path of reasoning, there has been a particular interest in the use of physical exercise as well as musical related activities. Although such therapies demonstrate potential, they also have limitations that may affect their use, calling for further exploration. Here, we propose dance as a potential parallel to physical and music therapies. Dance may be able to aid with both physical and cognitive impairments, particularly due to it combined nature of including both physical and cognitive stimulation. Not only does it incorporate physical and motor skill related activities, but also provides cognitive stimulation through engaging various cognitive functions such as perception, emotion, memory, all done in an enriched environment. Other more practical benefits, such as promoting adherence due to being enjoyable, are also discussed, along with the current literature on the application of dance as an intervention tool, as well as future directions required to evaluate the potential of dance as an alternative therapy in neurorehabilitation.

  3. Influences on selection of assistive technology for young children in South Africa: perspectives from rehabilitation professionals.

    Science.gov (United States)

    van Niekerk, Karin; Dada, Shakila; Tönsing, Kerstin

    2017-12-20

    Selection of assistive technology for young children is a complex process. Within a context with limited resources, such as South Africa, research is needed to determine the factors influencing the assistive technology selection process, as these could ultimately either facilitate or hinder the availability and accessibility of affordable, adaptable, acceptable, and high quality assistive technology for this age group. Two asynchronous online focus groups were conducted with 16 rehabilitation professionals to identify the factors they perceived to influence the selection and provision of assistive technology to young children within the South African context. A process of deductive thematic analysis was followed by inductive analysis of the data. Components of the Assistive Technology Device Selection Framework were used as themes to guide the deductive analysis, followed by inductive analysis to create subthemes. The important role of the professional was highlighted in negotiating all the factors to consider in the assistive technology selection and provision process. Adaptation of the Assistive Technology Device Selection Framework is suggested in order to facilitate application to low resourced contexts, such as South Africa. Implications for rehabilitation Assistive technology selection is a complex process with factors pertaining to the users (child and family) of the assistive technology, as well as the rehabilitation professional recommending the assistive technology influencing the process. Although it may be an important factor, the availability of financial resources to purchase assistive technology is not the only determining factor in providing appropriate assistive technology to young children in contexts with limited resources. Formalized support, such as reflective supervision or mentorship programs should be facilitated and utilized by recommending professionals. Home and school visits during assessment ensure a good match between assistive

  4. A Human–Robot Interaction Perspective on Assistive and Rehabilitation Robotics

    Directory of Open Access Journals (Sweden)

    Philipp Beckerle

    2017-05-01

    Full Text Available Assistive and rehabilitation devices are a promising and challenging field of recent robotics research. Motivated by societal needs such as aging populations, such devices can support motor functionality and subject training. The design, control, sensing, and assessment of the devices become more sophisticated due to a human in the loop. This paper gives a human–robot interaction perspective on current issues and opportunities in the field. On the topic of control and machine learning, approaches that support but do not distract subjects are reviewed. Options to provide sensory user feedback that are currently missing from robotic devices are outlined. Parallels between device acceptance and affective computing are made. Furthermore, requirements for functional assessment protocols that relate to real-world tasks are discussed. In all topic areas, the design of human-oriented frameworks and methods is dominated by challenges related to the close interaction between the human and robotic device. This paper discusses the aforementioned aspects in order to open up new perspectives for future robotic solutions.

  5. A Human–Robot Interaction Perspective on Assistive and Rehabilitation Robotics

    Science.gov (United States)

    Beckerle, Philipp; Salvietti, Gionata; Unal, Ramazan; Prattichizzo, Domenico; Rossi, Simone; Castellini, Claudio; Hirche, Sandra; Endo, Satoshi; Amor, Heni Ben; Ciocarlie, Matei; Mastrogiovanni, Fulvio; Argall, Brenna D.; Bianchi, Matteo

    2017-01-01

    Assistive and rehabilitation devices are a promising and challenging field of recent robotics research. Motivated by societal needs such as aging populations, such devices can support motor functionality and subject training. The design, control, sensing, and assessment of the devices become more sophisticated due to a human in the loop. This paper gives a human–robot interaction perspective on current issues and opportunities in the field. On the topic of control and machine learning, approaches that support but do not distract subjects are reviewed. Options to provide sensory user feedback that are currently missing from robotic devices are outlined. Parallels between device acceptance and affective computing are made. Furthermore, requirements for functional assessment protocols that relate to real-world tasks are discussed. In all topic areas, the design of human-oriented frameworks and methods is dominated by challenges related to the close interaction between the human and robotic device. This paper discusses the aforementioned aspects in order to open up new perspectives for future robotic solutions. PMID:28588473

  6. Acute cognitive dysfunction after hip fracture: frequency and risk factors in an optimized, multimodal, rehabilitation program

    DEFF Research Database (Denmark)

    Bitsch, Martin; Foss, Nicolai Bang; Kristensen, Billy Bjarne

    2006-01-01

    hip fracture surgery in an optimized, multimodal, peri-operative rehabilitation regimen. METHODS: One hundred unselected hip fracture patients treated in a well-defined, optimized, multimodal, peri-operative rehabilitation regimen were included. Patients were tested upon admission and on the second......BACKGROUND: Patients undergoing hip fracture surgery often experience acute post-operative cognitive dysfunction (APOCD). The pathogenesis of APOCD is probably multifactorial, and no single intervention has been successful in its prevention. No studies have investigated the incidence of APOCD after......, fourth and seventh post-operative days with the Mini Mental State Examination (MMSE) score. RESULTS: Thirty-two per cent of patients developed a significant post-operative cognitive decline, which was associated with several pre-fracture patient characteristics, including age and cognitive function...

  7. Variables that Affect Math Teacher Candidates' Intentions to Integrate Computer-Assisted Mathematics Education (CAME)

    Science.gov (United States)

    Erdogan, Ahmet

    2010-01-01

    Based on Social Cognitive Carier Theory (SCCT) (Lent, Brown, & Hackett, 1994, 2002), this study tested the effects of mathematics teacher candidates' self-efficacy in, outcome expectations from, and interest in CAME on their intentions to integrate Computer-Assisted Mathematics Education (CAME). While mathematics teacher candidates' outcome…

  8. An esthetics rehabilitation with computer-aided design/ computer-aided manufacturing technology.

    Science.gov (United States)

    Mazaro, Josá Vitor Quinelli; de Mello, Caroline Cantieri; Zavanelli, Adriana Cristina; Santiago, Joel Ferreira; Amoroso, Andressa Paschoal; Pellizzer, Eduardo Piza

    2014-07-01

    This paper describes a case of a rehabilitation involving Computer Aided Design/Computer Aided Manufacturing (CAD-CAM) system in implant supported and dental supported prostheses using zirconia as framework. The CAD-CAM technology has developed considerably over last few years, becoming a reality in dental practice. Among the widely used systems are the systems based on zirconia which demonstrate important physical and mechanical properties of high strength, adequate fracture toughness, biocompatibility and esthetics, and are indicated for unitary prosthetic restorations and posterior and anterior framework. All the modeling was performed by using CAD-CAM system and prostheses were cemented using resin cement best suited for each situation. The rehabilitation of the maxillary arch using zirconia framework demonstrated satisfactory esthetic and functional results after a 12-month control and revealed no biological and technical complications. This article shows the important of use technology CAD/CAM in the manufacture of dental prosthesis and implant-supported.

  9. Evaluation of a Web-Based Cognitive Rehabilitation Program in Cancer Survivors Reporting Cognitive Symptoms After Chemotherapy.

    Science.gov (United States)

    Bray, Victoria J; Dhillon, Haryana M; Bell, Melanie L; Kabourakis, Michael; Fiero, Mallorie H; Yip, Desmond; Boyle, Frances; Price, Melanie A; Vardy, Janette L

    2017-01-10

    Purpose Cognitive impairment is reported frequently by cancer survivors. There are no proven treatments. We evaluated a cognitive rehabilitation program (Insight) and compared it with standard care in cancer survivors self-reporting cognitive symptoms. Patients and Methods We recruited adult cancer survivors with a primary malignancy (excluding central nervous system malignancies) who had completed three or more cycles of adjuvant chemotherapy in the previous 6 to 60 months and reported persistent cognitive symptoms. All participants received a 30-minute telephone consultation and were then randomly assigned to the 15-week, home-based intervention or to standard care. Primary outcome was self-reported cognitive function (Functional Assessment of Cancer Therapy Cognitive Function [FACT-COG] perceived cognitive impairment [PCI] subscale): difference between groups after intervention (T2) and 6 months later (T3). Results A total of 242 participants were randomly assigned: median age, 53 years; 95% female. The primary outcome of difference in FACT-COG PCI was significant, with less PCI in the intervention group at T2 ( P cognitive symptoms compared with standard care. To our knowledge, this is the first large randomized controlled trial showing an improvement in self-reported cognitive function in cancer survivors, indicating that this intervention is a feasible treatment.

  10. Development of an Upper Limb Motorized Assistive-Rehabilitative Robot

    Science.gov (United States)

    Amiri, Masoud; Casolo, Federico

    While the number of people requiring help for the activities of daily living are increasing, several studies have been shown the effectiveness of robot training for upper limb functionality recovery. The robotic system described in this paper is an active end-effector based robot which can be used for assisting and rehabilitating of human upper limb. The robot is able to take into account desire of the patient for the support that patient needs to complete the task.

  11. Consumers' and providers' perceptions of utilizing a computer-assisted cognitive behavioral therapy for childhood anxiety.

    Science.gov (United States)

    Salloum, Alison; Crawford, Erika A; Lewin, Adam B; Storch, Eric A

    2015-01-01

    Computer-assisted cognitive behavioral therapy (CCBT) programs for childhood anxiety are being developed, although research about factors that contribute to implementation of CCBT in community mental health centers (CMHC) is limited. The purpose of this mixed-methods study was to explore consumers' and providers' perceptions of utilizing a CCBT for childhood anxiety in CMHC in an effort to identify factors that may impact implementation of CCBT in CMHC. Focus groups and interviews occurred with 7 parents, 6 children, 3 therapists, 3 project coordinators and 3 administrators who had participated in CCBT for childhood anxiety. Surveys of treatment satisfaction and treatment barriers were administered to consumers. RESULTS suggest that both consumers and providers were highly receptive to participation in and implementation of CCBT in CMHC. Implementation themes included positive receptiveness, factors related to therapists, treatment components, applicability of treatment, treatment content, initial implementation challenges, resources, dedicated staff, support, outreach, opportunities with the CMHC, payment, and treatment availability. As studies continue to demonstrate the effectiveness of CCBT for childhood anxiety, research needs to continue to examine factors that contribute to the successful implementation of such treatments in CMHC.

  12. Wrist Rehabilitation Assisted by an Electromyography-Driven Neuromuscular Electrical Stimulation Robot After Stroke.

    Science.gov (United States)

    Hu, Xiao-Ling; Tong, Raymond Kai-yu; Ho, Newmen S K; Xue, Jing-jing; Rong, Wei; Li, Leonard S W

    2015-09-01

    Augmented physical training with assistance from robot and neuromuscular electrical stimulation (NMES) may introduce intensive motor improvement in chronic stroke. To compare the rehabilitation effectiveness achieved by NMES robot-assisted wrist training and that by robot-assisted training. This study was a single-blinded randomized controlled trial with a 3-month follow-up. Twenty-six hemiplegic subjects with chronic stroke were randomly assigned to receive 20-session wrist training with an electromyography (EMG)-driven NMES robot (NMES robot group, n = 11) and with an EMG-driven robot (robot group, n = 15), completed within 7 consecutive weeks. Clinical scores, Fugl-Meyer Assessment (FMA), Modified Ashworth Score (MAS), and Action Research Arm Test (ARAT) were used to evaluate the training effects before and after the training, as well as 3 months later. An EMG parameter, muscle co-contraction index, was also applied to investigate the session-by-session variation in muscular coordination patterns during the training. The improvement in FMA (shoulder/elbow, wrist/hand) obtained in the NMES robot group was more significant than the robot group (P rehabilitation progress. © The Author(s) 2014.

  13. Computer-based, personalized cognitive training versus classical computer games: a randomized double-blind prospective trial of cognitive stimulation.

    Science.gov (United States)

    Peretz, Chava; Korczyn, Amos D; Shatil, Evelyn; Aharonson, Vered; Birnboim, Smadar; Giladi, Nir

    2011-01-01

    Many studies have suggested that cognitive training can result in cognitive gains in healthy older adults. We investigated whether personalized computerized cognitive training provides greater benefits than those obtained by playing conventional computer games. This was a randomized double-blind interventional study. Self-referred healthy older adults (n = 155, 68 ± 7 years old) were assigned to either a personalized, computerized cognitive training or to a computer games group. Cognitive performance was assessed at baseline and after 3 months by a neuropsychological assessment battery. Differences in cognitive performance scores between and within groups were evaluated using mixed effects models in 2 approaches: adherence only (AO; n = 121) and intention to treat (ITT; n = 155). Both groups improved in cognitive performance. The improvement in the personalized cognitive training group was significant (p computer games group it was significant (p games in improving visuospatial working memory (p = 0.0001), visuospatial learning (p = 0.0012) and focused attention (p = 0.0019). Personalized, computerized cognitive training appears to be more effective than computer games in improving cognitive performance in healthy older adults. Further studies are needed to evaluate the ecological validity of these findings. Copyright © 2011 S. Karger AG, Basel.

  14. 75 FR 21617 - Office of Special Education and Rehabilitative Services; Overview Information; Rehabilitation...

    Science.gov (United States)

    2010-04-26

    ... DEPARTMENT OF EDUCATION Office of Special Education and Rehabilitative Services; Overview.... The Assistant Secretary for Special Education and Rehabilitative Services may change the maximum..., Assistant Secretary for Special Education and Rehabilitative Services. [FR Doc. 2010-9635 Filed 4-23-10; 8...

  15. The Use of Computer-Assisted Home Exercises to Preserve Physical Function after a Vestibular Rehabilitation Program: A Randomized Controlled Study

    DEFF Research Database (Denmark)

    Brandt, Michael Smærup; Læssøe, Uffe; Grönvall, Erik

    2016-01-01

    . Materials and Methods. Single-blind, randomized, controlled follow-up study. Fifty-seven elderly patients with chronic dizziness were randomly assigned to a computer-assisted home exercise program or to home exercises as described in printed instructions and followed for tree month after discharge from......, and quality of life three months following discharge from hospital. In this specific setup, no greater effect was found by introducing a computer-assisted training program, when compared to standard home training guided by printed instructions. This trial is registered with NCT01344408.......Objective. The purpose of this study was to evaluate whether elderly patients with vestibular dysfunction are able to preserve physical functional level, reduction in dizziness, and the patient's quality of life when assistive computer technology is used in comparison with printed instructions...

  16. A Systematic Review on Existing Measures for the Subjective Assessment of Rehabilitation and Assistive Robot Devices

    Directory of Open Access Journals (Sweden)

    Yiannis Koumpouros

    2016-01-01

    Full Text Available The objective of the current study is to identify and classify outcome measures currently used for the assessment of rehabilitation or assistive robot devices. We conducted a systematic review of the literature using PubMed, MEDLINE, CIRRIE, and Scopus databases for studies that assessed rehabilitation or assistive robot devices from 1980 through January 2016. In all, 31 articles met all inclusion criteria. Tailor-made questionnaires were the most commonly used tool at 66.7%, while the great majority (93.9% of the studies used nonvalidated instruments. The study reveals the absence of a standard scale which makes it difficult to compare the results from different researchers. There is a great need, therefore, for a valid and reliable instrument to be available for use by the intended end users for the subjective assessment of robot devices. The study concludes by identifying two scales that have been validated in general assistive technology devices and could support the scope of subjective assessment in rehabilitation or assistive robots (however, with limited coverage and a new one called PYTHEIA, recently published. The latter intends to close the gap and help researchers and developers to evaluate, assess, and produce products that satisfy the real needs of the end users.

  17. Effects of robot-assisted training on upper limb functional recovery during the rehabilitation of poststroke patients.

    Science.gov (United States)

    Daunoraviciene, Kristina; Adomaviciene, Ausra; Grigonyte, Agne; Griškevičius, Julius; Juocevicius, Alvydas

    2018-05-18

    The study aims to determine the effectiveness of robot-assisted training in the recovery of stroke-affected arms using an exoskeleton robot Armeo Spring. To identify the effect of robot training on functional recovery of the arm. A total of 34 stroke patients were divided into either an experimental group (EG; n= 17) or a control group (n= 17). EG was also trained to use the Armeo Spring during occupational therapy. Both groups were clinically assessed before and after treatment. Statistical comparison methods (i.e. one-tailed t-tests for differences between two independent means and the simplest test) were conducted to compare motor recovery using robot-assisted training or conventional therapy. Patients assigned to the EG showed a statistically significant improvement in upper extremity motor function when compared to the CG by FIM (Peffect in the EG and CG was meaningful for shoulder and elbow kinematic parameters. The findings show the benefits of robot therapy in two areas of functional recovery. Task-oriented robotic training in rehabilitation setting facilitates recovery not only of the motor function of the paretic arm but also of the cognitive abilities in stroke patients.

  18. Outcomes from a pilot study using computer-based rehabilitative tools in a military population.

    Science.gov (United States)

    Sullivan, Katherine W; Quinn, Julia E; Pramuka, Michael; Sharkey, Laura A; French, Louis M

    2012-01-01

    Novel therapeutic approaches and outcome data are needed for cognitive rehabilitation for patients with a traumatic brain injury; computer-based programs may play a critical role in filling existing knowledge gaps. Brain-fitness computer programs can complement existing therapies, maximize neuroplasticity, provide treatment beyond the clinic, and deliver objective efficacy data. However, these approaches have not been extensively studied in the military and traumatic brain injury population. Walter Reed National Military Medical Center established its Brain Fitness Center (BFC) in 2008 as an adjunct to traditional cognitive therapies for wounded warriors. The BFC offers commercially available "brain-training" products for military Service Members to use in a supportive, structured environment. Over 250 Service Members have utilized this therapeutic intervention. Each patient receives subjective assessments pre and post BFC participation including the Mayo-Portland Adaptability Inventory-4 (MPAI-4), the Neurobehavioral Symptom Inventory (NBSI), and the Satisfaction with Life Scale (SWLS). A review of the first 29 BFC participants, who finished initial and repeat measures, was completed to determine the effectiveness of the BFC program. Two of the three questionnaires of self-reported symptom change completed before and after participation in the BFC revealed a statistically significant reduction in symptom severity based on MPAI and NBSI total scores (p < .05). There were no significant differences in the SWLS score. Despite the typical limitations of a retrospective chart review, such as variation in treatment procedures, preliminary results reveal a trend towards improved self-reported cognitive and functional symptoms.

  19. Coping with cancer-related cognitive dysfunction: a scoping review of the literature.

    Science.gov (United States)

    Sleight, Alix

    2016-01-01

    Cancer-related cognitive dysfunction (CRCD) impacts memory, attention, concentration, language, multi-tasking, and organizational skills and decreases participation and quality of life for cancer survivors. The objectives of this article are: (1) to outline the neuroscience of CRCD, its risk factors, and its effect on participation; and (2) to identify and summarize the literature on rehabilitation interventions and coping techniques for CRCD in cancer survivors. A scoping review of articles cited in PubMed, MEDLINE, PsychINFO, and CINAHL was performed. To be included, articles must have been published in a peer-reviewed scientific journal between 1996 and 2014, written in English, and included a quantitative or qualitative non-pharmacological study of interventions and/or coping strategies for adult cancer survivors experiencing CRCD. Ten articles met the inclusion criteria for final review. Six studies tested the efficacy of rehabilitation treatments on CRCD. Three involved cognitive-behavioral therapy (CBT), while three tested neuropsychological and/or cognitive training interventions. Four qualitative studies investigated coping strategies used by survivors with CRCD. CBT-based treatments and neuropsychological/cognitive training methods may ameliorate symptoms of CRCD. The most commonly-reported coping strategy is utilization of assistive technology and memory aids. Further research is needed about efficacious rehabilitation techniques for this population. Implications for Rehabilitation Cancer-related cognitive dysfunction (CRCD) may impact up to 50% of cancer survivors. CRCD can significantly decrease participation and quality of life during survivorship. Cognitive-behavioral therapy (CBT) and neuropsychological/cognitive training methods may ameliorate symptoms of CRCD. The most common coping strategy reported by cancer survivors with CRCD is the use of assistive technology and memory aids.

  20. Goal Setting for Cognitive Rehabilitation in Mild to Moderate Parkinson's Disease Dementia and Dementia with Lewy Bodies.

    Science.gov (United States)

    Watermeyer, Tamlyn J; Hindle, John V; Roberts, Julie; Lawrence, Catherine L; Martyr, Anthony; Lloyd-Williams, Huw; Brand, Andrew; Gutting, Petra; Hoare, Zoe; Edwards, Rhiannon Tudor; Clare, Linda

    2016-01-01

    Alongside the physical symptoms associated with Parkinson's disease dementia and dementia with Lewy bodies, health services must also address the cognitive impairments that accompany these conditions. There is growing interest in the use of nonpharmacological approaches to managing the consequences of cognitive disorder. Cognitive rehabilitation is a goal-orientated behavioural intervention which aims to enhance functional independence through the use of strategies specific to the individual's needs and abilities. Fundamental to this therapy is a person's capacity to set goals for rehabilitation. To date, no studies have assessed goal setting in early-stage Parkinson's disease dementia or dementia with Lewy bodies. Semistructured interviews were carried out with 29 participants from an ongoing trial of cognitive rehabilitation for people with these conditions. Here, we examined the goal statements provided by these participants using qualitative content analysis, exploring the types and nature of the goals set. Participants' goals reflected their motivations to learn new skills or improve performance in areas such as technology-use, self-management and orientation, medication management, and social and leisure activities. These results suggest that goal setting is achievable for these participants, provide insight into the everyday cognitive difficulties that they experience, and highlight possible domains as targets for intervention. The trial is registered with ISRCTN16584442 (DOI 10.1186/ISRCTN16584442 13/04/2015).

  1. CARS 2008: Computer Assisted Radiology and Surgery. Proceedings

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2008-06-15

    The proceedings contain contributions to the following topics: digital imaging, computed tomography, magnetic resonance, cardiac and vascular imaging, computer assisted radiation therapy, image processing and display, minimal invasive spinal surgery, computer assisted treatment of the prostate, the interventional radiology suite of the future, interventional oncology, computer assisted neurosurgery, computer assisted head and neck and ENT surgery, cardiovascular surgery, computer assisted orthopedic surgery, image processing and visualization, surgical robotics, instrumentation and navigation, surgical modelling, simulation and education, endoscopy and related techniques, workflow and new concepts in surgery, research training group 1126: intelligent surgery, digital operating room, image distribution and integration strategies, regional PACS and telemedicine, PACS - beyond radiology and E-learning, workflow and standardization, breast CAD, thoracic CAD, abdominal CAD, brain CAD, orthodontics, dentofacial orthopedics and airways, imaging and treating temporomandibular joint conditions, maxillofacial cone beam CT, craniomaxillofacial image fusion and CBCT incidental findings, image guided craniomaxillofacial procedures, imaging as a biomarker for therapy response, computer aided diagnosis. The Poster sessions cover the topics computer aided surgery, Euro PACS meeting, computer assisted radiology, computer aided diagnosis and computer assisted radiology and surgery.

  2. CARS 2008: Computer Assisted Radiology and Surgery. Proceedings

    International Nuclear Information System (INIS)

    2008-01-01

    The proceedings contain contributions to the following topics: digital imaging, computed tomography, magnetic resonance, cardiac and vascular imaging, computer assisted radiation therapy, image processing and display, minimal invasive spinal surgery, computer assisted treatment of the prostate, the interventional radiology suite of the future, interventional oncology, computer assisted neurosurgery, computer assisted head and neck and ENT surgery, cardiovascular surgery, computer assisted orthopedic surgery, image processing and visualization, surgical robotics, instrumentation and navigation, surgical modelling, simulation and education, endoscopy and related techniques, workflow and new concepts in surgery, research training group 1126: intelligent surgery, digital operating room, image distribution and integration strategies, regional PACS and telemedicine, PACS - beyond radiology and E-learning, workflow and standardization, breast CAD, thoracic CAD, abdominal CAD, brain CAD, orthodontics, dentofacial orthopedics and airways, imaging and treating temporomandibular joint conditions, maxillofacial cone beam CT, craniomaxillofacial image fusion and CBCT incidental findings, image guided craniomaxillofacial procedures, imaging as a biomarker for therapy response, computer aided diagnosis. The Poster sessions cover the topics computer aided surgery, Euro PACS meeting, computer assisted radiology, computer aided diagnosis and computer assisted radiology and surgery

  3. Left ventricular assist device: exercise capacity evolution and rehabilitation added value.

    Science.gov (United States)

    Lamotte, Michel X; Chimenti, Sara; Deboeck, Gael; Gillet, Alexis; Kacelenenbogen, Raymond; Strapart, Jonathan; Vandeneynde, Frédéric; Van Nooten, Guido; Antoine, Martine

    2018-06-01

    With more than 15,000 implanted patients worldwide and a survival rate of 80% at 1-year and 59% at 5-years, left ventricular assist device (LVAD) implantation has become an interesting strategy in the management of heart failure patients who are resistant to other kinds of treatment. There are limited data in the literature on the change over time of exercise capacity in LVAD patients, as well as limited knowledge about the beneficial effects that rehabilitation might have on these patients. Therefore, the aim of our study was to evaluate the evolution of exercise capacity on a cohort of patients implanted with the same device (HeartWare © ) and to analyse the potential impact of rehabilitation. Sixty-two patients implanted with a LVAD between June 2011 and June 2015 were screened. Exercise capacity was evaluated by cardiopulmonary exercise testing at 6 weeks, 6 and 12 months after implantation. We have observed significant differences in the exercise capacity and evolution between the trained and non-trained patients. Some of the trained patients nearly normalised their exercise capacity at the end of the rehabilitation programme. Exercise capacity of patient implanted with a HeartWare © LVAD increased in the early period after implantation. Rehabilitation allowed implanted patients to have a significantly better evolution compared to non-rehabilitated patients.

  4. Learning from professionals: Exploring cognitive rehabilitation strategies for the definition of the functional requirements of a telerehabilitation platform.

    Science.gov (United States)

    Rosso, Giovanni; Frisiello, Antonella; Trizio, Marco; Mosso, Cristina O; Bazzani, Marco

    2018-04-01

    In the past few years, the advances in Information and Communication Technology (ICT) led to the development of platforms and applications that aim to support cognitive rehabilitation therapy that contributes to extend patients' treatment at home. In our research we adopted the Human Centered Approach to design a cognitive rehabilitation platform that is able to provide tools and features tailored to the professional needs and strategies and also able to engage patients in their treatment process. In order to explore the clinicians' point of view on the neuropsychological intervention strategies, we applied two different techniques often used in human factors research: the Critical Decision Method to study professionals' strategies with a descriptive perspective, and the Hierarchical Task Analysis to analyze the processes with a normative view. The results of our research showed that the hybrid approach adopted allowed us to have a better focus on the cognitive rehabilitation process and on the professionals' decision making mechanism. This led to a better understanding of functional requirements for supporting clinician's strategic decision making, in terms of personalization of treatments, cognitive exercises settings and feedback customization. In conclusion, our research highlights the value of the CDM to focus deeply on which functionalities professionals require from a cognitive telerehabilitation system and allowed us to design more precisely clinician-patients interactions inside the system compared to prescriptive methods currently used. Our study offers contribution to the comprehension of the rehabilitation processes, suggesting the positive impacts of an "extended" clinic treatment by adopting a flexible and adaptable tool. Copyright © 2017. Published by Elsevier Ltd.

  5. Cognitive Computing for Security.

    Energy Technology Data Exchange (ETDEWEB)

    Debenedictis, Erik [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Rothganger, Fredrick [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Aimone, James Bradley [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Marinella, Matthew [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Evans, Brian Robert [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Warrender, Christina E. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Mickel, Patrick [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

    2015-12-01

    Final report for Cognitive Computing for Security LDRD 165613. It reports on the development of hybrid of general purpose/ne uromorphic computer architecture, with an emphasis on potential implementation with memristors.

  6. Usability testing of gaming and social media applications for stroke and cerebral palsy upper limb rehabilitation.

    Science.gov (United States)

    Valdés, Bulmaro A; Hilderman, Courtney G E; Hung, Chai-Ting; Shirzad, Navid; Van der Loos, H F Machiel

    2014-01-01

    As part of the FEATHERS (Functional Engagement in Assisted Therapy Through Exercise Robotics) project, two motion tracking and one social networking applications were developed for upper limb rehabilitation of stroke survivors and teenagers with cerebral palsy. The project aims to improve the engagement of clients during therapy by using video games and a social media platform. The applications allow users to control a cursor on a personal computer through bimanual motions, and to interact with their peers and therapists through the social media. The tracking applications use either a Microsoft Kinect or a PlayStation Eye camera, and the social media application was developed on Facebook. This paper presents a usability testing of these applications that was conducted with therapists from two rehabilitation clinics. The "Cognitive Walkthrough" and "Think Aloud" methods were used. The objectives of the study were to investigate the ease of use and potential issues or improvements of the applications, as well as the factors that facilitate and impede the adoption of technology in current rehabilitation programs.

  7. Computer Assisted Language Learning. Routledge Studies in Computer Assisted Language Learning

    Science.gov (United States)

    Pennington, Martha

    2011-01-01

    Computer-assisted language learning (CALL) is an approach to language teaching and learning in which computer technology is used as an aid to the presentation, reinforcement and assessment of material to be learned, usually including a substantial interactive element. This books provides an up-to date and comprehensive overview of…

  8. Design and implementation of visual-haptic assistive control system for virtual rehabilitation exercise and teleoperation manipulation.

    Science.gov (United States)

    Veras, Eduardo J; De Laurentis, Kathryn J; Dubey, Rajiv

    2008-01-01

    This paper describes the design and implementation of a control system that integrates visual and haptic information to give assistive force feedback through a haptic controller (Omni Phantom) to the user. A sensor-based assistive function and velocity scaling program provides force feedback that helps the user complete trajectory following exercises for rehabilitation purposes. This system also incorporates a PUMA robot for teleoperation, which implements a camera and a laser range finder, controlled in real time by a PC, were implemented into the system to help the user to define the intended path to the selected target. The real-time force feedback from the remote robot to the haptic controller is made possible by using effective multithreading programming strategies in the control system design and by novel sensor integration. The sensor-based assistant function concept applied to teleoperation as well as shared control enhances the motion range and manipulation capabilities of the users executing rehabilitation exercises such as trajectory following along a sensor-based defined path. The system is modularly designed to allow for integration of different master devices and sensors. Furthermore, because this real-time system is versatile the haptic component can be used separately from the telerobotic component; in other words, one can use the haptic device for rehabilitation purposes for cases in which assistance is needed to perform tasks (e.g., stroke rehab) and also for teleoperation with force feedback and sensor assistance in either supervisory or automatic modes.

  9. Caregiver and social assistant robot for rehabilitation and coaching for the elderly.

    Science.gov (United States)

    Pérez, P J; Garcia-Zapirain, B; Mendez-Zorrilla, A

    2015-01-01

    Socially assistive robotics (SAR) has been a major field of investigation during the last decade and, as it develops, the groups the technology can be applied to and all ways in which these can be assisted are rapidly increasing. The main objective is to design and develop a complete robotic agent, so that it performs physical and mental activities for elderly people to maintain their healthy life habits and, as a final result, improve their quality of life. LEGO Mindstorms NXT® robot's unique capacity for adaptability and engaging its users to develop coaching activities and assistive rehabilitation for the elderly. Such activities will aim to enhance healthy habits and provide training in physical and mental rehabilitation. The robot is attached to an iPod Touch that acts as its interface. The robot has been tested by a voluntary group of residents, also from that retirement home. Results in the variables of the questionnaire show scores above 4 points out of 5 for all the categories. Based on the tests, an easy to use Robot is prepared to deliver basic coaching for physical activities as proposed by the client, the staff of La Misericordia, who confirmed their satisfaction regarding this aspect.

  10. Robotic gait assistive technology as means to aggressive mobilization strategy in acute rehabilitation following severe diffuse axonal injury: a case study.

    Science.gov (United States)

    Stam, Daniel; Fernandez, Jennifer

    2017-07-01

    Diffuse axonal injury is a prominent cause of disablement post-traumatic brain injury. Utilization of the rapid expansion of our current scientific knowledge base combined with greater access to neurological and assistive technology as adjuncts to providing sensorimotor experience may yield innovative new approaches to rehabilitation based upon a dynamic model of brain response following injury. A 24-year-old female who sustained a traumatic brain injury, bilateral subdural hemorrhage, subarachnoid hemorrhage and severe diffuse axonal injury secondary to a motor vehicle collision. Evidence-based appraisal of present literature suggests a link between graded intensity of aerobic activity to facilitation of neuro-plastic change and up-regulation of neurotrophins essential to functional recovery post-diffuse axonal injury. Following resolution of paroxysmal autonomic instability with dystonia, aggressive early mobilization techniques were progressed utilizing robotic assistive gait technology in combination with conventional therapy. This approach allowed for arguably greater repetition and cardiovascular demands across a six-month inpatient rehabilitation stay. Outcomes in this case suggest that the use of assistive technology to adjunct higher level and intensity rehabilitation strategies may be a safe and effective means towards reduction of disablement following severe traumatic brain and neurological injury. Implications for Rehabilitation Functional recovery and neuroplasticity following diffuse neurological injury involves a complex process determined by the sensorimotor experience provided by rehabilitation clinicians. This process is in part modulated by intrinsic brain biochemical processes correlated to cardiovascular intensity of the activity provided. It is important that rehabilitation professionals monitor physiological response to higher intensity activities to provide an adaptive versus maladaptive response of central nervous system plasticity with

  11. The Predictive Value of Cognitive Impairments Measured at the Start of Clinical Rehabilitation for Health Status 1 Year and 3 Years Poststroke

    Science.gov (United States)

    Verhoeven, Clara L.; Schepers, Vera P.; Post, Marcel W.; van Heugten, Caroline M.

    2011-01-01

    The objective of this study was to investigate the value of screening for cognitive functions at the start of an inpatient rehabilitation programme to predict the health status 1 and 3 years poststroke. In this longitudinal cohort study of stroke patients in inpatient rehabilitation data of 134 participants were analysed. Cognitive and clinical…

  12. Customizable Rehabilitation Lower Limb Exoskeleton System

    Directory of Open Access Journals (Sweden)

    Riaan Stopforth

    2012-10-01

    Full Text Available Disabled people require assistance with the motion of their lower limbs to improve rehabilitation. Exoskeletons used for lower limb rehabilitation are highly priced and are not affordable to the lowerincome sector of the population. This paper describes an exoskeleton lower limb system that was designed keeping in mind that the cost must be as low as possible. The forward kinematic system that is used must be a simplified model to decrease computational time, yet allow the exoskeleton to be adjustable according to the patient's leg dimensions.

  13. Computer assisted tutoring in radiology

    International Nuclear Information System (INIS)

    Jeffery, N.

    1997-02-01

    The computer-based tutoring of visual concepts such as radiological images is a largely unexplored area. A review of the literature highlights limited use of computers as a means of radiological education, with the majority of systems being little more than hypermedia prototypes, on-line teaching files, and passive CD-Roms. Very few of the systems discussed in the research literature draw on the work from cognitive science and educational psychology for tutoring visual concepts. This thesis details and evaluates a method for indexing and retrieving images from large image databases via a cognitively informed graphical representation of visual concepts. This representation is derived using Multiple Correspondence Analysis from a statistical analysis of features present in the images. It is intended that this representation be used to assist in the computer based teaching of any discipline that requires the tutoring of visual concepts. The domain used as a test bed for this research is Magnetic Resonance Imaging in neuroradiology. Tutoring the interpretation of MR scans of the head represents a real practical problem due to the inherent complexity of the brain and variations in tissue contrast within image sequence and disease/pathology. The literature of concept categorisation and representation is critically reviewed to inform the design of a graphical representation of a concept (a pathology in the application domain). A specification for the design of an explicit representation of visual concepts is drawn from this literature review, together with methods of tutoring based around this model. A methodology for producing this representation is described, and implemented in the development of an overview plot for the concept of a disease of the brain, with associated statistical measures derived and operationalised for typicality and similarity of cases within a disease. These measures are precursors to the development of computer based tutoring strategies for image

  14. Computer assisted tutoring in radiology

    Energy Technology Data Exchange (ETDEWEB)

    Jeffery, N

    1997-02-01

    The computer-based tutoring of visual concepts such as radiological images is a largely unexplored area. A review of the literature highlights limited use of computers as a means of radiological education, with the majority of systems being little more than hypermedia prototypes, on-line teaching files, and passive CD-Roms. Very few of the systems discussed in the research literature draw on the work from cognitive science and educational psychology for tutoring visual concepts. This thesis details and evaluates a method for indexing and retrieving images from large image databases via a cognitively informed graphical representation of visual concepts. This representation is derived using Multiple Correspondence Analysis from a statistical analysis of features present in the images. It is intended that this representation be used to assist in the computer based teaching of any discipline that requires the tutoring of visual concepts. The domain used as a test bed for this research is Magnetic Resonance Imaging in neuroradiology. Tutoring the interpretation of MR scans of the head represents a real practical problem due to the inherent complexity of the brain and variations in tissue contrast within image sequence and disease/pathology. The literature of concept categorisation and representation is critically reviewed to inform the design of a graphical representation of a concept (a pathology in the application domain). A specification for the design of an explicit representation of visual concepts is drawn from this literature review, together with methods of tutoring based around this model. A methodology for producing this representation is described, and implemented in the development of an overview plot for the concept of a disease of the brain, with associated statistical measures derived and operationalised for typicality and similarity of cases within a disease. These measures are precursors to the development of computer based tutoring strategies for image

  15. Towards Effective Non-Invasive Brain-Computer Interfaces Dedicated to Gait Rehabilitation Systems

    Directory of Open Access Journals (Sweden)

    Thierry Castermans

    2013-12-01

    Full Text Available In the last few years, significant progress has been made in the field of walk rehabilitation. Motor cortex signals in bipedal monkeys have been interpreted to predict walk kinematics. Epidural electrical stimulation in rats and in one young paraplegic has been realized to partially restore motor control after spinal cord injury. However, these experimental trials are far from being applicable to all patients suffering from motor impairments. Therefore, it is thought that more simple rehabilitation systems are desirable in the meanwhile. The goal of this review is to describe and summarize the progress made in the development of non-invasive brain-computer interfaces dedicated to motor rehabilitation systems. In the first part, the main principles of human locomotion control are presented. The paper then focuses on the mechanisms of supra-spinal centers active during gait, including results from electroencephalography, functional brain imaging technologies [near-infrared spectroscopy (NIRS, functional magnetic resonance imaging (fMRI, positron-emission tomography (PET, single-photon emission-computed tomography (SPECT] and invasive studies. The first brain-computer interface (BCI applications to gait rehabilitation are then presented, with a discussion about the different strategies developed in the field. The challenges to raise for future systems are identified and discussed. Finally, we present some proposals to address these challenges, in order to contribute to the improvement of BCI for gait rehabilitation.

  16. Predicting Functional Recovery in Chronic Stroke Rehabilitation Using Event-Related Desynchronization-Synchronization during Robot-Assisted Movement

    Science.gov (United States)

    Gramigna, Cristina; Franceschetti, Silvana

    2016-01-01

    Although rehabilitation robotics seems to be a promising therapy in the rehabilitation of the upper limb in stroke patients, consensus is still lacking on its additive effects. Therefore, there is a need for determining the possible success of robotic interventions on selected patients, which in turn determine the necessity for new investigating instruments supporting the treatment decision-making process and customization. The objective of the work presented in this preliminary study was to verify that fully robot assistance would not affect the physiological oscillatory cortical activity related to a functional movement in healthy subjects. Further, the clinical results following the robotic treatment of a chronic stroke patient, who positively reacted to the robotic intervention, were analyzed and discussed. First results show that there is no difference in EEG activation pattern between assisted and no-assisted movement in healthy subjects. Even more importantly, the patient's pretreatment EEG activation pattern in no-assisted movement was completely altered, while it recovered to a quasi-physiological one in robot-assisted movement. The functional improvement following treatment was large. Using pretreatment EEG recording during robot-assisted movement might be a valid approach to assess the potential ability of the patient for recovering. PMID:27057546

  17. Early post-stroke cognition in stroke rehabilitation patients predicts functional outcome at 13 months.

    Science.gov (United States)

    Wagle, Jørgen; Farner, Lasse; Flekkøy, Kjell; Bruun Wyller, Torgeir; Sandvik, Leiv; Fure, Brynjar; Stensrød, Brynhild; Engedal, Knut

    2011-01-01

    To identify prognostic factors associated with functional outcome at 13 months in a sample of stroke rehabilitation patients. Specifically, we hypothesized that cognitive functioning early after stroke would predict long-term functional outcome independently of other factors. 163 stroke rehabilitation patients underwent a structured neuropsychological examination 2-3 weeks after hospital admittance, and their functional status was subsequently evaluated 13 months later with the modified Rankin Scale (mRS) as outcome measure. Three predictive models were built using linear regression analyses: a biological model (sociodemographics, apolipoprotein E genotype, prestroke vascular factors, lesion characteristics and neurological stroke-related impairment); a functional model (pre- and early post-stroke cognitive functioning, personal and instrumental activities of daily living, ADL, and depressive symptoms), and a combined model (including significant variables, with p value Stroke Scale; β = 0.402, p stroke cognitive functioning (Repeatable Battery of Neuropsychological Status, RBANS; β = -0.248, p = 0.001) and prestroke personal ADL (Barthel Index; β = -0.217, p = 0.002). Further linear regression analyses of which RBANS indexes and subtests best predicted long-term functional outcome showed that Coding (β = -0.484, p stroke cognitive functioning as measured by the RBANS is a significant and independent predictor of long-term functional post-stroke outcome. Copyright © 2011 S. Karger AG, Basel.

  18. Goal Setting for Cognitive Rehabilitation in Mild to Moderate Parkinson’s Disease Dementia and Dementia with Lewy Bodies

    Directory of Open Access Journals (Sweden)

    Tamlyn J. Watermeyer

    2016-01-01

    Full Text Available Alongside the physical symptoms associated with Parkinson’s disease dementia and dementia with Lewy bodies, health services must also address the cognitive impairments that accompany these conditions. There is growing interest in the use of nonpharmacological approaches to managing the consequences of cognitive disorder. Cognitive rehabilitation is a goal-orientated behavioural intervention which aims to enhance functional independence through the use of strategies specific to the individual’s needs and abilities. Fundamental to this therapy is a person’s capacity to set goals for rehabilitation. To date, no studies have assessed goal setting in early-stage Parkinson’s disease dementia or dementia with Lewy bodies. Semistructured interviews were carried out with 29 participants from an ongoing trial of cognitive rehabilitation for people with these conditions. Here, we examined the goal statements provided by these participants using qualitative content analysis, exploring the types and nature of the goals set. Participants’ goals reflected their motivations to learn new skills or improve performance in areas such as technology-use, self-management and orientation, medication management, and social and leisure activities. These results suggest that goal setting is achievable for these participants, provide insight into the everyday cognitive difficulties that they experience, and highlight possible domains as targets for intervention. The trial is registered with ISRCTN16584442 (DOI 10.1186/ISRCTN16584442 13/04/2015.

  19. Computational Cognitive Color Perception

    NARCIS (Netherlands)

    Ciftcioglu, O.; Bittermann, M.S.

    2016-01-01

    Comprehension of aesthetical color characteristics based on a computational model of visual perception and color cognition are presented. The computational comprehension is manifested by the machine’s capability of instantly assigning appropriate colors to the objects perceived. They form a scene

  20. How Does Rehabilitative & Assistive Technology Benefit People With Disabilities?

    Science.gov (United States)

    ... institutions Access information through computers and reading Enjoy music, sports, travel, and the arts Participate fully in ... of screen enlargers and magnifiers. 4 Assistive Technology Industry Association. (n.d.). What is assistive technology? How ...

  1. Adults with idiopathic scoliosis improve disability after motor and cognitive rehabilitation: results of a randomised controlled trial.

    Science.gov (United States)

    Monticone, Marco; Ambrosini, Emilia; Cazzaniga, Daniele; Rocca, Barbara; Motta, Lorenzo; Cerri, Cesare; Brayda-Bruno, Marco; Lovi, Alessio

    2016-10-01

    To evaluate the effects of motor and cognitive rehabilitation on disability in adults with idiopathic scoliosis at lower risk of progression. 130 adults with idiopathic scoliosis (main curve rehabilitation programme consisting of active self-correction, task-oriented exercises and cognitive-behavioural therapy (experimental group, 65 subjects, mean age of 51.6, females 48) or general physiotherapy consisting of active and passive mobilizations, stretching, and strengthening exercises of the spinal muscles (control group, 65 subjects, mean age of 51.7, females 46). Before, at the end, and 12 months after treatment, each participant completed the Oswestry disability index (ODI) (primary outcome), the Tampa scale for kinesiophobia, the pain catastrophizing scale, a pain numerical rating scale, and the Scoliosis Research Society-22 Patient Questionnaire. Radiological (Cobb angle) and clinical deformity (angle of trunk rotation) changes were also investigated. A linear mixed model for repeated measures was used for each outcome. Significant effects of time, group, and time by group interaction were found for all outcome measures (P cognitive rehabilitation also led to improvements in dysfunctional thoughts, pain, and quality of life. Changes were maintained for at least 1 year.

  2. Computational Intelligence and Game Design for Effective At-Home Stroke Rehabilitation.

    Science.gov (United States)

    Borghese, Nunzio Alberto; Pirovano, Michele; Lanzi, Pier Luca; Wüest, Seline; de Bruin, Eling D

    2013-04-01

    The aim of this article is to describe a game engine that has all the characteristics needed to support rehabilitation at home. The low-cost tracking devices recently introduced in the entertainment market allow measuring reliably at home, in real time, players' motion with a hands-free approach. Such systems have also become a source of inspiration for researchers working in rehabilitation. Computer games appear suited to guide rehabilitation because of their ability to engage the users. However, commercial videogames and game engines lack the peculiar functionalities required in rehabilitation: Games should be adapted to each patient's functional status, and monitoring the patient's motion is mandatory to avoid maladaptation. Feedback on performance and progression of the exercises should be provided. Lastly, several tracking devices should be considered, according to the patient's pathology and rehabilitation aims. We have analyzed the needs of the clinicians and of the patients associated in performing rehabilitation at home, identifying the characteristics that the game engine should have. The result of this analysis has led us to develop the Intelligent Game Engine for Rehabilitation (IGER) system, which combines the principles upon which commercial games are designed with the needs of rehabilitation. IGER is heavily based on computational intelligence: Adaptation of the difficulty level of the exercise is carried out through a Bayesian framework from the observation of the patient's success rate. Monitoring is implemented in fuzzy systems and based on rules defined for the exercises by clinicians. Several devices can be attached to IGER through an input abstraction layer, like the Nintendo ® (Kyoto, Japan) Wii™ Balance Board™, the Microsoft ® (Redmond, WA) Kinect, the Falcon from Novint Technologies (Albuquerque, NM), or the Tyromotion (Graz, Austria) Timo ® plate balance board. IGER is complemented with videogames embedded in a specific taxonomy

  3. Rehabilitation for improved cognition in patients with stress-related exhaustion disorder: RECO - a randomized clinical trial.

    Science.gov (United States)

    Malmberg Gavelin, Hanna; Eskilsson, Therese; Boraxbekk, Carl-Johan; Josefsson, Maria; Stigsdotter Neely, Anna; Slunga Järvholm, Lisbeth

    2018-04-25

    Stress-related exhaustion has been associated with selective and enduring cognitive impairments. However, little is known about how to address cognitive deficits in stress rehabilitation and how this influences stress recovery over time. The aim of this open-label, parallel randomized controlled trial (ClinicalTrials.gov: NCT03073772) was to investigate the long-term effects of 12 weeks cognitive or aerobic training on cognitive function, psychological health, and work ability for patients diagnosed with exhaustion disorder (ED). One-hundred-and-thirty-two patients (111 women) participating in multimodal stress rehabilitation were randomized to receive additional cognitive training (n = 44), additional aerobic training (n = 47), or no additional training (n = 41). Treatment effects were assessed before, immediately after and one-year post intervention. The primary outcome was global cognitive function. Secondary outcomes included domain-specific cognition, self-reported burnout, depression, anxiety, fatigue and work ability, aerobic capacity, and sick-leave levels. Intention-to-treat analysis revealed a small but lasting improvement in global cognitive functioning for the cognitive training group, paralleled by a large improvement on a trained updating task. The aerobic training group showed improvements in aerobic capacity and episodic memory immediately after training, but no long-term benefits. General improvements in psychological health and work ability were observed, with no difference between interventional groups. Our findings suggest that cognitive training may be a viable method to address cognitive impairments for patients with ED, whereas the effects of aerobic exercise on cognition may be more limited when performed during a restricted time period. The implications for clinical practice in supporting patients with ED to adhere to treatment are discussed.

  4. A natural language-based presentation of cognitive stimulation to people with dementia in assistive technology: A pilot study.

    Science.gov (United States)

    Dethlefs, Nina; Milders, Maarten; Cuayáhuitl, Heriberto; Al-Salkini, Turkey; Douglas, Lorraine

    2017-12-01

    Currently, an estimated 36 million people worldwide are affected by Alzheimer's disease or related dementias. In the absence of a cure, non-pharmacological interventions, such as cognitive stimulation, which slow down the rate of deterioration can benefit people with dementia and their caregivers. Such interventions have shown to improve well-being and slow down the rate of cognitive decline. It has further been shown that cognitive stimulation in interaction with a computer is as effective as with a human. However, the need to operate a computer often represents a difficulty for the elderly and stands in the way of widespread adoption. A possible solution to this obstacle is to provide a spoken natural language interface that allows people with dementia to interact with the cognitive stimulation software in the same way as they would interact with a human caregiver. This makes the assistive technology accessible to users regardless of their technical skills and provides a fully intuitive user experience. This article describes a pilot study that evaluated the feasibility of computer-based cognitive stimulation through a spoken natural language interface. Prototype software was evaluated with 23 users, including healthy elderly people and people with dementia. Feedback was overwhelmingly positive.

  5. A Case Study on Collective Cognition and Operation in Team-Based Computer Game Design by Middle-School Children

    Science.gov (United States)

    Ke, Fengfeng; Im, Tami

    2014-01-01

    This case study examined team-based computer-game design efforts by children with diverse abilities to explore the nature of their collective design actions and cognitive processes. Ten teams of middle-school children, with a high percentage of minority students, participated in a 6-weeks, computer-assisted math-game-design program. Essential…

  6. New framework for rehabilitation – fusion of cognitive and physical rehabilitation: the hope for dancing

    Science.gov (United States)

    Dhami, Prabhjot; Moreno, Sylvain; DeSouza, Joseph F. X.

    2015-01-01

    Neurorehabilitation programs are commonly employed with the goal to help restore functionality in patients. However, many of these therapies report only having a small impact. In response to the need for more effective and innovative approaches, rehabilitative methods that take advantage of the neuroplastic properties of the brain have been used to aid with both physical and cognitive impairments. Following this path of reasoning, there has been a particular interest in the use of physical exercise as well as musical related activities. Although such therapies demonstrate potential, they also have limitations that may affect their use, calling for further exploration. Here, we propose dance as a potential parallel to physical and music therapies. Dance may be able to aid with both physical and cognitive impairments, particularly due to it combined nature of including both physical and cognitive stimulation. Not only does it incorporate physical and motor skill related activities, but it can also engage various cognitive functions such as perception, emotion, and memory, all while done in an enriched environment. Other more practical benefits, such as promoting adherence due to being enjoyable, are also discussed, along with the current literature on the application of dance as an intervention tool, as well as future directions required to evaluate the potential of dance as an alternative therapy in neurorehabilitation. PMID:25674066

  7. Cognitive Approaches for Medicine in Cloud Computing.

    Science.gov (United States)

    Ogiela, Urszula; Takizawa, Makoto; Ogiela, Lidia

    2018-03-03

    This paper will present the application potential of the cognitive approach to data interpretation, with special reference to medical areas. The possibilities of using the meaning approach to data description and analysis will be proposed for data analysis tasks in Cloud Computing. The methods of cognitive data management in Cloud Computing are aimed to support the processes of protecting data against unauthorised takeover and they serve to enhance the data management processes. The accomplishment of the proposed tasks will be the definition of algorithms for the execution of meaning data interpretation processes in safe Cloud Computing. • We proposed a cognitive methods for data description. • Proposed a techniques for secure data in Cloud Computing. • Application of cognitive approaches for medicine was described.

  8. Predicting Functional Recovery in Chronic Stroke Rehabilitation Using Event-Related Desynchronization-Synchronization during Robot-Assisted Movement

    Directory of Open Access Journals (Sweden)

    Marco Caimmi

    2016-01-01

    Full Text Available Although rehabilitation robotics seems to be a promising therapy in the rehabilitation of the upper limb in stroke patients, consensus is still lacking on its additive effects. Therefore, there is a need for determining the possible success of robotic interventions on selected patients, which in turn determine the necessity for new investigating instruments supporting the treatment decision-making process and customization. The objective of the work presented in this preliminary study was to verify that fully robot assistance would not affect the physiological oscillatory cortical activity related to a functional movement in healthy subjects. Further, the clinical results following the robotic treatment of a chronic stroke patient, who positively reacted to the robotic intervention, were analyzed and discussed. First results show that there is no difference in EEG activation pattern between assisted and no-assisted movement in healthy subjects. Even more importantly, the patient’s pretreatment EEG activation pattern in no-assisted movement was completely altered, while it recovered to a quasi-physiological one in robot-assisted movement. The functional improvement following treatment was large. Using pretreatment EEG recording during robot-assisted movement might be a valid approach to assess the potential ability of the patient for recovering.

  9. Revisiting cognitive and learning styles in computer-assisted instruction: not so useful after all.

    Science.gov (United States)

    Cook, David A

    2012-06-01

    In a previous systematic review, the author proposed that adaptation to learners' cognitive and learning styles (CLSs) could improve the efficiency of computer-assisted instruction (CAI). In the present article, he questions that proposition, arguing that CLSs do not make a substantive difference in CAI. To support this argument, the author performed an updated systematic literature search, pooled new findings with those from the previous review, and reinterpreted this evidence with a focus on aptitude-treatment interactions. (An aptitude-treatment interaction occurs when a student with attribute 1 learns better with instructional approach A than with approach B, whereas a student with attribute 2 learns better with instructional approach B).Of 65 analyses reported in 48 studies, only 9 analyses (14%) showed significant interactions between CLS and instructional approach. It seems that aptitude-treatment interactions with CLSs are at best infrequent and small in magnitude. There are several possible explanations for this lack of effect. First, the influence of strong instructional methods likely dominates the impact of CLSs. Second, current methods for assessing CLSs lack validity evidence and are inadequate to accurately characterize the individual learner. Third, theories are vague, and empiric evidence is virtually nonexistent to guide the planning of style-targeted instructional designs. Adaptation to learners' CLSs thus seems unlikely to enhance CAI. The author recommends that educators focus on employing strong instructional methods. Educators might also consider assessing and adapting to learners' prior knowledge or allowing learners to select among alternate instructional approaches.

  10. Computer Assisted Instruction

    Science.gov (United States)

    Higgins, Paul

    1976-01-01

    Methodology for developing a computer assisted instruction (CAI) lesson (scripting, programing, and testing) is reviewed. A project done by Informatics Education Ltd. (IEL) for the Department of National Defense (DND) is used as an example. (JT)

  11. Evaluation of an ontology-based system for computerized cognitive rehabilitation.

    Science.gov (United States)

    Alloni, Anna; Quaglini, Silvana; Panzarasa, Silvia; Sinforiani, Elena; Bernini, Sara

    2018-07-01

    This paper describes the results of a randomized clinical trial about the effectiveness of a computerized rehabilitation treatment on a sample of 31 patients affected by Parkinson disease. Computerized exercises were administered by the therapists to the intervention group (n = 17) through the CoRe tool, which automatically generates a big variety of exercises leveraging on a stimuli set (words, sounds and images) organized into a dedicated ontology. A battery of standard neuropsychological tests was performed for patients' assessment at baseline, after the treatment (that lasted 1 month), and after 6 months from the treatment stop. The control group underwent a sham intervention. Results show a statistically significant clinical benefit from computerized rehabilitation with respect to sham treatment. For the intervention group, response time and response accuracy were integrated into a weighted score that accounts also for the specific cognitive burden of each exercise. Differently from the control group, the majority of patients in the intervention group showed an improvement in that score, more marked in the first week of treatment, and which lasts for the entire treatment period, which could account both for a quick learning effect and for an improvement of cognitive conditions. Good usability of CoRe, already observed in previous studies, was confirmed by the present trial, where the percentage of protocol completion in the intervention group is very high (all but one patient are above 90%). The CoRe system showed to be effective to improve some cognitive abilities in patients with Parkinson disease. However, after the end of the training, the benefit is hardly maintained over time. These findings support the implementation of CoRe in the clinical routine and the continuation of the treatment after discharge through the use of a homecare version of the system. Copyright © 2018 Elsevier B.V. All rights reserved.

  12. Computer assisted radiology and surgery. CARS 2010

    International Nuclear Information System (INIS)

    Anon.

    2010-01-01

    The conference proceedings include contributions to the following topics: (1) CARS Clinical Day: minimally invasive spiral surgery, interventional radiology; (2) CARS - computer assisted radiology and surgery: ophthalmology, stimulation methods, new approaches to diagnosis and therapy; (3) Computer assisted radiology 24th International congress and exhibition: computer tomography and magnetic resonance, digital angiographic imaging, digital radiography, ultrasound, computer assisted radiation therapy, medical workstations, image processing and display; (4) 14th Annual conference of the International Society for computer aided surgery; ENT-CMF head and neck surgery computer-assisted neurosurgery, cardiovascular surgery, image guided liver surgery, abdominal and laparoscopic surgery, computer-assisted orthopedic surgery, image processing and visualization, surgical robotics and instrumentation, surgical modeling, simulation and education; (5) 28th International EuroPACS meeting: image distribution and integration strategies, planning and evaluation, telemedicine and standards, workflow and data flow in radiology; (6) 11th CARS/SPIE/EuroPACS joint workshop on surgical PACS and the digital operating, management and assessment of OR systems and integration; (7) 12th International workshop on computer-aided diagnosis: special session on breast CAD, special session on thoracic CAD, special session on abdominal brain, lumbar spine CAD; (8) 16th computed Maxillofacial imaging congress: computed maxillofacial imaging in dental implantology, orthodontics and dentofacial orthopedics; approaches to 3D maxillofacial imaging; surgical navigation; (9) 2nd EuroNOTES/CARS workshop on NOTES: an interdisciplinary challenge; (10) 2nd EPMA/CARS workshop on personalized medicine and ICT.; (11)poster sessions.

  13. Computer assisted radiology and surgery. CARS 2010

    Energy Technology Data Exchange (ETDEWEB)

    Anon.

    2010-06-15

    The conference proceedings include contributions to the following topics: (1) CARS Clinical Day: minimally invasive spiral surgery, interventional radiology; (2) CARS - computer assisted radiology and surgery: ophthalmology, stimulation methods, new approaches to diagnosis and therapy; (3) Computer assisted radiology 24th International congress and exhibition: computer tomography and magnetic resonance, digital angiographic imaging, digital radiography, ultrasound, computer assisted radiation therapy, medical workstations, image processing and display; (4) 14th Annual conference of the International Society for computer aided surgery; ENT-CMF head and neck surgery computer-assisted neurosurgery, cardiovascular surgery, image guided liver surgery, abdominal and laparoscopic surgery, computer-assisted orthopedic surgery, image processing and visualization, surgical robotics and instrumentation, surgical modeling, simulation and education; (5) 28th International EuroPACS meeting: image distribution and integration strategies, planning and evaluation, telemedicine and standards, workflow and data flow in radiology; (6) 11th CARS/SPIE/EuroPACS joint workshop on surgical PACS and the digital operating, management and assessment of OR systems and integration; (7) 12th International workshop on computer-aided diagnosis: special session on breast CAD, special session on thoracic CAD, special session on abdominal brain, lumbar spine CAD; (8) 16th computed Maxillofacial imaging congress: computed maxillofacial imaging in dental implantology, orthodontics and dentofacial orthopedics; approaches to 3D maxillofacial imaging; surgical navigation; (9) 2nd EuroNOTES/CARS workshop on NOTES: an interdisciplinary challenge; (10) 2nd EPMA/CARS workshop on personalized medicine and ICT.; (11)poster sessions.

  14. Evolution of Cognitive Rehabilitation After Stroke From Traditional Techniques to Smart and Personalized Home-Based Information and Communication Technology Systems: Literature Review.

    Science.gov (United States)

    Cogollor, José M; Rojo-Lacal, Javier; Hermsdörfer, Joachim; Ferre, Manuel; Arredondo Waldmeyer, Maria Teresa; Giachritsis, Christos; Armstrong, Alan; Breñosa Martinez, Jose Manuel; Bautista Loza, Doris Anabelle; Sebastián, José María

    2018-03-26

    the selection of 8 different ICT-based approaches found in scientific-technical studies, 9 European projects funded by the European Commission that offer eHealth architectures, and other large-scale activities such as smart houses and the initiative City4Age. Stroke is one of the main causes that most negatively affect countries in the socioeconomic aspect. The design of new ICT-based systems should provide 4 main features for an efficient and personalized cognitive rehabilitation: support in the execution of complex daily tasks, automatic error detection, home-based performance, and accessibility. Only 33% of the European projects presented fulfilled those requirements at the same time. For this reason, current and future large-scale initiatives focused on eHealth and smart environments should try to solve this situation by providing more complete and sophisticated platforms. ©José M Cogollor, Javier Rojo-Lacal, Joachim Hermsdörfer, Manuel Ferre, Maria Teresa Arredondo Waldmeyer, Christos Giachritsis, Alan Armstrong, Jose Manuel Breñosa Martinez, Doris Anabelle Bautista Loza, José María Sebastián. Originally published in JMIR Rehabilitation and Assistive Technology (http://rehab.jmir.org), 26.03.2018.

  15. Cognitive, emotional, and neural benefits of musical leisure activities in aging and neurological rehabilitation: A critical review.

    Science.gov (United States)

    Särkämö, Teppo

    2017-04-28

    Music has the capacity to engage auditory, cognitive, motor, and emotional functions across cortical and subcortical brain regions and is relatively preserved in aging and dementia. Thus, music is a promising tool in the rehabilitation of aging-related neurological illnesses, such as stroke and Alzheimer disease. As the population ages and the incidence and prevalence of these illnesses rapidly increases, music-based interventions that are enjoyable and effective in the everyday care of the patients are needed. In addition to formal music therapy, musical leisure activities, such as music listening and singing, which patients can do on their own or with a caregiver, are a promising way to support psychological well-being during aging and in neurological rehabilitation. This review article provides an overview of current evidence on the cognitive, emotional, and neural effects of musical leisure activities both during normal aging and in the rehabilitation and care of stroke patients and people with dementia. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  16. Computer-assisted cognitive remediation therapy in schizophrenia: Durability of the effects and cost-utility analysis.

    Science.gov (United States)

    Garrido, Gemma; Penadés, Rafael; Barrios, Maite; Aragay, Núria; Ramos, Irene; Vallès, Vicenç; Faixa, Carlota; Vendrell, Josep M

    2017-08-01

    The durability of computer-assisted cognitive remediation (CACR) therapy over time and the cost-effectiveness of treatment remains unclear. The aim of the current study is to investigate the effectiveness of CACR and to examine the use and cost of acute psychiatric admissions before and after of CACR. Sixty-seven participants were initially recruited. For the follow-up study a total of 33 participants were enrolled, 20 to the CACR condition group and 13 to the active control condition group. All participants were assessed at baseline, post-therapy and 12 months post-therapy on neuropsychology, QoL and self-esteem measurements. The use and cost of acute psychiatric admissions were collected retrospectively at four assessment points: baseline, 12 months post-therapy, 24 months post-therapy, and 36 months post-therapy. The results indicated that treatment effectiveness persisted in the CACR group one year post-therapy on neuropsychological and well-being outcomes. The CACR group showed a clear decrease in the use of acute psychiatric admissions at 12, 24 and 36 months post-therapy, which lowered the global costs the acute psychiatric admissions at 12, 24 and 36 months post-therapy. The CACR is durable over at least a 12-month period, and CACR may be helping to reduce health care costs for schizophrenia patients. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

  17. Nature-assisted rehabilitation for reactions to severe stress and/or depression in a rehabilitation garden: long-term follow-up including comparisons with a matched population-based reference cohort.

    Science.gov (United States)

    Währborg, Peter; Petersson, Ingemar F; Grahn, Patrik

    2014-03-01

    To determine the effect of a nature-assisted rehabilitation programme in a group of patients with reactions to severe stress and/or mild to moderate depression. Changes in sick-leave status and healthcare consumption in these patients were compared with those in a matched population-based reference cohort (treatment as usual). Retrospective cohort study with a matched reference group from the general population. A total of 118 participants referred to a nature-assisted rehabilitation programme, and 678 controls recruited from the Skåne Health Care Register. For both groups, information on sick leave was extracted from the National Social Insurance Register and on healthcare consumption data from the Skåne Health Care Register. The interventional rehabilitation programme was designed as a multimodal programme involving professionals from horticulture and medicine. The programme was conducted in a rehabilitation garden, designed especially for this purpose. A significant reduction in healthcare consumption was noted among participants in the programme compared with the reference population. The main changes were a reduction in outpatient visits to primary healthcare and a reduction in inpatient psychiatric care. No significant difference in sick-leave status was found. A structured, nature-based rehabilitation programme for patients with reactions to severe stress and/or depression could be beneficial, as reflected in reduced healthcare consumption.

  18. [Computer-assisted temporomandibular joint reconstruction.

    Science.gov (United States)

    Zwetyenga, N; Mommers, X-A; Cheynet, F

    2013-08-02

    Prosthetic replacement of TMJ is gradually becoming a common procedure because of good functional and aesthetic results and low morbidity. Prosthetic models available can be standard or custom-made. Custom-made prosthesis are usually reserved for complex cases, but we think that computer assistance for custom-made prosthesis should be indicated for each case because it gives a greater implant stability and fewer complications. Computer assistance will further enlarge TMJ prosthesis replacement indications. Copyright © 2013. Published by Elsevier Masson SAS.

  19. Cognitive and Neurophysiological Effects of Non-invasive Brain Stimulation in Stroke Patients after Motor Rehabilitation.

    Science.gov (United States)

    D'Agata, Federico; Peila, Elena; Cicerale, Alessandro; Caglio, Marcella M; Caroppo, Paola; Vighetti, Sergio; Piedimonte, Alessandro; Minuto, Alice; Campagnoli, Marcello; Salatino, Adriana; Molo, Maria T; Mortara, Paolo; Pinessi, Lorenzo; Massazza, Giuseppe

    2016-01-01

    The primary aim of this study was to evaluate and compare the effectiveness of two specific Non-Invasive Brain Stimulation (NIBS) paradigms, the repetitive Transcranial Magnetic Stimulation (rTMS), and transcranial Direct Current Stimulation (tDCS), in the upper limb rehabilitation of patients with stroke. Short and long term outcomes (after 3 and 6 months, respectively) were evaluated. We measured, at multiple time points, the manual dexterity using a validated clinical scale (ARAT), electroencephalography auditory event related potentials, and neuropsychological performances in patients with chronic stroke of middle severity. Thirty four patients were enrolled and randomized. The intervention group was treated with a NIBS protocol longer than usual, applying a second cycle of stimulation, after a washout period, using different techniques in the two cycles (rTMS/tDCS). We compared the results with a control group treated with sham stimulation. We split the data analysis into three studies. In this first study we examined if a cumulative effect was clinically visible. In the second study we compared the effects of the two techniques. In the third study we explored if patients with minor cognitive impairment have most benefit from the treatment and if cognitive and motor outcomes were correlated. We found that the impairment in some cognitive domains cannot be considered an exclusion criterion for rehabilitation with NIBS. ERP improved, related to cognitive and attentional processes after stimulation on the motor cortex, but transitorily. This effect could be linked to the restoration of hemispheric balance or by the effects of distant connections. In our study the effects of the two NIBS were comparable, with some advantages using tDCS vs. rTMS in stroke rehabilitation. Finally we found that more than one cycle (2-4 weeks), spaced out by washout periods, should be used, only in responder patients, to obtain clinical relevant results.

  20. 75 FR 21614 - Office of Special Education and Rehabilitative Services; Overview Information; Rehabilitation...

    Science.gov (United States)

    2010-04-26

    ... DEPARTMENT OF EDUCATION Office of Special Education and Rehabilitative Services; Overview... $200,000 for a single budget period of 12 months. The Assistant Secretary for Special Education and... 21, 2010. Alexa Posny, Assistant Secretary for Special Education and Rehabilitative Services. [FR Doc...

  1. Early Childhood Teacher Candidates\\' Attitudes towards Computer and Computer Assisted Instruction

    OpenAIRE

    Oğuz, Evrim; Ellez, A. Murat; Akamca, Güzin Özyılmaz; Kesercioğlu, Teoman İ.; Girgin, Günseli

    2011-01-01

    The aim of this research is to evaluate preschool candidates’ attitudes towards computers andattitudes towards use of computer assisted instruction. The sample of this study includes 481 early childhoodeducation students who attended Dokuz Eylül University’s department of Early Childhood Education. Data werecollected by using “Scale of Computer Assisted Instruction Attitudes” developed by the Arslan (2006),“Computer Attitudes Scale” developed by Çelik & Bindak (2005) and “General Info...

  2. Toward Multimodal Human-Robot Interaction to Enhance Active Participation of Users in Gait Rehabilitation.

    Science.gov (United States)

    Gui, Kai; Liu, Honghai; Zhang, Dingguo

    2017-11-01

    Robotic exoskeletons for physical rehabilitation have been utilized for retraining patients suffering from paraplegia and enhancing motor recovery in recent years. However, users are not voluntarily involved in most systems. This paper aims to develop a locomotion trainer with multiple gait patterns, which can be controlled by the active motion intention of users. A multimodal human-robot interaction (HRI) system is established to enhance subject's active participation during gait rehabilitation, which includes cognitive HRI (cHRI) and physical HRI (pHRI). The cHRI adopts brain-computer interface based on steady-state visual evoked potential. The pHRI is realized via admittance control based on electromyography. A central pattern generator is utilized to produce rhythmic and continuous lower joint trajectories, and its state variables are regulated by cHRI and pHRI. A custom-made leg exoskeleton prototype with the proposed multimodal HRI is tested on healthy subjects and stroke patients. The results show that voluntary and active participation can be effectively involved to achieve various assistive gait patterns.

  3. Preliminary evidence of improved cognitive performance following vestibular rehabilitation in children with combined ADHD (cADHD) and concurrent vestibular impairment.

    Science.gov (United States)

    Lotfi, Younes; Rezazadeh, Nima; Moossavi, Abdollah; Haghgoo, Hojjat Allah; Rostami, Reza; Bakhshi, Enayatollah; Badfar, Faride; Moghadam, Sedigheh Farokhi; Sadeghi-Firoozabadi, Vahid; Khodabandelou, Yousef

    2017-12-01

    Balance function has been reported to be worse in ADHD children than in their normal peers. The present study hypothesized that an improvement in balance could result in better cognitive performance in children with ADHD and concurrent vestibular impairment. This study was designed to evaluate the effects of comprehensive vestibular rehabilitation therapy on the cognitive performance of children with combined ADHD and concurrent vestibular impairment. Subject were 54 children with combined ADHD. Those with severe vestibular impairment (n=33) were randomly assigned to two groups that were matched for age. A rehabilitation program comprising overall balance and gate, postural stability, and eye movement exercises was assigned to the intervention group. Subjects in the control group received no intervention for the same time period. Intervention was administered twice weekly for 12 weeks. Choice reaction time (CRT) and spatial working memory (SWM) subtypes of the Cambridge Neuropsychological Test Automated Battery (CANTAB) were completed pre- and post-intervention to determine the effects of vestibular rehabilitation on the cognitive performance of the subjects with ADHD and concurrent vestibular impairment. ANCOVA was used to compare the test results of the intervention and control group post-test. The percentage of correct trial scores for the CRT achieved by the intervention group post-test increased significantly compared to those of the control group (p=0.029). The CRT mean latency scores were significantly prolonged in the intervention group following intervention (p=0.007) compared to the control group. No significant change was found in spatial functioning of the subjects with ADHD following 12 weeks of intervention (p>0.05). The study highlights the effect of vestibular rehabilitation on the cognitive performance of children with combined ADHD and concurrent vestibular disorder. The findings indicate that attention can be affected by early vestibular

  4. Performance of freestanding inpatient rehabilitation hospitals before and after the rehabilitation prospective payment system.

    Science.gov (United States)

    Thompson, Jon M; McCue, Michael J

    2010-01-01

    Inpatient rehabilitation hospitals provide important services to patients to restore physical and cognitive functioning. Historically, these hospitals have been reimbursed by Medicare under a cost-based system; but in 2002, Medicare implemented a rehabilitation prospective payment system (PPS). Despite the implementation of a PPS for rehabilitation, there is limited published research that addresses the operating and financial performance of these hospitals. We examined operating and financial performance in the pre- and post-PPS periods for for-profit and nonprofit freestanding inpatient rehabilitation hospitals to test for pre- and post-PPS differences within the ownership groups. We identified freestanding inpatient rehabilitation hospitals from the Centers for Medicare and Medicaid Services Health Care Cost Report Information System database for the first two fiscal years under PPS. We excluded facilities that had fiscal years less than 270 days, facilities with missing data, and government facilities. We computed average values for performance variables for the facilities in the two consecutive fiscal years post-PPS. For the pre-PPS period, we collected data on these same facilities and, once facilities with missing data and fiscal years less than 270 days were excluded, computed average values for the two consecutive fiscal years pre-PPS. Our final sample of 140 inpatient rehabilitation facilities was composed of 44 nonprofit hospitals and 96 for-profit hospitals both pre- and post-PPS. We utilized a pairwise comparison test (t-test comparison) to measure the significance of differences on each performance variable between pre- and post-PPS periods within each ownership group. Findings show that both nonprofit and for-profit freestanding inpatient rehabilitation hospitals reduced length of stay, increased discharges, and increased profitability. Within the for-profit ownership group, the percentage of Medicare discharges increased and operating expense per

  5. Neurofeedback as a form of cognitive rehabilitation therapy following stroke: A systematic review.

    Directory of Open Access Journals (Sweden)

    Tian Renton

    Full Text Available Neurofeedback therapy (NFT has been used within a number of populations however it has not been applied or thoroughly examined as a form of cognitive rehabilitation within a stroke population. Objectives for this systematic review included: i identifying how NFT is utilized to treat cognitive deficits following stroke, ii examining the strength and quality of evidence to support the use of NFT as a form of cognitive rehabilitation therapy (CRT and iii providing recommendations for future investigations. Searches were conducted using OVID (Medline, Health Star, Embase + Embase Classic and PubMed databases. Additional searches were completed using the Cochrane Reviews library database, Google Scholar, the University of Toronto online library catalogue, ClinicalTrials.gov website and select journals. Searches were completed Feb/March 2015 and updated in June/July/Aug 2015. Eight studies were eligible for inclusion in this review. Studies were eligible for inclusion if they: i were specific to a stroke population, ii delivered CRT via a NFT protocol, iii included participants who were affected by a cognitive deficit(s following stroke (i.e. memory loss, loss of executive function, speech impairment etc.. NFT protocols were highly specific and varied within each study. The majority of studies identified improvements in participant cognitive deficits following the initiation of therapy. Reviewers assessed study quality using the Downs and Black Checklist for Measuring Study Quality tool; limited study quality and strength of evidence restricted generalizability of conclusions regarding the use of this therapy to the greater stroke population. Progression in this field requires further inquiry to strengthen methodology quality and study design. Future investigations should aim to standardize NFT protocols in an effort to understand the dose-response relationship between NFT and improvements in functional outcome. Future investigations should also place

  6. Neurofeedback as a form of cognitive rehabilitation therapy following stroke: A systematic review.

    Science.gov (United States)

    Renton, Tian; Tibbles, Alana; Topolovec-Vranic, Jane

    2017-01-01

    Neurofeedback therapy (NFT) has been used within a number of populations however it has not been applied or thoroughly examined as a form of cognitive rehabilitation within a stroke population. Objectives for this systematic review included: i) identifying how NFT is utilized to treat cognitive deficits following stroke, ii) examining the strength and quality of evidence to support the use of NFT as a form of cognitive rehabilitation therapy (CRT) and iii) providing recommendations for future investigations. Searches were conducted using OVID (Medline, Health Star, Embase + Embase Classic) and PubMed databases. Additional searches were completed using the Cochrane Reviews library database, Google Scholar, the University of Toronto online library catalogue, ClinicalTrials.gov website and select journals. Searches were completed Feb/March 2015 and updated in June/July/Aug 2015. Eight studies were eligible for inclusion in this review. Studies were eligible for inclusion if they: i) were specific to a stroke population, ii) delivered CRT via a NFT protocol, iii) included participants who were affected by a cognitive deficit(s) following stroke (i.e. memory loss, loss of executive function, speech impairment etc.). NFT protocols were highly specific and varied within each study. The majority of studies identified improvements in participant cognitive deficits following the initiation of therapy. Reviewers assessed study quality using the Downs and Black Checklist for Measuring Study Quality tool; limited study quality and strength of evidence restricted generalizability of conclusions regarding the use of this therapy to the greater stroke population. Progression in this field requires further inquiry to strengthen methodology quality and study design. Future investigations should aim to standardize NFT protocols in an effort to understand the dose-response relationship between NFT and improvements in functional outcome. Future investigations should also place a large

  7. Final priority; National Institute on Disability and Rehabilitation Research--Disability and Rehabilitation Projects and Centers Program--Rehabilitation Engineering Research Centers. Final priority.

    Science.gov (United States)

    2013-06-19

    The Assistant Secretary for Special Education and Rehabilitative Services announces a priority for a Rehabilitation Engineering Research Center (RERC) on Technologies to Support Successful Aging with Disability under the Disability and Rehabilitation Research Projects and Centers Program administered by the National Institute on Disability and Rehabilitation Research (NIDRR). The Assistant Secretary may use this priority for a competition in fiscal year (FY) 2013 and later years. We take this action to focus research attention on areas of national need. We intend to use this priority to improve outcomes for individuals with disabilities.

  8. Effects of computer-assisted oral anticoagulant therapy

    DEFF Research Database (Denmark)

    Rasmussen, Rune Skovgaard; Corell, Pernille; Madsen, Poul

    2012-01-01

    : Patients randomized to computer-assisted anticoagulation and the CoaguChek® system reached the therapeutic target range after 8 days compared to 14 days by prescriptions from physicians (p = 0.04). Time spent in the therapeutic target range did not differ between groups. The median INR value measured...... prescribed by physicians, and the total time spent within the therapeutic target range was similar. Thus computer-assisted oral anticoagulant therapy may reduce the cost of anticoagulation therapy without lowering the quality. INR values measured by CoaguChek® were reliable compared to measurements......UNLABELLED: BACKGROUND: Computer-assistance and self-monitoring lower the cost and may improve the quality of anticoagulation therapy. The main purpose of this clinical investigation was to use computer-assisted oral anticoagulant therapy to improve the time to reach and the time spent within...

  9. Nurses' and nurse assistants' beliefs, attitudes and actions related to role and function in an inpatient stroke rehabilitation unit-A qualitative study

    DEFF Research Database (Denmark)

    Loft, Mia I; Poulsen, Ingrid; Esbensen, Bente A

    2017-01-01

    AIMS AND OBJECTIVES: To explore nurses' and nurse assistants' beliefs, attitudes and actions related to their function in an inpatient stroke rehabilitation unit. BACKGROUND: Several attempts have been made to describe nurses' roles and functions in inpatient neurorehabilitation. However, current...... understandings of the contributions that nurses and nurse assistants make to neurorehabilitation remain sparse. DESIGN: Descriptive, interpretive qualitative study. METHODS: Participant observations were conducted during 1 month in a stroke rehabilitation unit at a university hospital in the Capital Region...... stroke rehabilitation. We obtained insights into nursing staff's beliefs and attitudes about rehabilitation-as well as their own role and function-and furthermore how the latter affects their actions in daily practice. RELEVANCE TO CLINICAL PRACTICE: The nursing role and function are still not clearly...

  10. Motor and psychosocial impact of robot-assisted gait training in a real-world rehabilitation setting: A pilot study.

    Directory of Open Access Journals (Sweden)

    Cira Fundarò

    Full Text Available In the last decade robotic devices have been applied in rehabilitation to overcome walking disability in neurologic diseases with promising results. Robot assisted gait training (RAGT using the Lokomat seems not only to improve gait parameters but also the perception of well-being. Data on the psychosocial patient-robot impact are limited, in particular in the real-world of RAGT, in the rehabilitation setting. During rehabilitation training, the Lokomat can be considered an "assistive device for movement". This allowed the use of the Psychosocial Impact of Assistive Device Scale- PIADS to describe patient interaction with the Lokomat. The primary aim of this pilot study was to evaluate the psychosocial impact of the Lokomat in an in-patient rehabilitation setting using the PIADS; secondary aims were to assess whether the psychosocial impact of RAGT is different between pathological sub-groups and if the Lokomat influenced functional variables (Functional Independence Measure scale-FIM and parameters provided by the Lokomat itself. Thirty-nine consecutive patients (69% males, 54.0±18.0 years eligible for Lokomat training, with etiologically heterogeneous walking disabilities (Parkinson's Disease, n = 10; Spinal Cord Injury, n = 21; Ictus Event, n = 8 were enrolled. Patients were assessed with the FIM before and after rehabilitation with Lokomat, and the PIADS was administered after the rehabilitative period with Lokomat. Overall the PIADS score was positive (35.8±21.6, as well as the three sub-scales, pertaining to "ability", "adaptability" and "self-esteem" (17.2±10.4, 8.9±5.5 and 10.1±6.6 respectively with no between-group differences. All patients significantly improved in gait measure and motor FIM scale (difference after-before treatment values: 11.7±9.8 and 11.2±10.3 respectively, increased treadmill speed (0.4 ± 0.2m/s, reduced body weight support (-14.0±9.5% and guidance force (-13.1 ± 10.7%. This pilot study indicates that

  11. From assistance towards restoration with epidural brain-computer interfacing.

    Science.gov (United States)

    Gharabaghi, Alireza; Naros, Georgios; Walter, Armin; Grimm, Florian; Schuermeyer, Marc; Roth, Alexander; Bogdan, Martin; Rosenstiel, Wolfgang; Birbaumer, Niels

    2014-01-01

    Today's implanted brain-computer interfaces make direct contact with the brain or even penetrate the tissue, bearing additional risks with regard to safety and stability. What is more, these approaches aim to control prosthetic devices as assistive tools and do not yet strive to become rehabilitative tools for restoring lost motor function. We introduced a less invasive, implantable interface by applying epidural electrocorticography in a chronic stroke survivor with a persistent motor deficit. He was trained to modulate his natural motor-related oscillatory brain activity by receiving online feedback. Epidural recordings of field potentials in the beta-frequency band projecting onto the anatomical hand knob proved most successful in discriminating between the attempt to move the paralyzed hand and to rest. These spectral features allowed for fast and reliable control of the feedback device in an online closed-loop paradigm. Only seven training sessions were required to significantly improve maximum wrist extension. For patients suffering from severe motor deficits, epidural implants may decode and train the brain activity generated during attempts to move with high spatial resolution, thus facilitating specific and high-intensity practice even in the absence of motor control. This would thus transform them from pure assistive devices to restorative tools in the context of reinforcement learning and neurorehabilitation.

  12. Relay-Assisted Primary and Secondary Transmissions in Cognitive Radio Networks

    KAUST Repository

    Shafie, Ahmed El; Khattab, Tamer; Salem, Ahmed Sultan

    2016-01-01

    We assume a set of cognitive relay nodes that assists both primary and secondary transmissions in a time-slotted cognitive radio networks. To regulate the channel access of the various nodes in the network, we propose an overlapped spectrum sensing

  13. ROBOT-ASSISTED SURGERY AND ROBOTS EXOSKELETONS FOR REHABILITATION: WORLD TECHNOLOGICAL LEADERS AND PERSPECTIVES OF RUSSIA

    Directory of Open Access Journals (Sweden)

    O. V. Cherchenko

    2015-01-01

    Full Text Available There was analysed the publication and patent activity with regard to two actively developing areas in the field of medical robototronics: robots-exoskeletons for rehabilitation of people with muscoloskeletal disorders and robot-assisted surgery. There was identified discrepancy in the structure of global and national publication and patent flows. There were revealed disadvantages of foreign innovations on robot-assisted surgery, which create prerequisites for promoting import-substituting innovations of domestic engineers. 

  14. Diagnosis, treatment, and rehabilitation in patients with dizziness and cognitive impairment

    Directory of Open Access Journals (Sweden)

    L. M. Antonenko

    2017-01-01

    Full Text Available Complaints of dizziness and instability are the common reason for seeking a neurologist's advice at an outpatient visit and can be the frequent reason for emergency hospitalization.Difficulty in diagnosing the causes of dizziness and instability is due to a diversity of diseases manifested by these symptoms. The list of etiological factors includes peripheral and central vestibular lesions and unrelated nervous system diseases. In a number of cases, dizziness and instability are concurrent with cognitive impairment. Complaints of poor concentration and memory, dizziness and instability can often be associated with brain degenerative and/or vascular lesions, as well as with pathological mood changes and anxiety disorder.The diagnosis of these diseases requires neurovestibular examination, cognitive testing, and assessment of the emotional status of patients. Early detection of the causes of dizziness and memory disorders ensures better treatment results. There are different approaches to therapy for dizziness and cognitive impairment: drug and non-drug correction techniques (vestibular rehabilitation and cognitive training. Biofeedback procedures were shown to be highly effective.The effect of tanakan in treating patients with involvement of the peripheral vestibular system and brain structures is discussed

  15. Final priority; National Institute on Disability and Rehabilitation Research--Disability and Rehabilitation Research Projects and Centers Program--Rehabilitation Engineering Research Centers. Final priority.

    Science.gov (United States)

    2013-06-14

    The Assistant Secretary for Special Education and Rehabilitative Services announces a priority for a Rehabilitation Engineering Research Center (RERC) on Universal Interfaces and Information Technology Access under the Disability and Rehabilitation Research Projects and Centers Program administered by the National Institute on Disability and Rehabilitation Research (NIDRR). The Assistant Secretary may use this priority for a competition in fiscal year (FY) 2013 and later years. We take this action to focus research attention on areas of national need. We intend to use this priority to improve outcomes for individuals with disabilities.

  16. Computer-Assisted Linguistic Analysis of the Peshitta

    NARCIS (Netherlands)

    Roorda, D.; Talstra, Eep; Dyk, Janet; van Keulen, Percy; Sikkel, Constantijn; Bosman, H.J.; Jenner, K.D.; Bakker, Dirk; Volkmer, J.A.; Gutman, Ariel; van Peursen, Wido Th.

    2014-01-01

    CALAP (Computer-Assisted Linguistic Analysis of the Peshitta), a joint research project of the Peshitta Institute Leiden and the Werkgroep Informatica at the Vrije Universiteit Amsterdam (1999-2005) CALAP concerned the computer-assisted analysis of the Peshitta to Kings (Janet Dyk and Percy van

  17. Enduring Effects of a Computer-Assisted Training Program For Cognitive Behavioral Therapy: A six-month follow-up of CBT4CBT*

    Science.gov (United States)

    Carroll, Kathleen M.; Ball, Samuel A.; Martino, Steve; Nich, Charla; Babuscio, Theresa A.; Rounsaville, Bruce J.

    2009-01-01

    Objectives To evaluate the durability of effects of a computer assisted version of cognitive behavioral therapy (CBT) as treatment for substance dependence through a 6 month follow-up. Methods Following a randomized clinical trial in which 73 individuals seeking outpatient treatment for substance dependence in an outpatient community setting were randomized to either standard treatment-as-usual (TAU) or TAU with 8 weeks of biweekly access to computer-based training for CBT (CBT4CBT), participants were interviewed one, three, and six months after the termination of study treatments. Results Sixty of the 73 participants were reached for follow-up (82%); follow up rates and availability of data were comparable across treatment conditions. Random regression analyses of use across time indicated significant differences between groups, such that those assigned to TAU increased their drug use across time while those assigned to CBT4CBT tended to improve slightly. The durability of the CBT4CBT effect remained even after controlling for treatment retention, treatment substance use outcomes, and exposure to other treatment during the follow-up period. Conclusions Computerized CBT4CBT appears to have both short-term and enduring effects on drug use. PMID:19041197

  18. Evaluation of data requirements for computerized constructability analysis of pavement rehabilitation projects.

    Science.gov (United States)

    2013-08-01

    This research aimed to evaluate the data requirements for computer assisted construction planning : and staging methods that can be implemented in pavement rehabilitation projects in the state of : Georgia. Results showed that two main issues for the...

  19. Efficacy of Cognitive Rehabilitation Therapy on Poststroke Depression among Survivors of First Stroke Attack in Ibadan, Nigeria.

    Science.gov (United States)

    Olukolade, Olugbemi; Osinowo, Helen O

    2017-01-01

    Poststroke depression (PSD) is a common complication after stroke. There is no adequate treatment for PSD. This study examined efficacy of cognitive rehabilitation therapy (CRT) in the treatment of PSD among stroke survivors. An experimental design, 30 participants with poststroke depression were randomly assigned into 3 groups of cognitive rehabilitation therapy (CRT), psychoeducation (PE), and the control group (CG). CRT consisted of nine sessions with three-phased sessions focusing on activity stimulation, negative thoughts, and people contacts, PE consisted of nine sessions focusing on knowledge on stroke and poststroke depression, and the CG group was on the waiting list. The BDI scale was used for assessing PSD at posttest. There was a significant difference in the efficacy of CRT, PE, and the CG on PSD, with CRT-CG mean difference of -9.4 ± 3.11 and PE-CG 1.0 ± 3.83. Furthermore, stress was not a confounding variable on the efficacy of CRT. The type of therapy significantly influenced PSD at posttest, with the CRT having greater mean reduction to CG (-11.1 ± 3.1) than PE to the CG (3.0 ± 3.8). Cognitive rehabilitation therapy significantly reduced poststroke depression. Hence, it should be integrated as an adjunct treatment of poststroke depression.

  20. Outcomes of a multimodal cognitive and physical rehabilitation program for persons with mild dementia and their caregivers: a goal-oriented approach

    Directory of Open Access Journals (Sweden)

    Chew J

    2015-10-01

    Full Text Available Justin Chew, Mei-Sian Chong, Yoke-Leng Fong, Laura Tay Department of Geriatric Medicine, Institute of Geriatrics and Active Ageing, Tan Tock Seng Hospital, Singapore, Singapore Background: Nonpharmacological interventions such as exercise and cognitive rehabilitation programs have shown promise in reducing the impact of dementia on the individual and the caregiver. In this study, we examine the effect of a multimodal cognitive and physical rehabilitation program for persons with mild dementia and their caregivers using conventional measures of cognition, behavior, quality of life (QoL, and caregiver burden together with goal attainment scaling (GAS, an individualized outcome measure.Methods: Goals were set at baseline, and GAS score was calculated at the end of the program. Participants were also assessed with the Chinese Mini-Mental State Examination, functional and behavioral scales (Barthel Index, Instrumental Activities of Daily Living, Neuropsychiatric Inventory Questionnaire, QoL, and caregiver burden using EuroQol-five dimension questionnaire and Zarit Burden Interview (ZBI. Differences in median scores postintervention were obtained. Further analysis of caregiver burden was undertaken utilizing the multidimensional classification of burden on the ZBI.Results: Thirty-four (61.8% patients were assessed to have met their goals (GAS score ≥50. Mean (standard deviation GAS score was 48.6 (6.5. Cognition goals were set in only 20.6%, followed by goals to improve engagement and socialization; reduce caregiver stress; and improve physical function, behavior, and mood. Median scores in the cognitive, functional, and QoL measures did not differ significantly pre- and postintervention. The intervention had a positive impact on role strain, a unique dimension of caregiver burden.Conclusion: This study provides evidence that a multimodal approach combining physical exercise and cognitive rehabilitation improves goal attainment and caregiver burden

  1. Early versus delayed rehabilitation treatment in hemiplegic patients with ischemic stroke: proprioceptive or cognitive approach?

    Science.gov (United States)

    Morreale, Manuela; Marchione, Pasquale; Pili, Antonio; Lauta, Antonella; Castiglia, Stefano F; Spallone, Aldo; Pierelli, Francesco; Giacomini, Patrizia

    2016-02-01

    Early/intensive mobilization may improve functional recovery after stroke but it is not clear which kind of "mobilization" is more effective. Proprioceptive neuromuscular facilitation (PNF) and cognitive therapeutic exercise (CTE) are widespread applied in post-stroke rehabilitation but their efficacy and safety have not been systematically investigated. To compare PNF and CTE methods in a two different time setting (early versus standard approach) in order to evaluate different role of time and techniques in functional recovery after acute ischemic stroke. We designed a prospectical multicenter blinded interventional study of early versus standard approach with two different methods by means of both PNF and CTE. A discrete stroke-dedicated area for out-of-thrombolysis patients, connected with two different comprehensive stroke centres in two different catchment areas. Three hundred and forty consecutive stroke patient with first ever sub-cortical ischemic stroke in the mean cerebral artery (MCA) territory and contralateral hemiplegia admitted within 6 and 24 hours from symptoms onset. All patients were randomly assigned by means of a computer generated randomization sequence in blocks of 4 to one to the 4 interventional groups: early versus delayed rehabilitation programs with Kabat's schemes or Perfetti's technique. Patients in both delayed group underwent to a standard protocol in the acute phase. disability at 3-12 months. Disability measures: modified Rankin Score and Barthel Index. Safety outcome: immobility-related adverse events. Six-Minute Walking Test, Motricity Index, Mini-Mental State Examination, Beck Depression Inventory. Disability was not different between groups at 3 months but Barthel Index significantly changed between early versus delayed groups at 12 months (P=0.01). Six-Minute Walking Test (P=0.01) and Motricity Index in both upper (P=0.01) and lower limbs (P=0.001) increased in early versus delayed groups regardless rehabilitation schedule. A

  2. Computer Assisted Advising Tool (CAAT).

    Science.gov (United States)

    Matsen, Marie E.

    Lane Community College's Computer Assisted Advising Tool (CAAT) is used by counselors to assist students in developing a plan for the completion of a degree or certificate. CAAT was designed to facilitate student advisement from matriculation to graduation by comparing degree requirements with the courses completed by students. Three major sources…

  3. [Acupuncture at Baihui(GV 20) and Shenting(GV 24) combined with basic treatment and regular rehabilitation for post-stroke cognitive impairment:a randomized controlled trial].

    Science.gov (United States)

    Zhan, Jie; Pan, Ruihuan; Guo, Youhua; Zhan, Lechang; He, Mingfeng; Wang, Qiuchun; Chen, Hongxia

    2016-08-12

    To observe the clinical effect of acupuncture at Baihui(GV 20) and Shenting(GV 24) combined with rehabilitation for post-stroke cognitive impairment(PSCI). Fifty patients with PSCI were randomly assigned to an observation group and a control group,25 cases in each one. In the control group,basic treatment and regular rehabilitation were applied. In the observation group,acupuncture at Baihui(GV 20) and Shenting(GV 24) and the same therapies as the control group were used for continuous four weeks,once a day and five times a week. Mini-mental state examination(MMSE) and Montreal cognitive assessment(MoCA) were observed before and after treatment in the two groups. After treatment,the scores of MMSE and MoCA were improved apparently(both P rehabilitation can obviously improve the cognitive function of PSCI,and the effect is superior to that of basic treatment and regular rehabilitation.

  4. ‘The Remembering Group’; facilitating a cognitive stimulation group in an inpatient health and rehabilitation setting.

    OpenAIRE

    Peacock-Brennan, Sinead; Jamal, S.; O’Sullivan, G.

    2016-01-01

    A trainee clinical psychologist and two occupational therapists reflect upon the\\ud experience of adapting a cognitive stimulation therapy group for an inpatient health\\ud and rehabilitation setting. The adaptations, benefits and challenges of implementing\\ud the group are discussed.

  5. Computer game assisted instruction and students' achievement in ...

    African Journals Online (AJOL)

    Computer game assisted instruction and students' achievement in social studies. ... This paper examines the effects of computer game assisted instructional method, student's achievement in social studies in ... AJOL African Journals Online.

  6. Selection for inpatient rehabilitation after severe stroke: what factors influence rehabilitation assessor decision-making?

    Science.gov (United States)

    Hakkennes, Sharon; Hill, Keith D; Brock, Kim; Bernhardt, Julie; Churilov, Leonid

    2013-01-01

    This study aimed to identify factors that assessors considered important in decision-making regarding suitability for inpatient rehabilitation after acute severe stroke. Multi-site prospective observational cohort study. Consecutive acute, severe stroke patients and their assessors for inpatient rehabilitation. Rehabilitation assessors completed a questionnaire, rating the importance (10 point visual analogue scale) and direction (positive, negative or neutral) of 15 patient related and 2 organisational items potentially affecting their decision regarding patients' acceptance to rehabilitation. Of the 75 patients referred to rehabilitation and included in this study 61 (81.3%) were accepted for inpatient rehabilitation. The items considered to be most important in the decision to accept the patient for rehabilitation were pre-morbid cognition, pre-morbid mobility and pre-morbid communication. For those not accepted the most important items were current mobility, social support and current cognition. Factor analysis revealed 3 underlying factors, interpreted as post-stroke status, pre-morbid status, and social attributes, accounting for 61.8% of the total variance. All were independently associated with acceptance for rehabilitation (p decision making process for acceptance to rehabilitation following severe stroke. Future models for selection for rehabilitation should consider inclusion of these factors.

  7. New Computer Assisted Diagnostic to Detect Alzheimer Disease

    Directory of Open Access Journals (Sweden)

    Ben Rabeh Amira

    2016-08-01

    Full Text Available We describe a new Computer Assisted Diagnosis (CAD to automatically detect Alzheimer Patients (AD, Mild Cognitive Impairment (MCI and elderly Controls, based on the segmentation and classification of the Hippocampus (H and Corpus Calosum (CC from Magnetic Resonance Images (MRI. For the segmentation we used a new method based on a deformable model to extract the area wishes, and then we computed the geometric and texture features. For the classification we proposed a new supervised method. We evaluated the accuracy of our method in a group of 25 patients with AD (age±standard-deviation (SD =70±6 years, 25 patients with MCI (age±SD=65±8 years and 25 elderly healthy controls (age±SD=60±8 years. For the AD patients we found an accuracy of the classification of 92%, for the MCI we found 88% and for the elderly patients we found 96%. Overall, we found our method to be 92% accurate. Our method can be a useful tool for diagnosing Alzheimer’s Disease in any of these Steps.

  8. Using upper limb kinematics to assess cognitive deficits in people living with both HIV and stroke.

    Science.gov (United States)

    Bui, Kevin D; Rai, Roshan; Johnson, Michelle J

    2017-07-01

    In this study, we aim to explore ways to objectively assess cognitive deficits in the stroke and HIV/stroke populations, where cognitive and motor impairments can be hard to separate. Using an upper limb rehabilitation robot called the Haptic TheraDrive, we collect performance error scores and motor learning data on the impaired and unimpaired limb during a trajectory tracking task. We compare these data to clinical cognitive scores. The preliminary results suggest a possible relationship between unimpaired upper limb performance error and visuospatial/executive function cognitive domains, but more work needs to be done to further investigate this. The potential of using robot-assisted technologies to measure unimpaired limb kinematics as a tool to assess cognitive deficits would be useful to inform more effective rehabilitation strategies for HIV, stroke, and HIV/stroke populations.

  9. 75 FR 21606 - Office of Special Education and Rehabilitative Services; Overview Information; Rehabilitation...

    Science.gov (United States)

    2010-04-26

    ... DEPARTMENT OF EDUCATION Office of Special Education and Rehabilitative Services; Overview.... Alexa Posny, Assistant Secretary for Special Education and Rehabilitative Services. [FR Doc. 2010-9626... education and training for rehabilitation personnel; (3) Disseminate, in a cost-effective manner...

  10. Maximizing Employment Outcomes through the Use of "Lower-Tech" Assistive Technology & Rehabilitation Engineering.

    Science.gov (United States)

    Grott, Ray

    2015-01-01

    For many people with disabilities, Assistive Technology tools and Rehabilitation Engineering principles are key to successful employment outcomes. At the same time, employers and service providers are often under the impression that accommodations and AT solutions require high-tech, complicated, and expensive technologies. This paper discusses how creative problem solving and a "keep it simple" mindset can result in very functional low-cost solutions.

  11. Web-based cognitive rehabilitation for survivors of adult cancer: A randomised controlled trial.

    Science.gov (United States)

    Mihuta, Mary E; Green, Heather J; Shum, David H K

    2018-04-01

    Cognitive dysfunction associated with cancer is frequently reported and can reduce quality of life. This study evaluated a Web-based cognitive rehabilitation therapy program (eReCog) in cancer survivors compared with a waitlist control group. Adult cancer survivors with self-reported cognitive symptoms who had completed primary treatment at least 6 months prior were recruited. Participants completed telephone screening and were randomly allocated to the 4-week online intervention or waitlist. Primary outcome was perceived cognitive impairment assessed with the Functional Assessment of Cancer Therapy-Cognitive Function version 3. Secondary outcomes were additional measures of subjective cognitive functioning, objective cognitive functioning, and psychosocial variables. Seventy-six women were allocated to the intervention (n = 40) or waitlist (n = 36). A significant interaction was found on the instrumental activities of daily living measure of self-reported prospective memory whereby the intervention group reported a greater reduction in prospective memory failures than the waitlist group. Interaction trends were noted on perceived cognitive impairments (P = .089) and executive functioning (P = .074). No significant interactions were observed on other measures of objective cognitive functioning or psychosocial variables. The Web-based intervention shows promise for improving self-reported cognitive functioning in adult cancer survivors. Further research is warranted to better understand the mechanisms by which the intervention might contribute to improved self-reported cognition. Copyright © 2017 John Wiley & Sons, Ltd.

  12. BCI and FES Based Therapy for Stroke Rehabilitation Using VR Facilities

    Directory of Open Access Journals (Sweden)

    Robert Gabriel Lupu

    2018-01-01

    Full Text Available In recent years, the assistive technologies and stroke rehabilitation methods have been empowered by the use of virtual reality environments and the facilities offered by brain computer interface systems and functional electrical stimulators. In this paper, a therapy system for stroke rehabilitation based on these revolutionary techniques is presented. Using a virtual reality Oculus Rift device, the proposed system ushers the patient in a virtual scenario where a virtual therapist coordinates the exercises aimed at restoring brain function. The electrical stimulator helps the patient to perform rehabilitation exercises and the brain computer interface system and an electrooculography device are used to determine if the exercises are executed properly. Laboratory tests on healthy people led to system validation from technical point of view. The clinical tests are in progress, but the preliminary results of the clinical tests have highlighted the good satisfaction degree of patients, the quick accommodation with the proposed therapy, and rapid progress for each user rehabilitation.

  13. Computer Multimedia Assisted English Vocabulary Teaching Courseware

    Directory of Open Access Journals (Sweden)

    Nan Yue

    2017-12-01

    Full Text Available English vocabulary is often regarded as the most boring link in English learning. However, English vocabulary is the basis of all aspects of English learning. Therefore, enriching the process of English vocabulary learning and stimulating the interest of English vocabulary learning are the keys to the reform of English vocabulary teaching. The computer multimedia is developing and popularizing rapidly with the rapid development of informationization and networking, which plays its role in more and more fields. The application of multimedia technology in the field of teaching is no longer strange. This paper mainly studied the design of computer multimedia assisted English vocabulary teaching courseware. First of all, this paper gave an overview of computer multimedia technology from the aspects of concept, characteristics, development and application situation, which cited and analyzed the cognitive learning theory and memory law. Under the guidance of scientific laws and in combination with the requirement analysis and pattern construction of English vocabulary teaching, this paper realized the module design, style design and database design of English vocabulary courseware. Finally, the content of English vocabulary teaching courseware was demonstrated, and its application effect was verified through the combination of subjective evaluation and objective evaluation. This article has an important guiding significance for stimulating students’ interest in English vocabulary learning and enhancing the quality of vocabulary teaching.

  14. The Role of Cognitive Factors in Predicting Balance and Fall Risk in a Neuro-Rehabilitation Setting

    OpenAIRE

    Saverino, A.; Waller, D.; Rantell, K.; Parry, R.; Moriarty, A.; Playford, E. D.

    2016-01-01

    Introduction\\ud \\ud There is a consistent body of evidence supporting the role of cognitive functions, particularly executive function, in the elderly and in neurological conditions which become more frequent with ageing. The aim of our study was to assess the role of different domains of cognitive functions to predict balance and fall risk in a sample of adults with various neurological conditions in a rehabilitation setting.\\ud \\ud Methods\\ud \\ud This was a prospective, cohort study conduct...

  15. [Guided and computer-assisted implant surgery and prosthetic: The continuous digital workflow].

    Science.gov (United States)

    Pascual, D; Vaysse, J

    2016-02-01

    New continuous digital workflow protocols of guided and computer-assisted implant surgery improve accuracy of implant positioning. The design of the future prosthesis is based on the available prosthetic space, gingival height and occlusal relationship with the opposing and adjacent teeth. The implant position and length depend on volume, density and bone quality, gingival height, tooth-implant and implant-implant distances, implant parallelism, axis and type of the future prosthesis. The crown modeled on the software will therefore serve as a guide to the future implant axis and not the reverse. The guide is made by 3D printing. The software determines surgical protocol with the drilling sequences. The unitary or plural prosthesis, modeled on the software and built before surgery, is loaded directly after implant placing, if needed. These protocols allow for a full continuity of the digital workflow. The software provides the surgeon and the dental technician a total freedom for the prosthetic-surgery guide design and the position of the implants. The prosthetic project, occlusal and aesthetic, taking the bony and surgical constraints into account, is optimized. The implant surgery is simplified and becomes less "stressful" for the patient and the surgeon. Guided and computer-assisted surgery with continuous digital workflow is becoming the technique of choice to improve the accuracy and quality of implant rehabilitation. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  16. Rehabilitation of activities of daily living in virtual environments with intuitive user interface and force feedback.

    Science.gov (United States)

    Chiang, Vico Chung-Lim; Lo, King-Hung; Choi, Kup-Sze

    2017-10-01

    To investigate the feasibility of using a virtual rehabilitation system with intuitive user interface and force feedback to improve the skills in activities of daily living (ADL). A virtual training system equipped with haptic devices was developed for the rehabilitation of three ADL tasks - door unlocking, water pouring and meat cutting. Twenty subjects with upper limb disabilities, supervised by two occupational therapists, received a four-session training using the system. The task completion time and the amount of water poured into a virtual glass were recorded. The performance of the three tasks in reality was assessed before and after the virtual training. Feedback of the participants was collected with questionnaires after the study. The completion time of the virtual tasks decreased during the training (p water successfully poured increased (p = 0.051). The score of the Borg scale of perceived exertion was 1.05 (SD = 1.85; 95% CI =  0.18-1.92) and that of the task specific feedback questionnaire was 31 (SD =  4.85; 95% CI =  28.66-33.34). The feedback of the therapists suggested a positive rehabilitation effect. The participants had positive perception towards the system. The system can potentially be used as a tool to complement conventional rehabilitation approaches of ADL. Implications for rehabilitation Rehabilitation of activities of daily living can be facilitated using computer-assisted approaches. The existing approaches focus on cognitive training rather than the manual skills. A virtual training system with intuitive user interface and force feedback was designed to improve the learning of the manual skills. The study shows that system could be used as a training tool to complement conventional rehabilitation approaches.

  17. COPD patients’ self-reported adherence, psychosocial factors and mild cognitive impairment in pulmonary rehabilitation

    Directory of Open Access Journals (Sweden)

    Pierobon A

    2017-07-01

    Full Text Available Antonia Pierobon,1 Elisa Sini Bottelli,1 Laura Ranzini,1 Claudio Bruschi,2 Roberto Maestri,3 Giorgio Bertolotti,4 Marinella Sommaruga,5 Valeria Torlaschi,1 Simona Callegari,1 Anna Giardini1 1Psychology Unit, 2Department of Pulmonary Rehabilitation, 3Department of Biomedical Engineering, Istituti Clinici Scientifici Maugeri, IRCCS, Montescano, 4Psychology Unit, Istituti Clinici Scientifici Maugeri, IRCCS, Tratate, 5Clinical Psychology and Social Support Unit, Istituti Clinici Scientifici Maugeri, IRCCS, Camaldoli, Italy Abstract: In addition to clinical comorbidities, psychological and neuropsychological problems are frequent in COPD and may affect pulmonary rehabilitation delivery and outcome. The aims of the study were to describe a COPD population in a rehabilitative setting as regards the patients depressive symptoms, anxiety, mild cognitive impairment (MCI and self-reported adherence and to analyze their relationships; to compare the COPD sample MCI scores with normative data; and to investigate which factors might predict adherence to prescribed physical exercise. This was a multicenter observational cross-sectional study. Of the 117 eligible stable COPD inpatients, 84 were enrolled according to Global initiative for chronic Obstructive Lung Disease (GOLD criteria (mainly in Stage III–IV. The assessment included Mini Mental State Examination (MMSE, Montreal Cognitive Assessment (MoCA, anxiety, depression and self-reported pharmacological and nonpharmacological adherence. From the MMSE, 3.6% of patients were found to be impaired, whereas from the MoCA 9.5% had a likely MCI. Patients referred had mild-severe depression (46.7%, anxiety (40.5%, good pharmacological adherence (80.3% and difficulties in following prescribed diet (24.1% and exercise (51.8%; they struggled with disease acceptance (30.9% and disease limitations acceptance (28.6%. Most of them received good family (89% or social (53% support. Nonpharmacological adherence

  18. Combined Cognitive-Motor Rehabilitation in Virtual Reality Improves Motor Outcomes in Chronic Stroke – A Pilot Study

    Directory of Open Access Journals (Sweden)

    Ana L. Faria

    2018-05-01

    Full Text Available 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. Virtual Reality (VR based methods for stroke rehabilitation have mainly focused on motor rehabilitation but there is increasing interest toward the integration of cognitive training for providing more effective solutions. Here we investigate the feasibility for stroke recovery of a virtual cognitive-motor task, the Reh@Task, which combines adapted arm reaching, and attention and memory training. 24 participants in the chronic stage of stroke, with cognitive and motor deficits, were allocated to one of two groups (VR, Control. Both groups were enrolled in conventional occupational therapy, which mostly involves motor training. Additionally, the VR group underwent training with the Reh@Task and the control group performed time-matched conventional occupational therapy. Motor and cognitive competences were assessed at baseline, end of treatment (1 month and at a 1-month follow-up through the Montreal Cognitive Assessment, Single Letter Cancelation, Digit Cancelation, Bells Test, Fugl-Meyer Assessment Test, Chedoke Arm and Hand Activity Inventory, Modified Ashworth Scale, and Barthel Index. Our results show that both groups improved in motor function over time, but the Reh@Task group displayed significantly higher between-group outcomes in the arm subpart of the Fugl-Meyer Assessment Test. Improvements in cognitive function were significant and similar in both groups. Overall, these results are supportive of the viability of VR tools that combine motor and cognitive training, such as the Reh@Task. Trial Registration: This trial was not registered because it is a small clinical study that addresses the feasibility of a prototype device.

  19. Computer-Assisted Discovery and Proof

    Energy Technology Data Exchange (ETDEWEB)

    Bailey, David H.; Borwein, Jonathan M.

    2007-12-10

    With the advent of powerful, widely-available mathematical software, combined with ever-faster computer hardware, we are approaching a day when both the discovery and proof of mathematical facts can be done in a computer-assisted manner. his article presents several specific examples of this new paradigm in action.

  20. Final priorities; National Institute on Disability and Rehabilitation Research--Disability and Rehabilitation Research Projects and Centers Program--Rehabilitation Engineering Research Centers. Final priorities.

    Science.gov (United States)

    2013-06-11

    The Assistant Secretary for Special Education and Rehabilitative Services announces priorities under the Disability and Rehabilitation Research Projects and Centers Program administered by the National Institute on Disability and Rehabilitation Research (NIDRR). Specifically, we announce priorities for a Rehabilitation Engineering Research Center (RERC) on Rehabilitation Strategies, Techniques, and Interventions (Priority 1), Information and Communication Technologies Access (Priority 2), Individual Mobility and Manipulation (Priority 3), and Physical Access and Transportation (Priority 4). The Assistant Secretary may use one or more of these priorities for competitions in fiscal year (FY) 2013 and later years. We take this action to focus research attention on areas of national need. We intend these priorities to improve community living and participation, health and function, and employment outcomes of individuals with disabilities.

  1. Multidisciplinary rehabilitation program: effects of a multimodal intervention for patients with Alzheimer’s disease and cognitive impairment without dementia

    Directory of Open Access Journals (Sweden)

    Glenda Dias Santos

    2015-12-01

    Full Text Available Abstract Background Non-pharmalogical interventions represent an important complement to standard pharmalogical treatment in dementia. Objective This study aims to evaluate the effects of a multidisciplinary rehabilitation program on cognitive ability, quality of life and depression symptoms in patients with Alzheimer’s disease (AD and cognitive impairment without dementia (CIND. Methods Ninety-seven older adults were recruited to the present study. Of these, 70 patients had mild AD and were allocated into experimental (n = 54 or control (n = 16 groups. Two additional active comparison groups were constituted with patients with moderate AD (n = 13 or with CIND (n = 14 who also received the intervention. The multidisciplinary rehabilitation program lasted for 12 weeks and was composed by sessions of memory training, recreational activities, verbal expression and writing, physical therapy and physical training, delivered in two weekly 6-hour sessions. Results As compared to controls, mild AD patients who received the intervention had improvements in cognition (p = 0.021 and quality of life (p = 0.003, along with a reduction in depressive symptoms (p < 0.001. As compared to baseline, CIND patients displayed at the end of the intervention improvements in cognition (p = 0.005 and depressive symptoms (p = 0.011. No such benefits were found among patients with moderate AD.Discussion: This multidisciplinary rehabilitation program was beneficial for patients with mild AD and CIND. However, patients with moderate dementia did not benefit from the intervention.

  2. 7th International Conference on Design Computing and Cognition

    CERN Document Server

    2017-01-01

    This book gathers the peer-reviewed and revised versions of papers from the Seventh International Conference on Design Computing and Cognition (DCC'16), held at Northwestern University, Evanston (Chicago), USA, from 27–29 June 2016. The material presented here reflects cutting-edge design research with a focus on artificial intelligence, cognitive science and computational theories. The papers are grouped under the following nine headings, describing advances in theory and applications alike and demonstrating the depth and breadth of design computing and design cognition: Design Creativity; Design Cognition - Design Approaches; Design Support; Design Grammars; Design Cognition - Design Behaviors; Design Processes; Design Synthesis; Design Activity and Design Knowledge. The book will be of particular interest to researchers, developers and users of advanced computation in design across all disciplines, and to all readers who need to gain a better understanding of designing.

  3. Brain-computer interfaces in neurological rehabilitation.

    Science.gov (United States)

    Daly, Janis J; Wolpaw, Jonathan R

    2008-11-01

    Recent advances in analysis of brain signals, training patients to control these signals, and improved computing capabilities have enabled people with severe motor disabilities to use their brain signals for communication and control of objects in their environment, thereby bypassing their impaired neuromuscular system. Non-invasive, electroencephalogram (EEG)-based brain-computer interface (BCI) technologies can be used to control a computer cursor or a limb orthosis, for word processing and accessing the internet, and for other functions such as environmental control or entertainment. By re-establishing some independence, BCI technologies can substantially improve the lives of people with devastating neurological disorders such as advanced amyotrophic lateral sclerosis. BCI technology might also restore more effective motor control to people after stroke or other traumatic brain disorders by helping to guide activity-dependent brain plasticity by use of EEG brain signals to indicate to the patient the current state of brain activity and to enable the user to subsequently lower abnormal activity. Alternatively, by use of brain signals to supplement impaired muscle control, BCIs might increase the efficacy of a rehabilitation protocol and thus improve muscle control for the patient.

  4. Development of virtual reality exercise of hand motion assist robot for rehabilitation therapy by patient self-motion control.

    Science.gov (United States)

    Ueki, Satoshi; Nishimoto, Yutaka; Abe, Motoyuki; Kawasaki, Haruhisa; Ito, Satoshi; Ishigure, Yasuhiko; Mizumoto, Jun; Ojika, Takeo

    2008-01-01

    This paper presents a virtual reality-enhanced hand rehabilitation support system with a symmetric master-slave motion assistant for independent rehabilitation therapies. Our aim is to provide fine motion exercise for a hand and fingers, which allows the impaired hand of a patient to be driven by his or her healthy hand on the opposite side. Since most disabilities caused by cerebral vascular accidents or bone fractures are hemiplegic, we adopted a symmetric master-slave motion assistant system in which the impaired hand is driven by the healthy hand on the opposite side. A VR environment displaying an effective exercise was created in consideration of system's characteristic. To verify the effectiveness of this system, a clinical test was executed by applying to six patients.

  5. Computer-assisted design/computer-assisted manufacturing systems: A revolution in restorative dentistry

    Directory of Open Access Journals (Sweden)

    Arbaz Sajjad

    2016-01-01

    Full Text Available For the better part of the past 20 years, dentistry has seen the development of many new all-ceramic materials and restorative techniques fueled by the desire to capture the ever elusive esthetic perfection. This has resulted in the fusion of the latest in material science and the pen ultimate in computer-assisted design/computer-assisted manufacturing (CAD/CAM technology. This case report describes the procedure for restoring the esthetic appearance of both the left and right maxillary peg-shaped lateral incisors with a metal-free sintered finely structured feldspar ceramic material using the latest laboratory CAD/CAM system. The use of CAD/CAM technology makes it possible to produce restorations faster with precision- fit and good esthetics overcoming the errors associated with traditional ceramo-metal technology. The incorporation of this treatment modality would mean that the dentist working procedures will have to be adapted in the methods of CAD/CAM technology.

  6. A randomized, controlled, single-blind, 6-month pilot study to evaluate the efficacy of MS-Line!: a cognitive rehabilitation programme for patients with multiple sclerosis.

    Science.gov (United States)

    Gich, Jordi; Freixanet, Jordi; García, Rafael; Vilanova, Joan Carles; Genís, David; Silva, Yolanda; Montalban, Xavier; Ramió-Torrentà, Lluís

    2015-09-01

    MS-Line! was created to provide an effective treatment for cognitive impairment in multiple sclerosis (MS) patients. To assess the efficacy of MS-Line!. A randomized, controlled, single-blind, 6-month pilot study. Patients were randomly assigned to an experimental group (cognitive rehabilitation with the programme) or to a control group (no cognitive rehabilitation). Randomization was stratified by cognitive impairment level. Cognitive assessment included: selective reminding test, 10/36 spatial recall test (10/36 SPART), symbol digit modalities test, paced auditory serial addition test, word list generation (WLG), FAS test, subtests of WAIS-III, Boston naming test (BNT), and trail making test (TMT). Forty-three patients (22 in the experimental group, 21 in the control group) were analyzed. Covariance analysis showed significant differences in 10/36 SPART (P=0.0002), 10/36 SPART delayed recall (P=0.0021), WLG (P=0.0123), LNS (P=0.0413), BNT (P=0.0007) and TMT-A (P=0.010) scores between groups. The study showed a significant improvement related to learning and visual memory, executive functions, attention and information processing speed, and naming ability in those patients who received cognitive rehabilitation. The results suggest that MS-Line! is effective in improving cognitive impairment in MS patients. © The Author(s), 2015.

  7. Efficacy of group cognitive rehabilitation therapy in multiple sclerosis.

    Science.gov (United States)

    Mani, A; Chohedri, E; Ravanfar, P; Mowla, A; Nikseresht, A

    2018-06-01

    Cognitive impairment occurs in 40%-65% of patients with multiple sclerosis (MS). Several techniques for cognitive rehabilitation (CR) in these patients have been evaluated; however, the results have been controversial. In this study, we investigated the efficacy of group compensatory CR in patients with MS-related cognitive impairment. Thirty-four female patients with diagnosed relapsing-remitting MS and evidence of impaired cognitive function were included and randomized to intervention (n = 17) and control (n = 17) groups. CR intervention consisted of eight 2-hour sessions of comprehensive group CR over a 4-week period that focused on improvement of memory, attention, and executive function. As placebo, the control group received the same number of non-therapeutic group sessions. Assessment of cognitive function was performed before intervention (pretest), at the end of intervention (post-test), and 3 months later (follow-up). The study population included 34 patients with a mean age of 35.5 years. Statistical comparison of memory assessments at 3-month follow-up showed significantly higher scores in the CR group than in the control group (93.33 vs 86.40 for Addenbrooke's Cognitive Examination test and 16.58 vs 12.00 for visual memory, 19.32 vs 14.05 for verbal memory, and 51.28 vs 44.41 for general scores on the Memory Functioning Questionnaire test, respectively). Wisconsin card sorting test score comparison showed significantly lower total time consumption in the CR group than in the control group (308.1 vs 340.8 seconds, respectively). Behavior rating inventory of executive function-adult scores in all four subtests were significantly higher in the CR group than in the control group (40.25 vs 55.4 for behavioral regulation index, 51.16 vs 68.6 for metacognition index, and 97.41 vs 124.00 for global executive composite, respectively). Attention was the only domain in which we did not observe any significant variation between groups in terms of post

  8. Rehabilitation of patients with motor disabilities using computer vision based techniques

    Directory of Open Access Journals (Sweden)

    Alejandro Reyes-Amaro

    2012-05-01

    Full Text Available In this paper we present details about the implementation of computer vision based applications for the rehabilitation of patients with motor disabilities. The applications are conceived as serious games, where the computer-patient interaction during playing contributes to the development of different motor skills. The use of computer vision methods allows the automatic guidance of the patient’s movements making constant specialized supervision unnecessary. The hardware requirements are limited to low-cost devices like usual webcams and Netbooks.

  9. Mina: A Sensorimotor Robotic Orthosis for Mobility Assistance

    OpenAIRE

    Raj, Anil K.; Neuhaus, Peter D.; Moucheboeuf, Adrien M.; Noorden, Jerryll H.; Lecoutre, David V.

    2011-01-01

    While most mobility options for persons with paraplegia or paraparesis employ wheeled solutions, significant adverse health, psychological, and social consequences result from wheelchair confinement. Modern robotic exoskeleton devices for gait assistance and rehabilitation, however, can support legged locomotion systems for those with lower extremity weakness or paralysis. The Florida Institute for Human and Machine Cognition (IHMC) has developed the Mina, a prototype sensorimotor robotic ort...

  10. Computer simulations in the high school: students' cognitive stages, science process skills and academic achievement in microbiology

    Science.gov (United States)

    Huppert, J.; Michal Lomask, S.; Lazarowitz, R.

    2002-08-01

    Computer-assisted learning, including simulated experiments, has great potential to address the problem solving process which is a complex activity. It requires a highly structured approach in order to understand the use of simulations as an instructional device. This study is based on a computer simulation program, 'The Growth Curve of Microorganisms', which required tenth grade biology students to use problem solving skills whilst simultaneously manipulating three independent variables in one simulated experiment. The aims were to investigate the computer simulation's impact on students' academic achievement and on their mastery of science process skills in relation to their cognitive stages. The results indicate that the concrete and transition operational students in the experimental group achieved significantly higher academic achievement than their counterparts in the control group. The higher the cognitive operational stage, the higher students' achievement was, except in the control group where students in the concrete and transition operational stages did not differ. Girls achieved equally with the boys in the experimental group. Students' academic achievement may indicate the potential impact a computer simulation program can have, enabling students with low reasoning abilities to cope successfully with learning concepts and principles in science which require high cognitive skills.

  11. 6th International Conference on Design Computing and Cognition

    CERN Document Server

    Hanna, Sean

    2015-01-01

    This book details the state-of-the-art of research and development in design computing and design cognition. It features more than 35 papers that were presented at the Sixth International Conference on Design Computing and Cognition, DCC’14, held at University College, London, UK. Inside, readers will find the work of expert researchers and practitioners that explores both advances in theory and application as well as demonstrates the depth and breadth of design computing and design cognition. This interdisciplinary coverage, which includes material from international research groups, examines design synthesis, design cognition, design creativity, design processes, design theory, design grammars, design support, and design ideation. Overall, the papers provide a bridge between design computing and design cognition. The confluence of these two fields continues to build the foundation for further advances and leads to an increased understanding of design as an activity whose influence continues to spread. ...

  12. An Individualized and Everyday Life Approach to Cognitive Rehabilitation in Schizophrenia: A Case Illustration

    Directory of Open Access Journals (Sweden)

    M.-N. Levaux

    2012-01-01

    Full Text Available Objective. The effectiveness of an individualized and everyday approach to cognitive rehabilitation for schizophrenia was examined in a case study. Method. After cognitive and functional assessment, concrete objectives were targeted for the person’s everyday complaints. Strategies were constructed based on an analysis of the cognitive profile, daily life functioning, and processes involved in activities. They included a memory strategy for reading, a diary to compensate memory difficulties, and working memory exercises to improve immediate processing of information when reading and following conversations. Efficacy was assessed with outcome measures. Results. The program had beneficial effects on the person’s cognitive and everyday functioning, which persisted at a 3-year follow-up. Conclusion. Findings provide suggestive evidence that an individualized and everyday approach may be a useful alternative in order to obtain a meaningfully lasting transfer of training to daily life, compared to the nomothetic ones which dominate the field.

  13. Enhanced neurorehabilitation techniques in the DVBIC Assisted Living Pilot Project.

    Science.gov (United States)

    Hoffman, Stuart W; Shesko, Kristina; Harrison, Catherine R

    2010-01-01

    Traumatic Brain Injury has been labeled the "silent epidemic" in our current wars. Both CBO and the RAND reports predict that the costs of these injuries will be both extensive and enduring. The projected costs are based not only upon the loss contribution of these warriors to our economy, but also the long-term medical and assistive care that will be needed to support these veterans for decades to come. Thus, the primary goal of the Assisted Living Pilot Project (ALPP) at the Defense and Veterans Brain Injury Center - Johnstown (DVBIC-J) is to promote the ability of the injured warrior to move from assisted living to living independently and to be self-supporting by providing a continuum of care. To accomplish this goal the DVBIC-J ALPP is providing full set of traditional services (physical, occupational, speech, psychological/cognitive, social/familial, vocational, and spiritual), along with "cutting-edge" rehabilitative treatment technologies. These cutting-edge therapies include transdisciplinary clinical consultations, interactive patient and family counseling, and telemedicine-teleconferencing for clinical evaluations and family/significant other care participation. These services will be available to those who require assisted living through their progression to community re-entry. The ALPP also serves as a vehicle for clinical trials to investigate the effects of an enriched environment (e.g., recreational therapies, massage, multisensory stimulation, etc.) on neurorehabilitation therapy, rural telemedicine for servicemembers with traumatic brain injury, and long-term outcome measures of those who have received neurorehabilitation services at the DVBIC-J site. DVBIC-J is also developing collaborative projects with universities and private industry to create an incubator for new rehabilitation technologies. The technologies that DVBIC-J will be focusing on will include assistive technologies (to assist cognitive, physical, and communicative impairments

  14. Using the Virtual Reality-Cognitive Rehabilitation Approach to Improve Contextual Processing in Children with Autism

    Directory of Open Access Journals (Sweden)

    Michelle Wang

    2013-01-01

    Full Text Available Background. This pilot study investigated the efficacy of a novel virtual reality-cognitive rehabilitation (VR-CR intervention to improve contextual processing of objects in children with autism. Previous research supports that children with autism show deficits in contextual processing, as well as deficits in its elementary components: abstraction and cognitive flexibility. Methods. Four children with autism participated in a multiple-baseline, single-subject study. The children were taught how to see objects in context by reinforcing attention to pivotal contextual information. Results. All children demonstrated statistically significant improvements in contextual processing and cognitive flexibility. Mixed results were found on the control test and changes in context-related behaviours. Conclusions. Larger-scale studies are warranted to determine the effectiveness and usability in comprehensive educational programs.

  15. Using the Virtual Reality-Cognitive Rehabilitation Approach to Improve Contextual Processing in Children with Autism

    Science.gov (United States)

    Reid, Denise

    2013-01-01

    Background. This pilot study investigated the efficacy of a novel virtual reality-cognitive rehabilitation (VR-CR) intervention to improve contextual processing of objects in children with autism. Previous research supports that children with autism show deficits in contextual processing, as well as deficits in its elementary components: abstraction and cognitive flexibility. Methods. Four children with autism participated in a multiple-baseline, single-subject study. The children were taught how to see objects in context by reinforcing attention to pivotal contextual information. Results. All children demonstrated statistically significant improvements in contextual processing and cognitive flexibility. Mixed results were found on the control test and changes in context-related behaviours. Conclusions. Larger-scale studies are warranted to determine the effectiveness and usability in comprehensive educational programs. PMID:24324379

  16. Increasing patient engagement in rehabilitation exercises using computer-based citizen science.

    Science.gov (United States)

    Laut, Jeffrey; Cappa, Francesco; Nov, Oded; Porfiri, Maurizio

    2015-01-01

    Patient motivation is an important factor to consider when developing rehabilitation programs. Here, we explore the effectiveness of active participation in web-based citizen science activities as a means of increasing participant engagement in rehabilitation exercises, through the use of a low-cost haptic joystick interfaced with a laptop computer. Using the joystick, patients navigate a virtual environment representing the site of a citizen science project situated in a polluted canal. Participants are tasked with following a path on a laptop screen representing the canal. The experiment consists of two conditions: in one condition, a citizen science component where participants classify images from the canal is included; and in the other, the citizen science component is absent. Both conditions are tested on a group of young patients undergoing rehabilitation treatments and a group of healthy subjects. A survey administered at the end of both tasks reveals that participants prefer performing the scientific task, and are more likely to choose to repeat it, even at the cost of increasing the time of their rehabilitation exercise. Furthermore, performance indices based on data collected from the joystick indicate significant differences in the trajectories created by patients and healthy subjects, suggesting that the low-cost device can be used in a rehabilitation setting for gauging patient recovery.

  17. A Computational Analysis Model for Open-ended Cognitions

    Science.gov (United States)

    Morita, Junya; Miwa, Kazuhisa

    In this paper, we propose a novel usage for computational cognitive models. In cognitive science, computational models have played a critical role of theories for human cognitions. Many computational models have simulated results of controlled psychological experiments successfully. However, there have been only a few attempts to apply the models to complex realistic phenomena. We call such a situation ``open-ended situation''. In this study, MAC/FAC (``many are called, but few are chosen''), proposed by [Forbus 95], that models two stages of analogical reasoning was applied to our open-ended psychological experiment. In our experiment, subjects were presented a cue story, and retrieved cases that had been learned in their everyday life. Following this, they rated inferential soundness (goodness as analogy) of each retrieved case. For each retrieved case, we computed two kinds of similarity scores (content vectors/structural evaluation scores) using the algorithms of the MAC/FAC. As a result, the computed content vectors explained the overall retrieval of cases well, whereas the structural evaluation scores had a strong relation to the rated scores. These results support the MAC/FAC's theoretical assumption - different similarities are involved on the two stages of analogical reasoning. Our study is an attempt to use a computational model as an analysis device for open-ended human cognitions.

  18. Virtual reality in rehabilitation after stroke

    Directory of Open Access Journals (Sweden)

    Krasnova-Goleva V.V.

    2016-01-01

    Full Text Available After a stroke many people have serious problems in motion activity, decline in cognitive activity, as well as a number of psychological problems that may accompany the man for many years. Motivational rehabilitation component plays a decisive role in the process of recovery after suffering a stroke. At present one of the most successful methods of rehabilitation is considered to be a recovery through "observation-imitation”, because this method enhances the plasticity of the brain and, as a result, rehabilitation potential. Modern rehabilitation using virtual reality had demonstrated good results to improve motor and cognitive skills, as well as the psychological condition

  19. Computer-assisted nuclear fuel manufacture

    International Nuclear Information System (INIS)

    Maloney, J.P.; Schaumann, S.M.; Stone, E.

    1976-01-01

    At the ERDA Savannah River Plant, a process monitor, which incorporates an online digital computer, assists in manufacturing fuel elements used to produce nuclides such as plutonium, tritium, and californium in the plant's nuclear reactors. Also, inventory functions assist in safeguarding fissile material and protecting against accidental nuclear criticality. Terminals at strategic locations throughout the process area enable production operators to send and receive instructions and information on each manufacturing step

  20. Computer-Based Training Programs for Older People with Mild Cognitive Impairment and/or Dementia

    Directory of Open Access Journals (Sweden)

    Blanka Klimova

    2017-05-01

    Full Text Available Currently, due to the demographic trends, the number of aging population groups is dramatically rising, especially in developed countries. This trend causes serious economic and social issues, but also an increase of aging disorders such as mild cognitive impairment (MCI or dementia in older population groups. MCI and dementia are connected with deterioration of cognitive functions. The aim of this mini review article is therefore to explore whether computer-based training programs might be an effective intervention tool for older people with MCI and/or dementia or not. The methods include a literature search in the world’s acknowledged databases: Web of Science, Scopus, Science Direct, MEDLINE and Springer, and consequently, evaluation of the findings of the relevant studies. The findings from the selected studies are quite neutral with respect to the efficacy of the computer assisted intervention programs on the improvement of basic cognitive functions. On the one hand, they suggest that the computer-based training interventions might generate some positive effects on patients with MCI and/or dementia, such as the improvement of learning and short-term memory, as well as behavioral symptoms. On the other hand, these training interventions seem to be short-term, with small sample sizes and their efficacy was proved only in the half of the detected studies. Therefore more longitudinal randomized controlled trials (RCTs are needed to prove the efficacy of the computer-based training programs among older individuals with MCI and/or dementia.

  1. Cognitive assessment and rehabilitation in virtual reality: theoretical review and practical implications

    Directory of Open Access Journals (Sweden)

    Negut, A.

    2014-07-01

    Full Text Available Virtual reality scenarios have been developed in order to assess cognitive functioning such as: memory, attention and executive function. Most scenarios replicate everyday situations like shopping activities, navigation through a park or a street, learning objects in an apartment or virtual office, or sitting and solving tasks in a classroom or apartment. Results of these studies support the use of virtual reality scenarios in neurocognitive assessment. Virtual scenarios that are used in cognitive training include a wide range of contexts from everyday life such as: a store, a kitchen, a city, as well as exercises like touching a ball on a screen for movement coordination, collecting a coconut and positioning it in a basket. Overall, virtual reality-based assessment or rehabilitation tools seem to be valid, reliable and efficient with an increased level of ecological validity.

  2. Effect of Virtual Reality on Cognition in Stroke Patients

    OpenAIRE

    Kim, Bo Ryun; Chun, Min Ho; Kim, Lee Suk; Park, Ji Young

    2011-01-01

    Objective To investigate the effect of virtual reality on the recovery of cognitive impairment in stroke patients. Method Twenty-eight patients (11 males and 17 females, mean age 64.2) with cognitive impairment following stroke were recruited for this study. All patients were randomly assigned to one of two groups, the virtual reality (VR) group (n=15) or the control group (n=13). The VR group received both virtual reality training and computer-based cognitive rehabilitation, whereas the cont...

  3. Inverse Kinematics for Upper Limb Compound Movement Estimation in Exoskeleton-Assisted Rehabilitation.

    Science.gov (United States)

    Cortés, Camilo; de Los Reyes-Guzmán, Ana; Scorza, Davide; Bertelsen, Álvaro; Carrasco, Eduardo; Gil-Agudo, Ángel; Ruiz-Salguero, Oscar; Flórez, Julián

    2016-01-01

    Robot-Assisted Rehabilitation (RAR) is relevant for treating patients affected by nervous system injuries (e.g., stroke and spinal cord injury). The accurate estimation of the joint angles of the patient limbs in RAR is critical to assess the patient improvement. The economical prevalent method to estimate the patient posture in Exoskeleton-based RAR is to approximate the limb joint angles with the ones of the Exoskeleton. This approximation is rough since their kinematic structures differ. Motion capture systems (MOCAPs) can improve the estimations, at the expenses of a considerable overload of the therapy setup. Alternatively, the Extended Inverse Kinematics Posture Estimation (EIKPE) computational method models the limb and Exoskeleton as differing parallel kinematic chains. EIKPE has been tested with single DOF movements of the wrist and elbow joints. This paper presents the assessment of EIKPE with elbow-shoulder compound movements (i.e., object prehension). Ground-truth for estimation assessment is obtained from an optical MOCAP (not intended for the treatment stage). The assessment shows EIKPE rendering a good numerical approximation of the actual posture during the compound movement execution, especially for the shoulder joint angles. This work opens the horizon for clinical studies with patient groups, Exoskeleton models, and movements types.

  4. Inverse Kinematics for Upper Limb Compound Movement Estimation in Exoskeleton-Assisted Rehabilitation

    Science.gov (United States)

    Cortés, Camilo; de los Reyes-Guzmán, Ana; Scorza, Davide; Bertelsen, Álvaro; Carrasco, Eduardo; Gil-Agudo, Ángel; Ruiz-Salguero, Oscar; Flórez, Julián

    2016-01-01

    Robot-Assisted Rehabilitation (RAR) is relevant for treating patients affected by nervous system injuries (e.g., stroke and spinal cord injury). The accurate estimation of the joint angles of the patient limbs in RAR is critical to assess the patient improvement. The economical prevalent method to estimate the patient posture in Exoskeleton-based RAR is to approximate the limb joint angles with the ones of the Exoskeleton. This approximation is rough since their kinematic structures differ. Motion capture systems (MOCAPs) can improve the estimations, at the expenses of a considerable overload of the therapy setup. Alternatively, the Extended Inverse Kinematics Posture Estimation (EIKPE) computational method models the limb and Exoskeleton as differing parallel kinematic chains. EIKPE has been tested with single DOF movements of the wrist and elbow joints. This paper presents the assessment of EIKPE with elbow-shoulder compound movements (i.e., object prehension). Ground-truth for estimation assessment is obtained from an optical MOCAP (not intended for the treatment stage). The assessment shows EIKPE rendering a good numerical approximation of the actual posture during the compound movement execution, especially for the shoulder joint angles. This work opens the horizon for clinical studies with patient groups, Exoskeleton models, and movements types. PMID:27403420

  5. Inverse Kinematics for Upper Limb Compound Movement Estimation in Exoskeleton-Assisted Rehabilitation

    Directory of Open Access Journals (Sweden)

    Camilo Cortés

    2016-01-01

    Full Text Available Robot-Assisted Rehabilitation (RAR is relevant for treating patients affected by nervous system injuries (e.g., stroke and spinal cord injury. The accurate estimation of the joint angles of the patient limbs in RAR is critical to assess the patient improvement. The economical prevalent method to estimate the patient posture in Exoskeleton-based RAR is to approximate the limb joint angles with the ones of the Exoskeleton. This approximation is rough since their kinematic structures differ. Motion capture systems (MOCAPs can improve the estimations, at the expenses of a considerable overload of the therapy setup. Alternatively, the Extended Inverse Kinematics Posture Estimation (EIKPE computational method models the limb and Exoskeleton as differing parallel kinematic chains. EIKPE has been tested with single DOF movements of the wrist and elbow joints. This paper presents the assessment of EIKPE with elbow-shoulder compound movements (i.e., object prehension. Ground-truth for estimation assessment is obtained from an optical MOCAP (not intended for the treatment stage. The assessment shows EIKPE rendering a good numerical approximation of the actual posture during the compound movement execution, especially for the shoulder joint angles. This work opens the horizon for clinical studies with patient groups, Exoskeleton models, and movements types.

  6. Recent Development of Rehabilitation Robots

    Directory of Open Access Journals (Sweden)

    Zhiqin Qian

    2015-02-01

    Full Text Available We have conducted a critical review on the development of rehabilitation robots to identify the limitations of existing studies and clarify some promising research directions in this field. This paper is presented to summarize our findings and understanding. The demands for assistive technologies for elderly and disabled population have been discussed, the advantages and disadvantages of rehabilitation robots as assistive technologies have been explored, the issues involved in the development of rehabilitation robots are investigated, some representative robots in this field by leading research institutes have been introduced, and a few of critical challenges in developing advanced rehabilitation robots have been identified. Finally to meet the challenges of developing practical rehabilitation robots, reconfigurable and modular systems have been proposed to meet the identified challenges, and a few of critical areas leading to the potential success of rehabilitation robots have been discussed.

  7. Rehabilitation of stroke patients with apraxia: the role of additional cognitive and motor impairments.

    Science.gov (United States)

    van Heugten, C M; Dekker, J; Deelman, B G; Stehmann-Saris, J C; Kinebanian, A

    2000-08-15

    The present study investigated which additional cognitive and motor impairments were present in stroke patients with apraxia and which of these factors influenced the effects of treatment. A group of 33 patients with apraxia were treated according to the guidelines of a therapy programme based on teaching patients strategies to compensate for the presence of apraxia. Patients were treated at occupational therapy departments in general hospitals, rehabilitation centres and nursing homes. The outcome of the strategy training was studied in a pre-post test design; measurements were conducted at baseline and after 12 weeks of therapy. The pretreatment scores of the patients with apraxia were compared to normscores and scores of a control group of patients without apraxia (n = 36) to investigate which impairments are present. The following variables were analysed in order to determine which factors influence outcome: additional neuropsychological deficits (comprehension of language, cognitive impairments due to dementia, neglect and short term memory), level of motor functioning, severity of apraxia and performance on activities of daily living (ADL), and some relevant patient characteristics (gender, age, type of stroke, time since stroke, and location of treatment). The results showed that the presence of apraxia is associated with the presence of additional cognitive and motor impairments. The successful outcome of strategy training was not negatively influenced by cognitive comorbidity. The outcome seemed to be more prominent in patients who were more severely impaired at the start of rehabilitation in terms of the degree of motor impairments, the severity of apraxia and the initial ADL dependence. The ADL observations, however, displayed a ceiling effect, which was taken into account in discussing the results. Demographic variables, especially age, did not predict the outcome of treatment. We suggest that the effect of this training is stronger in more severely

  8. Computer-assisted nuclear fuel manufacture

    International Nuclear Information System (INIS)

    Maloney, J.P.; Schaumann, C.M.; Stone, E.

    1976-06-01

    At the ERDA Savannah River Plant, a process monitor, which incorporates an online digital computer, assists in manufacturing fuel elements used to produce nuclides such as plutonium, tritium, and californium in the plant's nuclear reactors. Also, inventory functions assist in safeguarding fissile material and protecting against accidental nuclear criticality. Terminals at strategic locations throughout the process area enable production operators to send and receive instructions and information on each manufacturing step. 11 fig

  9. Competency Reference for Computer Assisted Drafting.

    Science.gov (United States)

    Oregon State Dept. of Education, Salem. Div. of Vocational Technical Education.

    This guide, developed in Oregon, lists competencies essential for students in computer-assisted drafting (CAD). Competencies are organized in eight categories: computer hardware, file usage and manipulation, basic drafting techniques, mechanical drafting, specialty disciplines, three dimensional drawing/design, plotting/printing, and advanced CAD.…

  10. Home-Based Computer Gaming in Vestibular Rehabilitation of Gaze and Balance Impairment.

    Science.gov (United States)

    Szturm, Tony; Reimer, Karen M; Hochman, Jordan

    2015-06-01

    Disease or damage of the vestibular sense organs cause a range of distressing symptoms and functional problems that could include loss of balance, gaze instability, disorientation, and dizziness. A novel computer-based rehabilitation system with therapeutic gaming application has been developed. This method allows different gaze and head movement exercises to be coupled to a wide range of inexpensive, commercial computer games. It can be used in standing, and thus graded balance demands using a sponge pad can be incorporated into the program. A case series pre- and postintervention study was conducted of nine adults diagnosed with peripheral vestibular dysfunction who received a 12-week home rehabilitation program. The feasibility and usability of the home computer-based therapeutic program were established. Study findings revealed that using head rotation to interact with computer games, when coupled to demanding balance conditions, resulted in significant improvements in standing balance, dynamic visual acuity, gaze control, and walking performance. Perception of dizziness as measured by the Dizziness Handicap Inventory also decreased significantly. These preliminary findings provide support that a low-cost home game-based exercise program is well suited to train standing balance and gaze control (with active and passive head motion).

  11. Smart portable rehabilitation devices

    Directory of Open Access Journals (Sweden)

    Leahey Matt

    2005-07-01

    Full Text Available Abstract Background The majority of current portable orthotic devices and rehabilitative braces provide stability, apply precise pressure, or help maintain alignment of the joints with out the capability for real time monitoring of the patient's motions and forces and without the ability for real time adjustments of the applied forces and motions. Improved technology has allowed for advancements where these devices can be designed to apply a form of tension to resist motion of the joint. These devices induce quicker recovery and are more effective at restoring proper biomechanics and improving muscle function. However, their shortcoming is in their inability to be adjusted in real-time, which is the most ideal form of a device for rehabilitation. This introduces a second class of devices beyond passive orthotics. It is comprised of "active" or powered devices, and although more complicated in design, they are definitely the most versatile. An active or powered orthotic, usually employs some type of actuator(s. Methods In this paper we present several new advancements in the area of smart rehabilitation devices that have been developed by the Northeastern University Robotics and Mechatronics Laboratory. They are all compact, wearable and portable devices and boast re-programmable, real time computer controlled functions as the central theme behind their operation. The sensory information and computer control of the three described devices make for highly efficient and versatile systems that represent a whole new breed in wearable rehabilitation devices. Their applications range from active-assistive rehabilitation to resistance exercise and even have applications in gait training. The three devices described are: a transportable continuous passive motion elbow device, a wearable electro-rheological fluid based knee resistance device, and a wearable electrical stimulation and biofeedback knee device. Results Laboratory tests of the devices

  12. Smart portable rehabilitation devices.

    Science.gov (United States)

    Mavroidis, Constantinos; Nikitczuk, Jason; Weinberg, Brian; Danaher, Gil; Jensen, Katherine; Pelletier, Philip; Prugnarola, Jennifer; Stuart, Ryan; Arango, Roberto; Leahey, Matt; Pavone, Robert; Provo, Andrew; Yasevac, Dan

    2005-07-12

    The majority of current portable orthotic devices and rehabilitative braces provide stability, apply precise pressure, or help maintain alignment of the joints with out the capability for real time monitoring of the patient's motions and forces and without the ability for real time adjustments of the applied forces and motions. Improved technology has allowed for advancements where these devices can be designed to apply a form of tension to resist motion of the joint. These devices induce quicker recovery and are more effective at restoring proper biomechanics and improving muscle function. However, their shortcoming is in their inability to be adjusted in real-time, which is the most ideal form of a device for rehabilitation. This introduces a second class of devices beyond passive orthotics. It is comprised of "active" or powered devices, and although more complicated in design, they are definitely the most versatile. An active or powered orthotic, usually employs some type of actuator(s). In this paper we present several new advancements in the area of smart rehabilitation devices that have been developed by the Northeastern University Robotics and Mechatronics Laboratory. They are all compact, wearable and portable devices and boast re-programmable, real time computer controlled functions as the central theme behind their operation. The sensory information and computer control of the three described devices make for highly efficient and versatile systems that represent a whole new breed in wearable rehabilitation devices. Their applications range from active-assistive rehabilitation to resistance exercise and even have applications in gait training. The three devices described are: a transportable continuous passive motion elbow device, a wearable electro-rheological fluid based knee resistance device, and a wearable electrical stimulation and biofeedback knee device. Laboratory tests of the devices demonstrated that they were able to meet their design

  13. The impact of falls on motor and cognitive recovery after discharge from in-patient stroke rehabilitation

    Science.gov (United States)

    Wong, Jennifer S.; Brooks, Dina; Inness, Elizabeth L.; Mansfield, Avril

    2016-01-01

    Background Falls are common among community-dwelling stroke survivors. The aim of this study was to (1) compare motor and cognitive outcomes between individuals who fell in the six months post-discharge from in-patient stroke rehabilitation and those who did not fall, and (2) explore potential mechanisms underlying the relationship between falls and recovery of motor and cognitive function. Methods Secondary analysis of a prospective cohort study of individuals discharged home from in-patient rehabilitation was conducted. Participants were recruited at discharge and completed a six-month falls monitoring period using postcards with follow-up. Non-fallers and fallers were compared at the six-month follow-up assessment on the Berg Balance Scale (BBS), Chedoke-McMaster Stroke Assessment (CMSA), gait speed, and Montreal Cognitive Assessment (MoCA). Measures of balance confidence and physical activity were also assessed. Results 23 fallers were matched to 23 non-fallers on age and functional balance scores at discharge. A total of 43 falls were reported during the study period (8 participants fell more than once). At follow-up, BBS scores (p=0.0066) and CMSA foot scores (p=0.0033) were significantly lower for fallers than non-fallers. The two groups did not differ on CMSA leg scores (p=0.049), gait speed (p=0.47) or MoCA (p=0.23). There was no significant association between change in balance confidence scores and change in physical activity levels among all participants from the first and third questionnaire (r=0.27, p=0.08). Conclusions Performance in balance and motor recovery of the foot were compromised in fallers when compared to non-fallers at six months post-discharge from in-patient stroke rehabilitation. PMID:27062418

  14. Public computing options for individuals with cognitive impairments: survey outcomes.

    Science.gov (United States)

    Fox, Lynn Elizabeth; Sohlberg, McKay Moore; Fickas, Stephen; Lemoncello, Rik; Prideaux, Jason

    2009-09-01

    To examine availability and accessibility of public computing for individuals with cognitive impairment (CI) who reside in the USA. A telephone survey was administered as a semi-structured interview to 145 informants representing seven types of public facilities across three geographically distinct regions using a snowball sampling technique. An Internet search of wireless (Wi-Fi) hotspots supplemented the survey. Survey results showed the availability of public computer terminals and Internet hotspots was greatest in the urban sample, followed by the mid-sized and rural cities. Across seven facility types surveyed, libraries had the highest percentage of access barriers, including complex queue procedures, login and password requirements, and limited technical support. University assistive technology centres and facilities with a restricted user policy, such as brain injury centres, had the lowest incidence of access barriers. Findings suggest optimal outcomes for people with CI will result from a careful match of technology and the user that takes into account potential barriers and opportunities to computing in an individual's preferred public environments. Trends in public computing, including the emergence of widespread Wi-Fi and limited access to terminals that permit auto-launch applications, should guide development of technology designed for use in public computing environments.

  15. Rehabilitating torture survivors

    DEFF Research Database (Denmark)

    Sjölund, Bengt H; Kastrup, Marianne; Montgomery, Edith

    2009-01-01

    survivors can be addressed from an evidence base generated both from traumatized and non-traumatized patient populations. Thus, trauma-focused cognitive behavioural therapy and/or eye movement desensitization and reprocessing, as well as interdisciplinary pain rehabilitation, should be components......, in December 2008. The main topics were: the context of torture; mental problems including psychotherapy; internet-based therapy and pharmaco-therapy; chronic pain; social integration and family; and functioning and rehabilitation. Available evidence highlights the importance of an interdisciplinary approach......, "Rehabilitating Torture Survivors", was organized by the Rehabilitation and Research Centre for Torture Victims (a rehabilitation clinic and global knowledge and research centre with government support) in collaboration with the Centre for Transcultural Psychiatry at Rigshospitalet in Copenhagen, Denmark...

  16. Final priority; National Institute on Disability and Rehabilitation Research--Rehabilitation Engineering Research Centers. Final priority.

    Science.gov (United States)

    2014-07-09

    The Assistant Secretary for Special Education and Rehabilitative Services announces a priority under the Disability and Rehabilitation Research Projects and Centers Program administered by the National Institute on Disability and Rehabilitation Research (NIDRR). Specifically, we announce a priority for a Rehabilitation Engineering Research Center (RERC) on Improving the Accessibility, Usability, and Performance of Technology for Individuals who are Deaf or Hard of Hearing. The Assistant Secretary may use this priority for competitions in fiscal year (FY) 2014 and later years. We take this action to focus research attention on an area of national need. We intend the priority to contribute to improving the accessibility, usability, and performance of technology for individuals who are deaf or hard of hearing.

  17. Cognitive Contributions to Freezing of Gait in Parkinson Disease: Implications for Physical Rehabilitation.

    Science.gov (United States)

    Peterson, Daniel S; King, Laurie A; Cohen, Rajal G; Horak, Fay B

    2016-05-01

    People with Parkinson disease (PD) who show freezing of gait also have dysfunction in cognitive domains that interact with mobility. Specifically, freezing of gait is associated with executive dysfunction involving response inhibition, divided attention or switching attention, and visuospatial function. The neural control impairments leading to freezing of gait have recently been attributed to higher-level, executive and attentional cortical processes involved in coordinating posture and gait rather than to lower-level, sensorimotor impairments. To date, rehabilitation for freezing of gait primarily has focused on compensatory mobility training to overcome freezing events, such as sensory cueing and voluntary step planning. Recently, a few interventions have focused on restitutive, rather than compensatory, therapy. Given the documented impairments in executive function specific to patients with PD who freeze and increasing evidence of overlap between cognitive and motor function, incorporating cognitive challenges with mobility training may have important benefits for patients with freezing of gait. Thus, a novel theoretical framework is proposed for exercise interventions that jointly address both the specific cognitive and mobility challenges of people with PD who freeze. © 2016 American Physical Therapy Association.

  18. CARS 2009. Computer assisted radiology and surgery. Proceedings

    International Nuclear Information System (INIS)

    Anon.

    2009-01-01

    The CARS 2009 proceedings include contributions and poster sessions concerning different conferences and workshops: computer assisted radiology, 23rd international congress and exhibition, CARS clinical day, 13th annual conference of the international society for computer aided surgery, 10th CARS/SPIE/EuroPACS joint workshop on surgical PACS and the digital operating, 11th international workshop on computer-aided diagnosis, 15th computed maxillofacial imaging congress, CARS - computer assisted radiology and surgery, 1st EPMA/CARS workshop on personalized medicine and ICT, JICARS - Japanese institutes of CARS, 1st EuroNotes/CTAC/CARS workshop on NOTES: an interdisciplinary challenge, 13th annual conference for computer aided surgery, 27th international EuroPACS meeting.

  19. Broadcast Copywriting and Computer Assisted Instruction.

    Science.gov (United States)

    Hagerman, William L.

    The teaching of broadcast copywriting can be enhanced by computer assisted instruction, especially in screening students' writing for adherence to classic "formulas" or "rules" for broadcast writing. Such rules might include avoiding cliches or not beginning a sentence with a subordinate clause. Other rules the computer can…

  20. Computer assisted pyeloplasty in children the retroperitoneal approach

    DEFF Research Database (Denmark)

    Olsen, L H; Jorgensen, T M

    2004-01-01

    PURPOSE: We describe the first series of computer assisted retroperitoneoscopic pyeloplasty in children using the Da Vinci Surgical System (Intuitive Surgical, Inc., Mountainview, California) with regard to setup, method, operation time, complications and preliminary outcome. The small space...... with the Da Vinci Surgical System. With the patient in a lateral semiprone position the retroperitoneal space was developed by blunt and balloon dissection. Three ports were placed for the computer assisted system and 1 for assistance. Pyeloplasty was performed with the mounted system placed behind...

  1. Rehabilitation Robots: Concepts and Applications in Stroke Rehabilitation

    Directory of Open Access Journals (Sweden)

    Mohammad Ali Ahmadi-Pajouh

    2017-02-01

    Full Text Available Robotics is a tool to assist human in different applications from industry to medicine. There are many reasons that human tends to use these machines. They are very reliable in repetitive, high precision, preprogrammed and high risk jobs in which human is not too good enough. In medicine, robotic applications are evolving so fast that in near future nobody can imagine a surgery without a robot involved. In Rehabilitation we have the same scenario; there are commercialized robots to assist disable people to eat and perform daily activities. There are also clinical rehabilitation robots which can train handicaps. They can help subjects as a passive tool that improves low level impairments such as rigidity. On the other hand robots can train brain as an active tool to have a better movement again. We will see how robots can help therapist to apply repetitive passive movements in quadriplegic subject (i.e. in Brunnstrom stages 1 to 3. On the other hand they can teach subjects how to complete a task in an active manner (i.e. in stages 5 and 6 which can facilitate neuroplasticity. There are different robots designed for different organs; for example rehabilitation of upper extremities (e.g. Gloreha or lower extremities (e.g. Lokomat. There are also exoskeleton robots to help subjects to grip objects and perform ADLs easily (e.g. Bioservo or help paraplegic patient to walk again (e.g. Rewalk. In this talk, we will also discuss about how robots are helping rehab specialist to improve standard protocols. For example we will show how action observation therapy, bimanual therapy, assistive active therapy, proprioceptive facilitation and passive mobilization therapy are realized using an upper extremity rehabilitation robot. Robotics is the future of technology and rehabilitation needs this technology. Be part of this technology!

  2. Development of a theory-guided pan-European computer-assisted safer sex intervention.

    Science.gov (United States)

    Nöstlinger, Christiana; Borms, Ruth; Dec-Pietrowska, Joanna; Dias, Sonia; Rojas, Daniela; Platteau, Tom; Vanden Berghe, Wim; Kok, Gerjo

    2016-12-01

    HIV is a growing public health problem in Europe, with men-having-sex-with-men and migrants from endemic regions as the most affected key populations. More evidence on effective behavioral interventions to reduce sexual risk is needed. This article describes the systematic development of a theory-guided computer-assisted safer sex intervention, aiming at supporting people living with HIV in sexual risk reduction. We applied the Intervention Mapping (IM) protocol to develop this counseling intervention in the framework of a European multicenter study. We conducted a needs assessment guided by the information-motivation-behavioral (IMB) skills model, formulated change objectives and selected theory-based methods and practical strategies, i.e. interactive computer-assisted modules as supporting tools for provider-delivered counseling. Theoretical foundations were the IMB skills model, social cognitive theory and the transtheoretical model, complemented by dual process models of affective decision making to account for the specifics of sexual behavior. The counseling approach for delivering three individual sessions was tailored to participants' needs and contexts, adopting elements of motivational interviewing and cognitive-behavioral therapy. We implemented and evaluated the intervention using a randomized controlled trial combined with a process evaluation. IM provided a useful framework for developing a coherent intervention for heterogeneous target groups, which was feasible and effective across the culturally diverse settings. This article responds to the need for transparent descriptions of the development and content of evidence-based behavior change interventions as potential pillars of effective combination prevention strategies. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  3. Computer Assisted Instructional Design for Computer-Based Instruction. Final Report. Working Papers.

    Science.gov (United States)

    Russell, Daniel M.; Pirolli, Peter

    Recent advances in artificial intelligence and the cognitive sciences have made it possible to develop successful intelligent computer-aided instructional systems for technical and scientific training. In addition, computer-aided design (CAD) environments that support the rapid development of such computer-based instruction have also been recently…

  4. Rehabilitation of stroke patients with apraxia: the role of additional cognitive and motor impairments.

    OpenAIRE

    Heugten, C.M. van; Dekker, J.; Deelman, B.G.; Stehmann-Saris, J.C.; Kinebanian, A.

    2000-01-01

    PURPOSE: The present study investigated which additional cognitive and motor impairments were present in stroke patients with apraxia and which of these factors influenced the effects of treatment. METHOD: A group of 33 patients with apraxia were treated according to the guidelines of a therapy programme based on teaching patients strategies to compensate for the presence of apraxia. Patients were treated at occupational therapy departments in general hospitals, rehabilitation centres and nur...

  5. Access to the Arts through Assistive Technology.

    Science.gov (United States)

    Frame, Charles

    Personnel in the rehabilitation field have come to recognize the possibilities and implications of computers as assistive technology for disabled persons. This manual provides information on how to adapt the Unicorn Board, Touch Talker/Light Talker overlays, the Adaptive Firmware Card setup disk, and Trace-Transparent Access Module (T-TAM) to…

  6. Using Artificial Intelligence to Adapt Level of Difficulty in a Cognitive Training Program

    DEFF Research Database (Denmark)

    Wilms, Inge Linda

    Increasingly, computer-based training is being used within the field of rehabilitation in the effort to improve cognitive functions such as memory, attention and language2,4,5. As a complement to clinical training, computer-based training is a fairly inexpensive way of increasing the intensity an...

  7. Computer assisted holographic moire contouring

    Science.gov (United States)

    Sciammarella, Cesar A.

    2000-01-01

    Theoretical analyses and experimental results on holographic moire contouring on diffusely reflecting objects are presented. The sensitivity and limitations of the method are discussed. Particular emphasis is put on computer-assisted data retrieval, processing, and recording.

  8. Reliability of computer designed surgical guides in six implant rehabilitations with two years follow-up.

    Science.gov (United States)

    Giordano, Mauro; Ausiello, Pietro; Martorelli, Massimo; Sorrentino, Roberto

    2012-09-01

    To evaluate the reliability and accuracy of computer-designed surgical guides in osseointegrated oral implant rehabilitation. Six implant rehabilitations, with a total of 17 implants, were completed with computer-designed surgical guides, performed with the master model developed by muco-compressive and muco-static impressions. In the first case, the surgical guide had exclusively mucosal support, in the second case exclusively dental support. For all six cases computer-aided surgical planning was performed by virtual analyses with 3D models obtained by dental scan DICOM data. The accuracy and stability of implant osseointegration over two years post surgery was then evaluated with clinical and radiographic examinations. Radiographic examination, performed with digital acquisitions (RVG - Radio Video graph) and parallel techniques, allowed two-dimensional feedback with a margin of linear error of 10%. Implant osseointegration was recorded for all the examined rehabilitations. During the clinical and radiographic post-surgical assessments, over the following two years, the peri-implant bone level was found to be stable and without appearance of any complications. The margin of error recorded between pre-operative positions assigned by virtual analysis and the post-surgical digital radiographic observations was as low as 0.2mm. Computer-guided implant surgery can be very effective in oral rehabilitations, providing an opportunity for the surgeon: (a) to avoid the necessity of muco-periosteal detachments and then (b) to perform minimally invasive interventions, whenever appropriate, with a flapless approach. Copyright © 2012 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.

  9. Interdisciplinary Cognitive-Behavioral Therapy as Part of Lumbar Spinal Fusion Surgery Rehabilitation: Experience of Patients With Chronic Low Back Pain.

    Science.gov (United States)

    Lindgreen, Pil; Rolving, Nanna; Nielsen, Claus Vinther; Lomborg, Kirsten

    2016-01-01

    Patients receiving lumbar spinal fusion surgery often have persisting postoperative pain negatively affecting their daily life. These patients may be helped by interdisciplinary cognitive-behavioral therapy which is recognized as an effective intervention for improving beneficial pain coping behavior, thereby facilitating the rehabilitation process of patients with chronic pain. The purpose of this study was to describe the lived experience of patients recovering from lumbar spinal fusion surgery and to explore potential similarities and disparities in pain coping behavior between receivers and nonreceivers of interdisciplinary cognitive-behavioral group therapy. We conducted semistructured interviews with 10 patients; 5 receiving cognitive-behavioral therapy in connection with their lumbar spinal fusion surgery and 5 receiving usual care. We conducted a phenomenological analysis to reach our first aim and then conducted a comparative content analysis to reach our second aim. Patients' postoperative experience was characterized by the need to adapt to the limitations imposed by back discomfort (coexisting with the back), need for recognition and support from others regarding their pain, a relatively long rehabilitation period during which they "awaited the result of surgery", and ambivalence toward analgesics. The patients in both groups had similar negative perception of analgesics and tended to abstain from them to avoid addiction. Coping behavior apparently differed among receivers and nonreceivers of interdisciplinary cognitive-behavioral group therapy. Receivers prevented or minimized pain by resting before pain onset, whereas nonreceivers awaited pain onset before resting. The postoperative experience entailed ambivalence, causing uncertainty, worry and insecurity. This ambivalence was relieved when others recognized the patient's pain and offered support. Cognitive-behavioral therapy as part of rehabilitation may have encouraged beneficial pain coping

  10. Tailor-made rehabilitation approach using multiple types of hybrid assistive limb robots for acute stroke patients: A pilot study.

    Science.gov (United States)

    Fukuda, Hiroyuki; Morishita, Takashi; Ogata, Toshiyasu; Saita, Kazuya; Hyakutake, Koichi; Watanabe, Junko; Shiota, Etsuji; Inoue, Tooru

    2016-01-01

    This article investigated the feasibility of a tailor-made neurorehabilitation approach using multiple types of hybrid assistive limb (HAL) robots for acute stroke patients. We investigated the clinical outcomes of patients who underwent rehabilitation using the HAL robots. The Brunnstrom stage, Barthel index (BI), and functional independence measure (FIM) were evaluated at baseline and when patients were transferred to a rehabilitation facility. Scores were compared between the multiple-robot rehabilitation and single-robot rehabilitation groups. Nine hemiplegic acute stroke patients (five men and four women; mean age 59.4 ± 12.5 years; four hemorrhagic stroke and five ischemic stroke) underwent rehabilitation using multiple types of HAL robots for 19.4 ± 12.5 days, and 14 patients (six men and eight women; mean age 63.2 ± 13.9 years; nine hemorrhagic stroke and five ischemic stroke) underwent rehabilitation using a single type of HAL robot for 14.9 ± 8.9 days. The multiple-robot rehabilitation group showed significantly better outcomes in the Brunnstrom stage of the upper extremity, BI, and FIM scores. To the best of the authors' knowledge, this is the first pilot study demonstrating the feasibility of rehabilitation using multiple exoskeleton robots. The tailor-made rehabilitation approach may be useful for the treatment of acute stroke.

  11. Strategic Cognitive Sequencing: A Computational Cognitive Neuroscience Approach

    Directory of Open Access Journals (Sweden)

    Seth A. Herd

    2013-01-01

    Full Text Available We address strategic cognitive sequencing, the “outer loop” of human cognition: how the brain decides what cognitive process to apply at a given moment to solve complex, multistep cognitive tasks. We argue that this topic has been neglected relative to its importance for systematic reasons but that recent work on how individual brain systems accomplish their computations has set the stage for productively addressing how brain regions coordinate over time to accomplish our most impressive thinking. We present four preliminary neural network models. The first addresses how the prefrontal cortex (PFC and basal ganglia (BG cooperate to perform trial-and-error learning of short sequences; the next, how several areas of PFC learn to make predictions of likely reward, and how this contributes to the BG making decisions at the level of strategies. The third models address how PFC, BG, parietal cortex, and hippocampus can work together to memorize sequences of cognitive actions from instruction (or “self-instruction”. The last shows how a constraint satisfaction process can find useful plans. The PFC maintains current and goal states and associates from both of these to find a “bridging” state, an abstract plan. We discuss how these processes could work together to produce strategic cognitive sequencing and discuss future directions in this area.

  12. Methodological Aspects of Cognitive Rehabilitation with Eye Movement Desensitization and Reprocessing (EMDR

    Directory of Open Access Journals (Sweden)

    Afsaneh Zarghi

    2013-02-01

    Full Text Available A variety of nervous system components such as medulla, pons, midbrain, cerebellum, basal ganglia, parietal, frontal and occipital lobes have role in Eye Movement Desensitization and Reprocessing (EMDR processes. The eye movement is done simultaneously for attracting client's attention to an external stimulus while concentrating on a certain internal subject. Eye movement guided by therapist is the most common attention stimulus. The role of eye movement has been documented previously in relation with cognitive processing mechanisms. A series of systemic experiments have shown that the eyes’ spontaneous movement is associated with emotional and cognitive changes and results in decreased excitement, .exibility in attention, memory processing, and enhanced semantic recalling. Eye movement also decreases the memory's image clarity and the accompanying excitement. By using EMDR, we can reach some parts of memory which were inaccessible before and also emotionally intolerable. Various researches emphasize on the effectiveness of EMDR in treating and curing phobias, pains, and dependent personality disorders. Consequently, due to the involvement of multiple neural system components, this palliative method of treatment can also help to rehabilitate the neuro-cognitive system.

  13. The provision of feedback through computer-based technology to promote self-managed post-stroke rehabilitation in the home.

    Science.gov (United States)

    Parker, Jack; Mawson, Susan; Mountain, Gail; Nasr, Nasrin; Davies, Richard; Zheng, Huiru

    2014-11-01

    Building on previous research findings, this article describes the development of the feedback interfaces for a Personalised Self-Managed Rehabilitation System (PSMrS) for home-based post-stroke rehabilitation using computer-based technology. Embedded within a realistic evaluative methodological approach, the development of the feedback interfaces for the PSMrS involved the incorporation of existing and emerging theories and a hybrid of health and social sciences research and user-centred design methods. User testing confirmed that extrinsic feedback for home-based post-stroke rehabilitation through computer-based technology needs to be personalisable, accurate, rewarding and measurable. In addition, user testing also confirmed the feasibility of using specific components of the PSMrS. A number of key elements are crucial for the development and potential utilisation of technology in what is an inevitable shift towards the use of innovative methods of delivering post-stroke rehabilitation. This includes the specific elements that are essential for the promotion of self-managed rehabilitation and rehabilitative behaviour change; the impact of the context on the mechanisms; and, importantly, the need for reliability and accuracy of the technology.

  14. Short-term effects of exercise and music on cognitive performance among participants in a cardiac rehabilitation program.

    Science.gov (United States)

    Emery, Charles F; Hsiao, Evana T; Hill, Scott M; Frid, David J

    2003-01-01

    Exercise has been associated with improved cognitive performance among patients with coronary artery disease. Music listening has been associated with enhanced cognitive functioning among healthy adults. This study evaluated the combined influence of exercise and music listening on cognitive performance among patients in cardiac rehabilitation (CR). Using a within-subjects repeated measures design, this study was conducted in an outpatient University-based CR facility. Thirty-three men and women (mean age = 62.6 +/- 10.5 years) participated in this study. Participants completed 1 exercise session accompanied by music and a second exercise session without music. Order of conditions was assigned randomly. Before and after each exercise session, participants completed a brief assessment of depression and anxiety, and a cognitive test of verbal fluency. The music condition was associated with significant improvements in verbal fluency, but the no-music control condition was not associated with cognitive change. The study provides preliminary evidence of the combined benefit of exercise and music listening for cognitive performance among patients in CR.

  15. [Domiciliary rehabilitation: an innovative form of outpatient medical rehabilitation].

    Science.gov (United States)

    Schmidt-Ohlemann, M; Schweizer, C

    2009-02-01

    Domiciliary rehabilitation is an innovative form of outpatient medical rehabilitation. All components of service provision are delivered in the rehabilitant's home by a multidisciplinary team headed by a physician. The key context factors in the rehab process can be taken into account firsthand. The target group of domiciliary rehabilitation consists of multimorbid patients with severe functional limitations and complex assistance needs, whose rehabilitation options would be poor without this outreach service. Here, as suggested by the WHO concept of functional health, the interaction between health condition and environmental factors is kept in view much better than in other forms of rehabilitation. The positive effects and the efficiency of the rehabilitation measures provided can be assessed very well at a high descriptive level. This fact had been a precondition for legal establishment of domiciliary rehabilitation as a regular service. Domiciliary rehabilitation not only complies with key demands in the health and social policy fields, such as priority of outpatient over inpatient treatment or rehabilitation to precede and accompany long term care, it also constitutes an alternative concept challenging the traditional inpatient rehabilitation approach. The patient, hence, no longer is to fit into the institutional framework of outpatient or inpatient rehabilitation, but the team will fit into the specifics of the patient's unique social and material situation.

  16. From Resource-Adaptive Navigation Assistance to Augmented Cognition

    Science.gov (United States)

    Zimmer, Hubert D.; Münzer, Stefan; Baus, Jörg

    In an assistance scenario, a computer provides purposive information supporting a human user in an everyday situation. Wayfinding with navigation assistance is a prototypical assistance scenario. The present chapter analyzes the interplay of the resources of the assistance system and the resources of the user. The navigation assistance system provides geographic knowledge, positioning information, route planning, spatial overview information, and route commands at decision points. The user's resources encompass spatial knowledge, spatial abilities and visuo-spatial working memory, orientation strategies, and cultural habit. Flexible adaptations of the assistance system to available resources of the user are described, taking different wayfinding goals, situational constraints, and individual differences into account. Throughout the chapter, the idea is pursued that the available resources of the user should be kept active.

  17. [Emotion recognition rehabilitation combined with cognitive stimulation for people with Alzheimer's disease. Efficacy for cognition and functional aspects].

    Science.gov (United States)

    Garcia-Casal, J A; Goni-Imizcoz, M; Perea-Bartolome, M V; Garcia-Moja, C; Calvo-Simal, S; Cardelle-Garcia, F; Franco-Martin, M

    2017-08-01

    The ability to recognize facial emotional expression is essential for social interactions and adapting to the environment. Emotion recognition is impaired in people with Alzheimer's disease (AD), thus rehabilitation of these skills has the potential to elicit significant benefits. To assess the efficacy of a combined treatment of rehabilitation of emotion recognition (RER) and cognitive stimulation (CS) for people with AD, due to its potential implications for more effective psychosocial interventions. 36 patients were assigned to one of three experimental conditions: an experimental group (EG) that received 20 sessions of RER and 20 sessions of CS; a control group (CG) that received 40 sessions of CS, and a treatment as usual group (TAU). 32 patients completed the treatment (77.53 ± 5.43 years). Significant differences were found in MMSE30 (F = 5.10; p = 0.013), MMSE35 (F = 4.16; p = 0.026), affect recognition (Z = -2.81; p = 0.005) and basic activities of daily living (Z = -2.27; p = 0.018) favouring the efficacy of the combined treatment. The TAU group showed a decline in depression (Z = -1.99; p = 0.048), apathy (Z = -2.30; p = 0.022) and anosognosia (Z = -2.19; p = 0.028). The combined treatment of RER + CS was more effective than TAU and CS alone for the treatment of patients with AD. This is the first study about the rehabilitation of affect recognition in AD.

  18. Incorporating computer-assisted assessment to Bachelor of Science ...

    African Journals Online (AJOL)

    The use of computers in education has already been established for decades. Computers have been used from lesson preparations, presentations, and student assessments. Many authors have studied the design, implementation, and impact of computer-assisted assessment (CAA) (also called computer-based testing, ...

  19. Accuracy of computer-assisted cervicle pedicle screw installation

    International Nuclear Information System (INIS)

    Zhang Honglei; Zhou Dongsheng; Jang Zhensong

    2009-01-01

    Objective: To investigate the accuracy of computer-assisted cervical pedicle screw installation and the reason of screw malposition. Methods: A total of 172 cervical pedicle screws were installed by computer-assisted navigation for 30 patients with lower cervical spinal diseases. All the patients were examined by X-ray and CT after operation. Screw's position and direction were measured on the sagittal and transectional images of intraoperative navigation and post-operative CT. Then linear regression analysis was taken between navigational and post-operative CT's images. Results: Two screws perforated the upper pedicle wall, 3 perforated the lateral pedicle wall.There was a positive linear correlation between navigational and post-operative CT's images. Conclusion: Computer-assisted navigation can provide the high accuracy of cervical pedicle screw installation and excursion phenomenon is reason of screw malposition. (authors)

  20. Computer assisted active learning system development for critical thinking in history of civilization

    Directory of Open Access Journals (Sweden)

    Adem Karahoca

    2010-03-01

    Full Text Available This study investigates a Computer Assisted Learning System (CALS according to the several factors that promote flow wherestudents are fully involved into the learning activities for history of civilization lessons. The designed CALS supported bymeta – cognitive (cognitive maps and multimedia tools (movies, flash cards and quiz applications that help students to reacha flow state in learning by actively by engaging students’ critical thinking and providing an environment for active participation.The research data was collected using focus group surveys from a randomly selected 54 students enrolled in history ofcivilization at Bahcesehir University in Istanbul, Turkey. Results showed that 53.7% of students can be in flow via implementedCALS. Also according to the results, the flow has significant predictors in the course enjoyment, perceived competence ofcourse, value–usefulness and the challenge–learning style match according to nature of course in such a CALS.

  1. A framework for cognitive monitoring using computer game interactions.

    Science.gov (United States)

    Jimison, Holly B; Pavel, Misha; Bissell, Payton; McKanna, James

    2007-01-01

    Many countries are faced with a rapidly increasing economic and social challenge of caring for their elderly population. Cognitive issues are at the forefront of the list of concerns. People over the age of 75 are at risk for medically related cognitive decline and confusion, and the early detection of cognitive problems would allow for more effective clinical intervention. However, standard cognitive assessments are not diagnostically sensitive and are performed infrequently. To address these issues, we have developed a set of adaptive computer games to monitor cognitive performance in a home environment. Assessment algorithms for various aspects of cognition are embedded in the games. The monitoring of these metrics allows us to detect within subject trends over time, providing a method for the early detection of cognitive decline. In addition, the real-time information on cognitive state is used to adapt the user interface to the needs of the individual user. In this paper we describe the software architecture and methodology for monitoring cognitive performance using data from natural computer interactions in a home setting.

  2. [Basic concept in computer assisted surgery].

    Science.gov (United States)

    Merloz, Philippe; Wu, Hao

    2006-03-01

    To investigate application of medical digital imaging systems and computer technologies in orthopedics. The main computer-assisted surgery systems comprise the four following subcategories. (1) A collection and recording process for digital data on each patient, including preoperative images (CT scans, MRI, standard X-rays), intraoperative visualization (fluoroscopy, ultrasound), and intraoperative position and orientation of surgical instruments or bone sections (using 3D localises). Data merging based on the matching of preoperative imaging (CT scans, MRI, standard X-rays) and intraoperative visualization (anatomical landmarks, or bone surfaces digitized intraoperatively via 3D localiser; intraoperative ultrasound images processed for delineation of bone contours). (2) In cases where only intraoperative images are used for computer-assisted surgical navigation, the calibration of the intraoperative imaging system replaces the merged data system, which is then no longer necessary. (3) A system that provides aid in decision-making, so that the surgical approach is planned on basis of multimodal information: the interactive positioning of surgical instruments or bone sections transmitted via pre- or intraoperative images, display of elements to guide surgical navigation (direction, axis, orientation, length and diameter of a surgical instrument, impingement, etc. ). And (4) A system that monitors the surgical procedure, thereby ensuring that the optimal strategy defined at the preoperative stage is taken into account. It is possible that computer-assisted orthopedic surgery systems will enable surgeons to better assess the accuracy and reliability of the various operative techniques, an indispensable stage in the optimization of surgery.

  3. Utilizing Computer Integration to Assist Nursing

    OpenAIRE

    Hujcs, Marianne

    1990-01-01

    As the use of computers in health care continues to increase, methods of using these computers to assist nursing practice are also increasing. This paper describes how integration within a hospital information system (HIS) contributed to the development of a report format and computer generated alerts used by nurses. Discussion also includes how the report and alerts impact those nurses providing bedside care as well as how integration of an HIS creates challenges for nursing.

  4. Bioinformation processing a primer on computational cognitive science

    CERN Document Server

    Peterson, James K

    2016-01-01

    This book shows how mathematics, computer science and science can be usefully and seamlessly intertwined. It begins with a general model of cognitive processes in a network of computational nodes, such as neurons, using a variety of tools from mathematics, computational science and neurobiology. It then moves on to solve the diffusion model from a low-level random walk point of view. It also demonstrates how this idea can be used in a new approach to solving the cable equation, in order to better understand the neural computation approximations. It introduces specialized data for emotional content, which allows a brain model to be built using MatLab tools, and also highlights a simple model of cognitive dysfunction.

  5. A pilot study and brief overview of rehabilitation via virtual environment in patients suffering from dementia.

    Science.gov (United States)

    Fasilis, Th; Patrikelis, P; Siatouni, A; Alexoudi, A; Veretzioti, A; Zachou, L; Gatzonis, S-St

    2018-01-01

    Dementia is one of the increasing problems of modern societies. The immediate cure is not a possible solution, at least at the moment, but science has found a number of new ways to retard and under specific conditions to halt its development. A potential, and constantly evolving scientific field is the use of Computerized Cognitive Rehabilitation (CCR) and Virtual Environments (Vr.E). According to the existing literature, subjecting patients to various neuro-rehabilitative conditions within 3D virtual environments, allows them to obtain significant therapeutic benefits in which both transferability and durations over time are observed, in relation to the training period of the intervention. In the present study we examine whether "Serious Games (SGs)" - (learning and rehabilitating games in virtual and augmented reality) - have utilitarian value in the field of cognitive neurorehabilitation, concerned with demented population. For research purposes, we have conducted a number of case studies, based on 10 elderly patients, suffering from moderate or mild severity impairment of higher cortical functions, attributed to various types of dementias (Vascular, Alzheimer's disease, DLB dementia and mixed dementia). Each participant underwent rehabilitative intervention through our SG for a total of 10 hours within 4-5 weeks period. At the end of the cognitive rehabilitation program, patients' performance was assessed based in standard neuropsychological tests (measuring: working memory, memory retention, attention, problem solving, rigid thinking and executive function) and the results were compared with measurements taken before, during, and at the end of the intervention. Our experimental hypothesis states that there will be a significant difference between the results of cognitive performance of the patients between the pre- and post- rehabilitative period, consequential of the Interactive Computer-based Training (ICT). In conclusion, a review and brief analysis of the

  6. Computer-assisted versus non-computer-assisted preoperative planning of corrective osteotomy for extra-articular distal radius malunions: a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Stockmans Filip

    2010-12-01

    Full Text Available Abstract Background Malunion is the most common complication of distal radius fracture. It has previously been demonstrated that there is a correlation between the quality of anatomical correction and overall wrist function. However, surgical correction can be difficult because of the often complex anatomy associated with this condition. Computer assisted surgical planning, combined with patient-specific surgical guides, has the potential to improve pre-operative understanding of patient anatomy as well as intra-operative accuracy. For patients with malunion of the distal radius fracture, this technology could significantly improve clinical outcomes that largely depend on the quality of restoration of normal anatomy. Therefore, the objective of this study is to compare patient outcomes after corrective osteotomy for distal radius malunion with and without preoperative computer-assisted planning and peri-operative patient-specific surgical guides. Methods/Design This study is a multi-center randomized controlled trial of conventional planning versus computer-assisted planning for surgical correction of distal radius malunion. Adult patients with extra-articular malunion of the distal radius will be invited to enroll in our study. After providing informed consent, subjects will be randomized to two groups: one group will receive corrective surgery with conventional preoperative planning, while the other will receive corrective surgery with computer-assisted pre-operative planning and peri-operative patient specific surgical guides. In the computer-assisted planning group, a CT scan of the affected forearm as well as the normal, contralateral forearm will be obtained. The images will be used to construct a 3D anatomical model of the defect and patient-specific surgical guides will be manufactured. Outcome will be measured by DASH and PRWE scores, grip strength, radiographic measurements, and patient satisfaction at 3, 6, and 12 months

  7. The Role of Cognitive Factors in Predicting Balance and Fall Risk in a Neuro-Rehabilitation Setting.

    Science.gov (United States)

    Saverino, A; Waller, D; Rantell, K; Parry, R; Moriarty, A; Playford, E D

    2016-01-01

    There is a consistent body of evidence supporting the role of cognitive functions, particularly executive function, in the elderly and in neurological conditions which become more frequent with ageing. The aim of our study was to assess the role of different domains of cognitive functions to predict balance and fall risk in a sample of adults with various neurological conditions in a rehabilitation setting. This was a prospective, cohort study conducted in a single centre in the UK. 114 participants consecutively admitted to a Neuro-Rehabilitation Unit were prospectively assessed for fall accidents. Baseline assessment included a measure of balance (Berg Balance Scale) and a battery of standard cognitive tests measuring executive function, speed of information processing, verbal and visual memory, visual perception and intellectual function. The outcomes of interest were the risk of becoming a faller, balance and fall rate. Two tests of executive function were significantly associated with fall risk, the Stroop Colour Word Test (IRR 1.01, 95% CI 1.00-1.03) and the number of errors on part B of the Trail Making Test (IRR 1.23, 95% CI 1.03-1.49). Composite scores of executive function, speed of information processing and visual memory domains resulted in 2 to 3 times increased likelihood of having better balance (OR 2.74 95% CI 1.08 to 6.94, OR 2.72 95% CI 1.16 to 6.36 and OR 2.44 95% CI 1.11 to 5.35 respectively). Our results show that specific subcomponents of executive functions are able to predict fall risk, while a more global cognitive dysfunction is associated with poorer balance.

  8. The Role of Cognitive Factors in Predicting Balance and Fall Risk in a Neuro-Rehabilitation Setting.

    Directory of Open Access Journals (Sweden)

    A Saverino

    Full Text Available There is a consistent body of evidence supporting the role of cognitive functions, particularly executive function, in the elderly and in neurological conditions which become more frequent with ageing. The aim of our study was to assess the role of different domains of cognitive functions to predict balance and fall risk in a sample of adults with various neurological conditions in a rehabilitation setting.This was a prospective, cohort study conducted in a single centre in the UK. 114 participants consecutively admitted to a Neuro-Rehabilitation Unit were prospectively assessed for fall accidents. Baseline assessment included a measure of balance (Berg Balance Scale and a battery of standard cognitive tests measuring executive function, speed of information processing, verbal and visual memory, visual perception and intellectual function. The outcomes of interest were the risk of becoming a faller, balance and fall rate.Two tests of executive function were significantly associated with fall risk, the Stroop Colour Word Test (IRR 1.01, 95% CI 1.00-1.03 and the number of errors on part B of the Trail Making Test (IRR 1.23, 95% CI 1.03-1.49. Composite scores of executive function, speed of information processing and visual memory domains resulted in 2 to 3 times increased likelihood of having better balance (OR 2.74 95% CI 1.08 to 6.94, OR 2.72 95% CI 1.16 to 6.36 and OR 2.44 95% CI 1.11 to 5.35 respectively.Our results show that specific subcomponents of executive functions are able to predict fall risk, while a more global cognitive dysfunction is associated with poorer balance.

  9. Collaborative Assistive Robot for Mobility Enhancement (CARMEN) The bare necessities assisted wheelchair navigation and beyond

    CERN Document Server

    Urdiales, Cristina

    2012-01-01

    In nowadays aging society, many people require mobility assistance. Sometimes, assistive devices need a certain degree of autonomy when users' disabilities difficult manual control. However, clinicians report that excessive assistance may lead to loss of residual skills and frustration. Shared control focuses on deciding when users need help and providing it. Collaborative control aims at giving just the right amount of help in a transparent, seamless way. This book presents the collaborative control paradigm. User performance may be indicative of physical/cognitive condition, so it is used to decide how much help is needed. Besides, collaborative control integrates machine and user commands so that people contribute to self-motion at all times. Collaborative control was extensively tested for 3 years using a robotized wheelchair at a rehabilitation hospital in Rome with volunteer inpatients presenting different disabilities, ranging from mild to severe. We also present a taxonomy of common metrics for wheelc...

  10. Oral and maxillofacial surgery with computer-assisted navigation system.

    Science.gov (United States)

    Kawachi, Homare; Kawachi, Yasuyuki; Ikeda, Chihaya; Takagi, Ryo; Katakura, Akira; Shibahara, Takahiko

    2010-01-01

    Intraoperative computer-assisted navigation has gained acceptance in maxillofacial surgery with applications in an increasing number of indications. We adapted a commercially available wireless passive marker system which allows calibration and tracking of virtually every instrument in maxillofacial surgery. Virtual computer-generated anatomical structures are displayed intraoperatively in a semi-immersive head-up display. Continuous observation of the operating field facilitated by computer assistance enables surgical navigation in accordance with the physician's preoperative plans. This case report documents the potential for augmented visualization concepts in surgical resection of tumors in the oral and maxillofacial region. We report a case of T3N2bM0 carcinoma of the maxillary gingival which was surgically resected with the assistance of the Stryker Navigation Cart System. This system was found to be useful in assisting preoperative planning and intraoperative monitoring.

  11. Memory rehabilitation for the working memory of patients with multiple sclerosis (MS).

    Science.gov (United States)

    Mousavi, Shokoufeh; Zare, Hossein; Etemadifar, Masoud; Taher Neshatdoost, Hamid

    2018-05-01

    The main cognitive impairments in multiple sclerosis (MS) affect the working memory, processing speed, and performances that are in close interaction with one another. Cognitive problems in MS are influenced to a lesser degree by disease recovery medications or treatments,but cognitive rehabilitation is considered one of the promising methods for cure. There is evidence regarding the effectiveness of cognitive rehabilitation for MS patients in various stages of the disease. Since the impairment in working memory is one of the main MS deficits, a particular training that affects this cognitive domain can be of a great value. This study aims to determine the effectiveness of memory rehabilitation on the working memory performance of MS patients. Sixty MS patients with cognitive impairment and similar in terms of demographic characteristics, duration of disease, neurological problems, and mental health were randomly assigned to three groups: namely, experimental, placebo, and control. Patients' cognitive evaluation incorporated baseline assessments immediately post-intervention and 5 weeks post-intervention. The experimental group received a cognitive rehabilitation program in one-hour sessions on a weekly basis for 8 weeks. The placebo group received relaxation techniques on a weekly basis; the control group received no intervention. The results of this study showed that the cognitive rehabilitation program had a positive effect on the working memory performance of patients with MS in the experimental group. These results were achieved in immediate evaluation (post-test) and follow-up 5 weeks after intervention. There was no significant difference in working memory performance between the placebo group and the control group. According to the study, there is evidence for the effectiveness of a memory rehabilitation program for the working memory of patients with MS. Cognitive rehabilitation can improve working memory disorders and have a positive effect on the

  12. Improved computer-assisted nuclear imaging in renovascular hypertension

    International Nuclear Information System (INIS)

    Gross, M.L.; Nally, J.V.; Potvini, W.J.; Clarke, H.S. Jr.; Higgins, J.T.; Windham, J.P.

    1985-01-01

    A computer-assisted program with digital background subtraction has been developed to analyze the initial 90 second Tc-99m DTPA renal flow scans in an attempt to quantitate the early isotope delivery to and uptake by the kidney. This study was designed to compare the computer-assisted 90 second DTPA scan with the conventional 30 minute I-131 Hippuran scan. Six patients with angiographically-proven unilateral renal artery stenosis were studied. The time activity curves for both studies were derived from regions of interest selected from the computer acquired dynamic images. The following parameters were used to assess renal blood flow: differential maximum activity, minimum/maximum activity ratio, and peak width. The computer-assisted DTPA study accurately predicted (6/6) the stenosed side documented angiographically, whereas the conventional Hippuran scan was clearly predictive in only 2/6. In selected cases successfully corrected surgically, the DTPA study proved superior in assessing the degree of patency of the graft. The best discriminatory factors when compared to a template synthesized from curves obtained from normal subjects were differential maximum activity and peak width. The authors conclude that: 1) the computer-assisted 90 second DTPA renal blood flow scan was superior to the conventional I-131 Hippuran scan in demonstrating unilateral reno-vascular disease; 2) the DTPA study was highly predictive of the angiographic findings; and 3) this non-invasive study should prove useful in the diagnosis and serial evaluation following surgery and/or angioplasty for renal artery stenosis

  13. Computer-Assisted Evaluation of Videokymographic Data

    Czech Academy of Sciences Publication Activity Database

    Novozámský, Adam; Sedlář, Jiří; Zita, A.; Švec, J. G.; Zitová, Barbara; Flusser, Jan; Hauzar, D.

    2013-01-01

    Roč. 1, č. 1 (2013), s. 49-49 ISSN 1805-8698. [EFMI STC Prague Data and Knowledge for Medical Decision Support. 17.04.2013-19.04.2013, Praha] Institutional support: RVO:67985556 Keywords : videokymography * image process ing * computerassisted evaluation Subject RIV: JD - Computer Applications, Robotics http://library.utia.cas.cz/separaty/2013/ZOI/novozamsky-computer-assisted evaluation of videokymographic data.pdf

  14. To EDF: PHOEBUS, computer-assisted engineering

    International Nuclear Information System (INIS)

    Lecocq, P.; Goudal, J.C.; Barache, J.M.; Feingold, D.; Cornon, P.

    1986-01-01

    EDF has built a modular integrated computer-assisted nuclear engineering (CAE) system called POEBUS. Since 1975, the Organization has been interested in CAE which places computer methods and technology at the disposal of the engineering department. This paper describes the changes and their effect on the techniques in use, working methods and the personnel called on to put them into operation [fr

  15. Rehabilitation Engineering & Assistive Technology Society (RESNA) position on the application of wheelchair standing devices: 2013 current state of the literature.

    Science.gov (United States)

    Dicianno, Brad E; Morgan, Amy; Lieberman, Jenny; Rosen, Lauren

    2016-01-01

    This article, approved by the Rehabilitation Engineering & Assistive Technology Society of North America Board of Directors on December 23, 2013, shares typical clinical applications and provides evidence from the literature supporting the use of wheelchair standers.

  16. Cognitive Remediation in Schizophrenia

    Directory of Open Access Journals (Sweden)

    Joana Vieira

    2014-06-01

    Full Text Available Several reviews of the literature support the idea that cognitive deficits observed in a large percentage of patients with schizophrenia are responsible for the cognitive performance deficit and functional disability associated with the disease. The grow- ing importance of neurocognition in Psychiatry, especially with regard to planning strategies and rehabilitative therapies to improve the prognosis of patients contrib- utes to the interest of achieving this literature review on cognitive rehabilitation in schizophrenia. In this work, drawn from research in the areas of schizophrenia, cog- nition, cognitive rehabilitation and cognitive remediation (2000-2012 through PubMed and The Cochrane Collaboration, it is intended, to describe the types of psychological and behavioral therapies recommended in the treatment of cognitive disabilities in patients diagnosed with schizophrenia. This review will also highlight the clinical and scientific evidence of each of these therapies, as their effect on cognitive performance, symptoms and functionality in patients with schizophrenia.

  17. Rehabilitation of a patient with stroke

    Directory of Open Access Journals (Sweden)

    Apurba Barman

    2013-01-01

    Full Text Available Stroke is a significant cause of long-term disability world-wide. The post-stroke disabilities are due to loss of locomotion, activity of daily living, cognition and communication skills. Rehabilitation is an integral part of medical management and continues longitudinally through acute care, post-acute care and community reintegration. The objectives of stroke rehabilitation are to maximize the functional independence, minimize the disabilities, reintegrate back into the home and community and improve the self-esteem of patient. A comprehensive stroke rehabilitation service should provide early assessment of impairments and disabilities, management and prevention of complications and well-organized rehabilitation program in both in-patient and out-patient settings. A multidisciplinary or interdisciplinary team approach is necessary to reduce the post-stroke disabilities. It has many members, including physicians, physical therapists, occupational therapists, speech and language pathologists, orthotist, psychotherapists, social workers, vocational rehabilitation therapists, rehabilitation nurse, patients, families and other caregivers. Physicians caring for patients with stroke during rehabilitation must be aware of potential medical complications, as well as a number of special problems that may complicate recovery, including cognitive deficits, aphasia, dysphagia, urinary incontinence, shoulder pain, spasticity, falls and depression. Involvement of patient and caregivers in the rehabilitation process is essential. This article outlines the salient features of the early comprehensive rehabilitation after stroke.

  18. Applicability of a motor rehabilitation system in stroke victims

    Directory of Open Access Journals (Sweden)

    Maíra Izzadora Souza Carneiro

    Full Text Available Abstract Introduction: The recovery of stroke patients is long and boring due to the repetitive nature of the exercises used and the length of treatment. Thus, we started using virtual reality as an alternative and, because of its advantages, health professionals are adapting video games for physical therapy. However, there are some limitations, such as the fact that games are designed for entertainment and not for therapeutic purposes. Objective: In order to mitigate gaps in assistive devices for physical therapy, this study describes the development and applicability of a computer support system for motor rehabilitation - Ikapp - in stroke victims. Methods: Twenty-seven stroke patients filled out a socioeconomic questionnaire, tested Ikapp during five minutes and answered a usability and satisfaction questionnaire about handling the tool. The chi-square test was used to analyze any association between sociodemographic factors and the features of the system. Results: The Ikapp system can be an excellent device to assist neurological rehabilitation of stroke patients, as participants questionnaires showed that 85.2% were satisfied in regard to motivation and inclusion of Ikapp in physiotherapy and 77.8% relative to ease of interaction with the tool. Conclusion: The Ikapp system proved to be an easy-to-use and accessible computer support system for patients with functional limitations.

  19. A Parameter Estimation Method for Dynamic Computational Cognitive Models

    NARCIS (Netherlands)

    Thilakarathne, D.J.

    2015-01-01

    A dynamic computational cognitive model can be used to explore a selected complex cognitive phenomenon by providing some features or patterns over time. More specifically, it can be used to simulate, analyse and explain the behaviour of such a cognitive phenomenon. It generates output data in the

  20. Rehabilitation of cortical blindness secondary to stroke.

    Science.gov (United States)

    Gaber, Tarek A-Z K

    2010-01-01

    Cortical blindness is a rare complication of posterior circulation stroke. However, its complex presentation with sensory, physical, cognitive and behavioural impairments makes it one of the most challenging. Appropriate approach from a rehabilitation standpoint was never reported. Our study aims to discuss the rehabilitation methods and outcomes of a cohort of patients with cortical blindness. The notes of all patients with cortical blindness referred to a local NHS rehabilitation service in the last 6~years were examined. Patients' demographics, presenting symptoms, scan findings, rehabilitation programmes and outcomes were documented. Seven patients presented to our service, six of them were males. The mean age was 63. Patients 1, 2 and 3 had total blindness with severe cognitive and behavioural impairments, wandering and akathisia. All of them failed to respond to any rehabilitation effort and the focus was on damage limitation. Pharmacological interventions had a modest impact on behaviour and sleep pattern. The 3 patients were discharged to a nursing facility. Patients 4, 5, 6 and 7 had partial blindness with variable severity. All of them suffered from significant memory impairment. However, none suffered from any behavioural, physical or other cognitive impairment. Rehabilitation efforts on 3 patients were carried out collaboratively between brain injury occupational therapists and sensory disability officers. All patients experienced significant improvement in handicap and they all maintained community placements. This small cohort of patients suggests that the rehabilitation philosophy and outcomes of these 2 distinct groups of either total or partial cortical blindness differ significantly.

  1. Understanding Cognitive Performance During Robot-Assisted Surgery.

    Science.gov (United States)

    Guru, Khurshid A; Shafiei, Somayeh B; Khan, Atif; Hussein, Ahmed A; Sharif, Mohamed; Esfahani, Ehsan T

    2015-10-01

    To understand cognitive function of an expert surgeon in various surgical scenarios while performing robot-assisted surgery. In an Internal Review Board approved study, National Aeronautics and Space Administration-Task Load Index (NASA-TLX) questionnaire with surgical field notes were simultaneously completed. A wireless electroencephalography (EEG) headset was used to monitor brain activity during all procedures. Three key portions were evaluated: lysis of adhesions, extended lymph node dissection, and urethro-vesical anastomosis (UVA). Cognitive metrics extracted were distraction, mental workload, and mental state. In evaluating lysis of adhesions, mental state (EEG) was associated with better performance (NASA-TLX). Utilizing more mental resources resulted in better performance as self-reported. Outcomes of lysis were highly dependent on cognitive function and decision-making skills. In evaluating extended lymph node dissection, there was a negative correlation between distraction level (EEG) and mental demand, physical demand and effort (NASA-TLX). Similar to lysis of adhesion, utilizing more mental resources resulted in better performance (NASA-TLX). Lastly, with UVA, workload (EEG) negatively correlated with mental and temporal demand and was associated with better performance (NASA-TLX). The EEG recorded workload as seen here was a combination of both cognitive performance (finding solution) and motor workload (execution). Majority of workload was contributed by motor workload of an expert surgeon. During UVA, muscle memory and motor skills of expert are keys to completing the UVA. Cognitive analysis shows that expert surgeons utilized different mental resources based on their need. Copyright © 2015 Elsevier Inc. All rights reserved.

  2. Computer assisted diagnosis of benign bone tumours

    International Nuclear Information System (INIS)

    Samardziski, M.; Zafiroski, G.; Janevska, V.; Miladinova, D.; Popeska, Z.

    2004-01-01

    Background. The aim of this study is to determine the correlation between computer-assisted diagnosis (CAD) of benign bone tumours (BBT) and their histological type. Patients and method. Altogether 120 patients were included in two groups. The retrospective group comprised 68 patients in whom the histological type of BBT was known prior to computer analysis. The prospective group comprised 52 patients in whom the histological type of BBT was unknown prior to computer analysis. Computer program was efficient and easy to use. Results. Average percent of histological type confirmed with CAD in the retrospective and prospective groups was 72.06% and 76.92%, respectively. Histological confirmation of CAD in specific BBT was 91.42% for enchondroma, 96.15% for osteoid-osteoma, and 98.08% for osteochondroma. Significantly lower percentage of CAD confirmation of fibroma, chondromixoid fibroma, osteoclastoma, desmoplastic fibroma and osteobalstoma due to their adverse biological character or complex anatomic localization is understandable. Conclusions. The results speak in favour of the assumption that computer assisted diagnosis of bone tumours program may improve the diagnostic accuracy of the examiner. (author)

  3. Medical image computing and computer-assisted intervention - MICCAI 2005. Proceedings; Pt. 1

    International Nuclear Information System (INIS)

    Duncan, J.S.; Gerig, G.

    2005-01-01

    The two-volume set LNCS 3749 and LNCS 3750 constitutes the refereed proceedings of the 8th International Conference on Medical Image Computing and Computer-Assisted Intervention, MICCAI 2005, held in Palm Springs, CA, USA, in October 2005. Based on rigorous peer reviews the program committee selected 237 carefully revised full papers from 632 submissions for presentation in two volumes. The first volume includes all the contributions related to image analysis and validation, vascular image segmentation, image registration, diffusion tensor image analysis, image segmentation and analysis, clinical applications - validation, imaging systems - visualization, computer assisted diagnosis, cellular and molecular image analysis, physically-based modeling, robotics and intervention, medical image computing for clinical applications, and biological imaging - simulation and modeling. The second volume collects the papers related to robotics, image-guided surgery and interventions, image registration, medical image computing, structural and functional brain analysis, model-based image analysis, image-guided intervention: simulation, modeling and display, and image segmentation and analysis. (orig.)

  4. Medical image computing and computer-assisted intervention - MICCAI 2005. Proceedings; Pt. 1

    Energy Technology Data Exchange (ETDEWEB)

    Duncan, J.S. [Yale Univ., New Haven, CT (United States). Dept. of Biomedical Engineering and Diagnostic Radiology; Gerig, G. (eds.) [North Carolina Univ., Chapel Hill (United States). Dept. of Computer Science

    2005-07-01

    The two-volume set LNCS 3749 and LNCS 3750 constitutes the refereed proceedings of the 8th International Conference on Medical Image Computing and Computer-Assisted Intervention, MICCAI 2005, held in Palm Springs, CA, USA, in October 2005. Based on rigorous peer reviews the program committee selected 237 carefully revised full papers from 632 submissions for presentation in two volumes. The first volume includes all the contributions related to image analysis and validation, vascular image segmentation, image registration, diffusion tensor image analysis, image segmentation and analysis, clinical applications - validation, imaging systems - visualization, computer assisted diagnosis, cellular and molecular image analysis, physically-based modeling, robotics and intervention, medical image computing for clinical applications, and biological imaging - simulation and modeling. The second volume collects the papers related to robotics, image-guided surgery and interventions, image registration, medical image computing, structural and functional brain analysis, model-based image analysis, image-guided intervention: simulation, modeling and display, and image segmentation and analysis. (orig.)

  5. Virtual reality rehabilitation from social cognitive and motor learning theoretical perspectives in stroke population.

    Science.gov (United States)

    Imam, Bita; Jarus, Tal

    2014-01-01

    Objectives. To identify the virtual reality (VR) interventions used for the lower extremity rehabilitation in stroke population and to explain their underlying training mechanisms using Social Cognitive (SCT) and Motor Learning (MLT) theoretical frameworks. Methods. Medline, Embase, Cinahl, and Cochrane databases were searched up to July 11, 2013. Randomized controlled trials that included a VR intervention for lower extremity rehabilitation in stroke population were included. The Physiotherapy Evidence Database (PEDro) scale was used to assess the quality of the included studies. The underlying training mechanisms involved in each VR intervention were explained according to the principles of SCT (vicarious learning, performance accomplishment, and verbal persuasion) and MLT (focus of attention, order and predictability of practice, augmented feedback, and feedback fading). Results. Eleven studies were included. PEDro scores varied from 3 to 7/10. All studies but one showed significant improvement in outcomes in favour of the VR group (P learning through providing a task-oriented and graduated learning under a variable and unpredictable practice.

  6. Nurses' Assessment of Rehabilitation Potential and Prediction of Functional Status at Discharge from Inpatient Rehabilitation

    Science.gov (United States)

    Myers, Jamie S.; Grigsby, Jim; Teel, Cynthia S.; Kramer, Andrew M.

    2009-01-01

    The goals of this study were to evaluate the accuracy of nurses' predictions of rehabilitation potential in older adults admitted to inpatient rehabilitation facilities and to ascertain whether the addition of a measure of executive cognitive function would enhance predictive accuracy. Secondary analysis was performed on prospective data collected…

  7. Non-invasive brain-computer interface system: towards its application as assistive technology.

    Science.gov (United States)

    Cincotti, Febo; Mattia, Donatella; Aloise, Fabio; Bufalari, Simona; Schalk, Gerwin; Oriolo, Giuseppe; Cherubini, Andrea; Marciani, Maria Grazia; Babiloni, Fabio

    2008-04-15

    The quality of life of people suffering from severe motor disabilities can benefit from the use of current assistive technology capable of ameliorating communication, house-environment management and mobility, according to the user's residual motor abilities. Brain-computer interfaces (BCIs) are systems that can translate brain activity into signals that control external devices. Thus they can represent the only technology for severely paralyzed patients to increase or maintain their communication and control options. Here we report on a pilot study in which a system was implemented and validated to allow disabled persons to improve or recover their mobility (directly or by emulation) and communication within the surrounding environment. The system is based on a software controller that offers to the user a communication interface that is matched with the individual's residual motor abilities. Patients (n=14) with severe motor disabilities due to progressive neurodegenerative disorders were trained to use the system prototype under a rehabilitation program carried out in a house-like furnished space. All users utilized regular assistive control options (e.g., microswitches or head trackers). In addition, four subjects learned to operate the system by means of a non-invasive EEG-based BCI. This system was controlled by the subjects' voluntary modulations of EEG sensorimotor rhythms recorded on the scalp; this skill was learnt even though the subjects have not had control over their limbs for a long time. We conclude that such a prototype system, which integrates several different assistive technologies including a BCI system, can potentially facilitate the translation from pre-clinical demonstrations to a clinical useful BCI.

  8. Decoding sensorimotor rhythms during robotic-assisted treadmill walking for brain computer interface (BCI) applications

    NARCIS (Netherlands)

    Garcia Cossio, E.; Severens, M.; Nienhuis, B.; Duysens, J.; Desain, P.; Keijsers, N.; Farquhar, J.

    2015-01-01

    Locomotor malfunction represents a major problem in some neurological disorders like stroke and spinal cord injury. Robot-assisted walking devices have been used during rehabilitation of patients with these ailments for regaining and improving walking ability. Previous studies showed the advantage

  9. [Secondary benefits of cognitive rehabilitation for a chronic ethylic patient: effects on disorder consciousness, motivation, and global therapeutic cooperation].

    Science.gov (United States)

    Siccardi, L; Vautel-Pons, D; dos Santos, M Teixera; Camus, N; Louchart de la Chapelle, S

    2014-06-01

    Alcoholism causes psychological, behavioral and cognitive symptoms that need to be addressed together. The neuropsychological alterations among alcohol-dependent people are considered to make the therapeutic work complex and longer. A cognitive rehabilitation program is sometimes difficult to achieve with these patients. Functional results are often difficult to anticipate. However, the consequences of this therapeutic approach are multiple and there are many interactions between psycho-affective, behavioral and cognitive components. A neuropsychological approach can be used like a tool to improve metacognition. A bad contribution to treatment programs is often secondary to the illusion of a satisfying intellectual functioning. Patients' motivation for the therapeutic work is very changeable. A complete consciousness of impairments can help them to stay involved. The following case shows the cognitive effects and secondary benefits associated with a neuropsychological work, which was carried out by a chronic ethylic patient with severe physical and cognitive symptoms. The patient aged 50, with a good qualification level (scientific section in the final year of secondary school, with no diploma, then attended a training program to become a croupier) was suffering from chronic alcoholism since his adolescence. He arrived in the closed unit after many hospitalizations in psychiatric and hepato-gastroenterology units. He had been showing mental confusion. He presented a frontal and subcortical profile of alcohol-related dementia according to Oslin's criteria. MRI revealed global cerebral atrophy, more pronounced on the fronto-parietal cortex with cerebellar leukoencephalopathy, but no pontine central myelinolysis. The neurocognitive program had two main lines: reducing attentional, executive and graphical deficits with training exercises (individual and group sessions) and compensating memory, and executive disorders with an external aid. The cognitive program had been

  10. Cognitive learning and its future in urology: surgical skills teaching and assessment.

    Science.gov (United States)

    Shafiei, Somayeh B; Hussein, Ahmed A; Guru, Khurshid A

    2017-07-01

    The aim of this study is to provide an overview of the current status of novel cognitive training approaches in surgery and to investigate the potential role of cognitive training in surgical education. Kinematics of end-effector trajectories, as well as cognitive state features of surgeon trainees and mentors have recently been studied as modalities to objectively evaluate the expertise level of trainees and to shorten the learning process. Virtual reality and haptics also have shown promising in research results in improving the surgical learning process by providing feedback to the trainee. 'Cognitive training' is a novel approach to enhance training and surgical performance. The utility of cognitive training in improving motor skills in other fields, including sports and rehabilitation, is promising enough to justify its utilization to improve surgical performance. However, some surgical procedures, especially ones performed during human-robot interaction in robot-assisted surgery, are much more complicated than sport and rehabilitation. Cognitive training has shown promising results in surgical skills-acquisition in complicated environments such as surgery. However, these methods are mostly developed in research groups using limited individuals. Transferring this research into the clinical applications is a demanding challenge. The aim of this review is to provide an overview of the current status of these novel cognitive training approaches in surgery and to investigate the potential role of cognitive training in surgical education.

  11. Individualized Special Education with Cognitive Skill Assessment.

    Science.gov (United States)

    Kurhila, Jaakko; Laine, Tei

    2000-01-01

    Describes AHMED (Adaptive and Assistive Hypermedia in Education), a computer learning environment which supports the evaluation of disabled children's cognitive skills in addition to supporting openness in learning materials and adaptivity in learning events. Discusses cognitive modeling and compares it to previous intelligent tutoring systems.…

  12. Paradigme(s émergent(s autour des apprentissages collectifs médiatisés en langues Emerging Paradigms in the Field of Computer-Assisted Collective Language Learning

    Directory of Open Access Journals (Sweden)

    Katerina Zourou

    2007-11-01

    Full Text Available De nombreuses recherches se penchent sur l'évolution du champ de l'Apprentissage des Langues Assisté par Ordinateur (Alao, nous aborderons ici les problématiques liées aux nouvelles approches en sciences cognitives et en particulier la cognition distribuée et les Acao (Apprentissages Collectifs Assistés par Ordinateur, Computer Supported Collaborative Learning, CSCL, dans la terminologie anglophone. Après un survol des débats menés à l'intérieur de ces champs, nous nous questionnerons sur leurs retentissements en Alao en nous focalisant sur les travaux anglo-saxons, actuellement plus nombreux que les recherches francophones. Notre article propose d'apporter quelques éléments de réponse aux interrogations suivantes : de quelle manière les différents courants en apprentissage de langues médiatisé réagissent-ils aux débats portant sur l'indissociabilité du social et du culturel (notamment technologique en apprentissage et en cognition ? Que nous disent les mutations actuelles en Alao sur la pertinence de cette approche ? Quel serait son potentiel pour les discussions théoriques et méthodologiques en Alao ?The evolution of Computer Assisted Language Learning (CALL is the subject of many studies. We will discuss the influence of cognitive sciences and more specifically the distributed cognition paradigm and the latest developments in Computer Supported Collaborative Learning (CSCL. After a review of the discussions carried out in these fields, we will point out their repercussions on CALL, by focusing on current literature in English, more abundant than French literature is at the time. Some of the questions we will try to elucidate are the following: how do the various trends in CALL respond to the discussions about the non-dissociability of social and cultural (in particular technological properties in learning and cognition? What do the current changes in CALL tell us of relevance to this approach? Which would be its

  13. Applications of Brain–Machine Interface Systems in Stroke Recovery and Rehabilitation

    Science.gov (United States)

    Francisco, Gerard E.; Contreras-Vidal, Jose L.

    2014-01-01

    Stroke is a leading cause of disability, significantly impacting the quality of life (QOL) in survivors, and rehabilitation remains the mainstay of treatment in these patients. Recent engineering and technological advances such as brain-machine interfaces (BMI) and robotic rehabilitative devices are promising to enhance stroke neu-rorehabilitation, to accelerate functional recovery and improve QOL. This review discusses the recent applications of BMI and robotic-assisted rehabilitation in stroke patients. We present the framework for integrated BMI and robotic-assisted therapies, and discuss their potential therapeutic, assistive and diagnostic functions in stroke rehabilitation. Finally, we conclude with an outlook on the potential challenges and future directions of these neurotechnologies, and their impact on clinical rehabilitation. PMID:25110624

  14. Cognitive Rehabilitation for Mild Traumatic Brain Injury

    Science.gov (United States)

    2009-06-08

    Cate Miller, Dr. Maria Mouratidis, Dr. George Prigatano, Dr. Carole Roth, LTC Michael Russell, LT Rick Schobitz, Dr. Joel Scholten, CAPT Edward Simmer...New York: The Guilford Press. Gordon W.A, Zafonte R., Cicerone, K., Cantor , J., Brown, M., Lombard, L., Goldsmith, R, & Chandna, T. (2006...Traumatic brain injury rehabilitation: State of the science. American Journal of Physical Medicine and Rehabilitation, 85, 343–82. Gordon, W.A., Cantor

  15. Cognitive-linguistic effort in multidisciplinary stroke rehabilitation: Decreasing vs. increasing cues for word retrieval.

    Science.gov (United States)

    Choe, Yu-Kyong; Foster, Tammie; Asselin, Abigail; LeVander, Meagan; Baird, Jennifer

    2017-04-01

    Approximately 24% of stroke survivors experience co-occurring aphasia and hemiparesis. These individuals typically attend back-to-back therapy sessions. However, sequentially scheduled therapy may trigger physical and mental fatigue and have an adverse impact on treatment outcomes. The current study tested a hypothesis that exerting less effort during a therapy session would reduce overall fatigue and enhance functional recovery. Two stroke survivors chronically challenged by non-fluent aphasia and right hemiparesis sequentially completed verbal naming and upper-limb tasks on their home computers. The level of cognitive-linguistic effort in speech/language practice was manipulated by presenting verbal naming tasks in two conditions: Decreasing cues (i.e., most-to-least support for word retrieval), and Increasing cues (i.e., least-to-most support). The participants completed the same upper-limb exercises throughout the study periods. Both individuals showed a statistically significant advantage of decreasing cues over increasing cues in word retrieval during the practice period, but not at the end of the practice period or thereafter. The participant with moderate aphasia and hemiparesis achieved clinically meaningful gains in upper-limb functions following the decreasing cues condition, but not after the increasing cues condition. Preliminary findings from the current study suggest a positive impact of decreasing cues in the context of multidisciplinary stroke rehabilitation.

  16. Robot-Aided Upper-Limb Rehabilitation Based on Motor Imagery EEG

    Directory of Open Access Journals (Sweden)

    Baoguo Xu

    2011-09-01

    Full Text Available Stroke is a leading cause of disability worldwide. In this paper, a novel robot-assisted rehabilitation system based on motor imagery electroencephalography (EEG is developed for regular training of neurological rehabilitation for upper limb stroke patients. Firstly, three-dimensional animation was used to guide the patient image the upper limb movement and EEG signals were acquired by EEG amplifier. Secondly, eigenvectors were extracted by harmonic wavelet transform (HWT and linear discriminant analysis (LDA classifier was utilized to classify the pattern of the left and right upper limb motor imagery EEG signals. Finally, PC triggered the upper limb rehabilitation robot to perform motor therapy and gave the virtual feedback. Using this robot-assisted upper limb rehabilitation system, the patient's EEG of upper limb movement imagination is translated to control rehabilitation robot directly. Consequently, the proposed rehabilitation system can fully explore the patient's motivation and attention and directly facilitate upper limb post-stroke rehabilitation therapy. Experimental results on unimpaired participants were presented to demonstrate the feasibility of the rehabilitation system. Combining robot-assisted training with motor imagery-based BCI will make future rehabilitation therapy more effective. Clinical testing is still required for further proving this assumption.

  17. Computational models of music perception and cognition I: The perceptual and cognitive processing chain

    Science.gov (United States)

    Purwins, Hendrik; Herrera, Perfecto; Grachten, Maarten; Hazan, Amaury; Marxer, Ricard; Serra, Xavier

    2008-09-01

    We present a review on perception and cognition models designed for or applicable to music. An emphasis is put on computational implementations. We include findings from different disciplines: neuroscience, psychology, cognitive science, artificial intelligence, and musicology. The article summarizes the methodology that these disciplines use to approach the phenomena of music understanding, the localization of musical processes in the brain, and the flow of cognitive operations involved in turning physical signals into musical symbols, going from the transducers to the memory systems of the brain. We discuss formal models developed to emulate, explain and predict phenomena involved in early auditory processing, pitch processing, grouping, source separation, and music structure computation. We cover generic computational architectures of attention, memory, and expectation that can be instantiated and tuned to deal with specific musical phenomena. Criteria for the evaluation of such models are presented and discussed. Thereby, we lay out the general framework that provides the basis for the discussion of domain-specific music models in Part II.

  18. Eco-Cognitive Computationalism: From Mimetic Minds to Morphology-Based Enhancement of Mimetic Bodies

    Directory of Open Access Journals (Sweden)

    Lorenzo Magnani

    2018-06-01

    Full Text Available Eco-cognitive computationalism sees computation in context, exploiting the ideas developed in those projects that have originated the recent views on embodied, situated, and distributed cognition. Turing’s original intellectual perspective has already clearly depicted the evolutionary emergence in humans of information, meaning, and of the first rudimentary forms of cognition, as the result of a complex interplay and simultaneous coevolution, in time, of the states of brain/mind, body, and external environment. This cognitive process played a fundamental heuristic role in Turing’s invention of the universal logical computing machine. It is by extending this eco-cognitive perspective that we can see that the recent emphasis on the simplification of cognitive and motor tasks generated in organic agents by morphological aspects implies the construction of appropriate “mimetic bodies”, able to render the accompanied computation simpler, according to a general appeal to the “simplexity” of animal embodied cognition. I hope it will become clear that eco-cognitive computationalism does not aim at furnishing a final and stable definition of the concept of computation, such as a textbook or a different epistemological approach could provide: I intend to take into account the historical and dynamical character of the concept, to propose an intellectual framework that depicts how we can understand not only the change of its meaning, but also the “emergence” of new forms of computations.

  19. COPD patients' self-reported adherence, psychosocial factors and mild cognitive impairment in pulmonary rehabilitation.

    Science.gov (United States)

    Pierobon, Antonia; Sini Bottelli, Elisa; Ranzini, Laura; Bruschi, Claudio; Maestri, Roberto; Bertolotti, Giorgio; Sommaruga, Marinella; Torlaschi, Valeria; Callegari, Simona; Giardini, Anna

    2017-01-01

    In addition to clinical comorbidities, psychological and neuropsychological problems are frequent in COPD and may affect pulmonary rehabilitation delivery and outcome. The aims of the study were to describe a COPD population in a rehabilitative setting as regards the patients depressive symptoms, anxiety, mild cognitive impairment (MCI) and self-reported adherence and to analyze their relationships; to compare the COPD sample MCI scores with normative data; and to investigate which factors might predict adherence to prescribed physical exercise. This was a multicenter observational cross-sectional study. Of the 117 eligible stable COPD inpatients, 84 were enrolled according to Global initiative for chronic Obstructive Lung Disease (GOLD) criteria (mainly in Stage III-IV). The assessment included Mini Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), anxiety, depression and self-reported pharmacological and nonpharmacological adherence. From the MMSE, 3.6% of patients were found to be impaired, whereas from the MoCA 9.5% had a likely MCI. Patients referred had mild-severe depression (46.7%), anxiety (40.5%), good pharmacological adherence (80.3%) and difficulties in following prescribed diet (24.1%) and exercise (51.8%); they struggled with disease acceptance (30.9%) and disease limitations acceptance (28.6%). Most of them received good family (89%) or social (53%) support. Nonpharmacological adherence, depression, anxiety and MCI showed significant relations with 6-minute walking test, body mass index (BMI) and GOLD. Depression was related to autonomous long-term oxygen therapy modifications, disease perception, family support and MCI. In the multivariate logistic regression analysis, higher BMI, higher depression and lower anxiety predicted lower adherence to exercise prescriptions ( P =0.0004, odds ratio =0.796, 95% CI =0.701, 0.903; P =0.009, odds ratio =0.356, 95% CI =0.165, 0.770; and P =0.05, odds ratio =2.361, 95% CI =0.995, 5

  20. Cognition beyond the brain computation, interactivity and human artifice

    CERN Document Server

    Cowley, Stephen J

    2013-01-01

    Arguing that a collective dimension has given cognitive flexibility to human intelligence, this book shows that traditional cognitive psychology underplays the role of bodies, dialogue, diagrams, tools, talk, customs, habits, computers and cultural practices.

  1. D-amphetamine improves cognitive deficits and physical therapy promotes fine motor rehabilitation in a rat embolic stroke model

    DEFF Research Database (Denmark)

    Rasmussen, Rune Skovgaard; Overgaard, K; Hildebrandt-Eriksen, E S

    2006-01-01

    regarding gross motor performance. CONCLUSIONS: After embolization, physical therapy improved fine motor performance and D-amph accelerated rehabilitation of cognitive performance as observed in the rats of the THERAPY and D-AMPH groups. As a result of the administration of a high dose of D-amph, the rats......BACKGROUND AND PURPOSE: The purpose of this study was to examine the effects of D-amphetamine (D-amph) and physical therapy separately or combined on fine motor performance, gross motor performance and cognition after middle cerebral artery thromboembolization in rats. METHODS: Seventy-four rats...... on days 21-28 after surgery, rats of the SHAM and THERAPY groups had better fine motor performance than those of the CONTROL (P cognitive performance than CONTROL rats (P

  2. Computer-Assisted Instruction: Authoring Languages. ERIC Digest.

    Science.gov (United States)

    Reeves, Thomas C.

    One of the most perplexing tasks in producing computer-assisted instruction (CAI) is the authoring process. Authoring is generally defined as the process of turning the flowcharts, control algorithms, format sheets, and other documentation of a CAI program's design into computer code that will operationalize the simulation on the delivery system.…

  3. Considerations for designing robotic upper limb rehabilitation devices

    Science.gov (United States)

    Nadas, I.; Vaida, C.; Gherman, B.; Pisla, D.; Carbone, G.

    2017-12-01

    The present study highlights the advantages of robotic systems for post-stroke rehabilitation of the upper limb. The latest demographic studies illustrate a continuous increase of the average life span, which leads to a continuous increase of stroke incidents and patients requiring rehabilitation. Some studies estimate that by 2030 the number of physical therapists will be insufficient for the patients requiring physical rehabilitation, imposing a shift in the current methodologies. A viable option is the implementation of robotic systems that assist the patient in performing rehabilitation exercises, the physical therapist role being to establish the therapeutic program for each patient and monitor their individual progress. Using a set of clinical measurements for the upper limb motions, the analysis of rehabilitation robotic systems provides a comparative study between the motions required by clinicians and the ones that robotic systems perform for different therapeutic exercises. A critical analysis of existing robots is performed using several classifications: mechanical design, assistance type, actuation and power transmission, control systems and human robot interaction (HRI) strategies. This classification will determine a set of pre-requirements for the definition of new concepts and efficient solutions for robotic assisted rehabilitation therapy.

  4. A Computational Framework for Quantitative Evaluation of Movement during Rehabilitation

    Science.gov (United States)

    Chen, Yinpeng; Duff, Margaret; Lehrer, Nicole; Sundaram, Hari; He, Jiping; Wolf, Steven L.; Rikakis, Thanassis

    2011-06-01

    This paper presents a novel generalized computational framework for quantitative kinematic evaluation of movement in a rehabilitation clinic setting. The framework integrates clinical knowledge and computational data-driven analysis together in a systematic manner. The framework provides three key benefits to rehabilitation: (a) the resulting continuous normalized measure allows the clinician to monitor movement quality on a fine scale and easily compare impairments across participants, (b) the framework reveals the effect of individual movement components on the composite movement performance helping the clinician decide the training foci, and (c) the evaluation runs in real-time, which allows the clinician to constantly track a patient's progress and make appropriate adaptations to the therapy protocol. The creation of such an evaluation is difficult because of the sparse amount of recorded clinical observations, the high dimensionality of movement and high variations in subject's performance. We address these issues by modeling the evaluation function as linear combination of multiple normalized kinematic attributes y = Σwiφi(xi) and estimating the attribute normalization function φi(ṡ) by integrating distributions of idealized movement and deviated movement. The weights wi are derived from a therapist's pair-wise comparison using a modified RankSVM algorithm. We have applied this framework to evaluate upper limb movement for stroke survivors with excellent results—the evaluation results are highly correlated to the therapist's observations.

  5. Promoting Intrinsic and Extrinsic Motivation among Chemistry Students Using Computer-Assisted Instruction

    Science.gov (United States)

    Gambari, Isiaka A.; Gbodi, Bimpe E.; Olakanmi, Eyitao U.; Abalaka, Eneojo N.

    2016-01-01

    The role of computer-assisted instruction in promoting intrinsic and extrinsic motivation among Nigerian secondary school chemistry students was investigated in this study. The study employed two modes of computer-assisted instruction (computer simulation instruction and computer tutorial instructional packages) and two levels of gender (male and…

  6. Effects of Web-Based Cognitive Apprenticeship and Time Management on the Development of Computing Skills in Cloud Classroom: A Quasi-Experimental Approach

    Science.gov (United States)

    Wu, Hsiao-Chi; Shen, Pei-Di; Chen, Yi-Fen; Tsai, Chia-Wen

    2016-01-01

    Web-based learning is generally a solitary process without teachers' on-the-spot assistance. In this study, a quasi-experiment was conducted to explore the effects of various combinations of Web-Based Cognitive Apprenticeship (WBCA) and Time Management (TM) on the development of students' computing skills. Three class cohorts of 124 freshmen in a…

  7. Computer-Based Cognitive Training for Mild Cognitive Impairment: Results from a Pilot Randomized, Controlled Trial

    OpenAIRE

    Barnes, Deborah E.; Yaffe, Kristine; Belfor, Nataliya; Jagust, William J.; DeCarli, Charles; Reed, Bruce R.; Kramer, Joel H.

    2009-01-01

    We performed a pilot randomized, controlled trial of intensive, computer-based cognitive training in 47 subjects with mild cognitive impairment (MCI). The intervention group performed exercises specifically designed to improve auditory processing speed and accuracy for 100 minutes/day, 5 days/week for 6 weeks; the control group performed more passive computer activities (reading, listening, visuospatial game) for similar amounts of time. Subjects had a mean age of 74 years and 60% were men; 7...

  8. Robot-Assisted Rehabilitation of Ankle Plantar Flexors Spasticity: A Three-Month Study with Proprioceptive Neuromuscular Facilitation

    Directory of Open Access Journals (Sweden)

    Zhihao Zhou

    2016-11-01

    Full Text Available In this paper, we aim to investigate the effect of Proprioceptive Neuromuscular Facilitation (PNF based rehabilitation for ankle plantar flexors spasticity by using a Robotic Ankle-foot Rehabilitation System (RARS. A modified robot-assisted system was proposed and seven post-stroke patients with hemiplegic spastic ankles participated a three-month of robotic PNF training. Their impaired sides were used as the experimental group while their unimpaired sides as the control group. A robotic intervention for the experimental group generally started from a two minutes passive stretching to warm-up or relax the soleus and gastrocnemius muscle and also ended with the same one. Then a PNF training session included 30 trails was activated between them. The rehabilitation trainings were carried out three times a week as an addition of their regular rehabilitation exercise. Passive ankle joint range of motion, resistance torque and stiffness were measured in both ankles before and after the intervention. The changes in Achilles' tendon length, walking speed, and lower limb function were also evaluated by the same physician or physiotherapist for each participant. Biomechanical measurements before interventions showed significant difference between the experimental group and the control group due to ankle spasticity. For the control group, there was no significant difference in the three months with no robotic intervention. But for the experimental group, passive dorsiflexion range of motion increased ( p0.05 . The robotic rehabilitation also improved the muscle strength ( p0.05 and fast walking speed ( p<0.05 . These results indicated that PNF based robotic intervention could significantly alleviate lower limb spasticity and improve the motor function in chronic stroke participant. The robotic system could potentially be used as an effective tool in post-stroke rehabilitation training.

  9. Cognition, behaviour and academic skills after cognitive rehabilitation in Ugandan children surviving severe malaria: a randomised trial

    Directory of Open Access Journals (Sweden)

    John Chandy C

    2011-08-01

    Full Text Available Abstract Background Infection with severe malaria in African children is associated with not only a high mortality but also a high risk of cognitive deficits. There is evidence that interventions done a few years after the illness are effective but nothing is known about those done immediately after the illness. We designed a study in which children who had suffered from severe malaria three months earlier were enrolled into a cognitive intervention program and assessed for the immediate benefit in cognitive, academic and behavioral outcomes. Methods This parallel group randomised study was carried out in Kampala City, Uganda between February 2008 and October 2010. Sixty-one Ugandan children aged 5 to 12 years with severe malaria were assessed for cognition (using the Kaufman Assessment Battery for Children, second edition and the Test of Variables of Attention, academic skills (Wide Range Achievement Test, third edition and psychopathologic behaviour (Child Behaviour Checklist three months after an episode of severe malaria. Twenty-eight were randomised to sixteen sessions of computerised cognitive rehabilitation training lasting eight weeks and 33 to a non-treatment group. Post-intervention assessments were done a month after conclusion of the intervention. Analysis of covariance was used to detect any differences between the two groups after post-intervention assessment, adjusting for age, sex, weight for age z score, quality of the home environment, time between admission and post-intervention testing and pre-intervention score. The primary outcome was improvement in attention scores for the intervention group. This trial is registered with Current Controlled Trials, number ISRCTN53183087. Results Significant intervention effects were observed in the intervention group for learning mean score (SE, [93.89 (4.00 vs 106.38 (4.32, P = 0.04] but for working memory the intervention group performed poorly [27.42 (0.66 vs 25.34 (0.73, P = 0.04]. No

  10. Seventh Medical Image Computing and Computer Assisted Intervention Conference (MICCAI 2012)

    CERN Document Server

    Miller, Karol; Nielsen, Poul; Computational Biomechanics for Medicine : Models, Algorithms and Implementation

    2013-01-01

    One of the greatest challenges for mechanical engineers is to extend the success of computational mechanics to fields outside traditional engineering, in particular to biology, biomedical sciences, and medicine. This book is an opportunity for computational biomechanics specialists to present and exchange opinions on the opportunities of applying their techniques to computer-integrated medicine. Computational Biomechanics for Medicine: Models, Algorithms and Implementation collects the papers from the Seventh Computational Biomechanics for Medicine Workshop held in Nice in conjunction with the Medical Image Computing and Computer Assisted Intervention conference. The topics covered include: medical image analysis, image-guided surgery, surgical simulation, surgical intervention planning, disease prognosis and diagnostics, injury mechanism analysis, implant and prostheses design, and medical robotics.

  11. The effect of a therapeutic regimen of Traditional Chinese Medicine rehabilitation for post-stroke cognitive impairment: study protocol for a randomized controlled trial.

    Science.gov (United States)

    Huang, Jia; Lin, Zhengkun; Wang, Qin; Liu, Feiwen; Liu, Jiao; Fang, Yunhua; Chen, Shanjia; Zhou, Xiaoxuan; Hong, Wenjun; Wu, Jinsong; Madrigal-Mora, Natalia; Zheng, Guohua; Yang, Shanli; Tao, Jing; Chen, Lidian

    2015-06-16

    Post-stroke cognitive impairment (PSCI) lessens quality of life, restricts the rehabilitation of stroke, and increases the social and economic burden stroke imposes on patients and their families. Therefore effective treatment is of paramount importance. However, the treatment of PSCI is very limited. The primary aim of this protocol is to propose a lower cost and more effective therapy, and to confirm the long-term effectiveness of a therapeutic regimen of Traditional Chinese Medicine (TCM) rehabilitation for PSCI. A prospective, multicenter, large sample, randomized controlled trial will be conducted. A total of 416 eligible patients will be recruited from seven inpatient and outpatient stroke rehabilitation units and randomly allocated into a therapeutic regimen of TCM rehabilitation group or cognitive training (CT) control group. The intervention period of both groups will last 12 weeks (30 minutes per day, five days per week). Primary and secondary outcomes will be measured at baseline, 12 weeks (at the end of the intervention), and 36 weeks (after the 24-week follow-up period). This protocol presents an objective design of a multicenter, large sample, randomized controlled trial that aims to put forward a lower cost and more effective therapy, and confirm the long-term effectiveness of a therapeutic regimen of TCM rehabilitation for PSCI through subjective and objective assessments, as well as highlight its economic advantages. This trial was registered with the Chinese Clinical Trial Registry (identifier: ChiCTR-TRC-14004872 ) on 23 June 2014.

  12. Virtual Reality Rehabilitation from Social Cognitive and Motor Learning Theoretical Perspectives in Stroke Population

    Directory of Open Access Journals (Sweden)

    Bita Imam

    2014-01-01

    Full Text Available Objectives. To identify the virtual reality (VR interventions used for the lower extremity rehabilitation in stroke population and to explain their underlying training mechanisms using Social Cognitive (SCT and Motor Learning (MLT theoretical frameworks. Methods. Medline, Embase, Cinahl, and Cochrane databases were searched up to July 11, 2013. Randomized controlled trials that included a VR intervention for lower extremity rehabilitation in stroke population were included. The Physiotherapy Evidence Database (PEDro scale was used to assess the quality of the included studies. The underlying training mechanisms involved in each VR intervention were explained according to the principles of SCT (vicarious learning, performance accomplishment, and verbal persuasion and MLT (focus of attention, order and predictability of practice, augmented feedback, and feedback fading. Results. Eleven studies were included. PEDro scores varied from 3 to 7/10. All studies but one showed significant improvement in outcomes in favour of the VR group (P<0.05. Ten VR interventions followed the principle of performance accomplishment. All the eleven VR interventions directed subject’s attention externally, whereas nine provided training in an unpredictable and variable fashion. Conclusions. The results of this review suggest that VR applications used for lower extremity rehabilitation in stroke population predominantly mediate learning through providing a task-oriented and graduated learning under a variable and unpredictable practice.

  13. Brain training improves recovery after stroke but waiting list improves equally: A multicenter randomized controlled trial of a computer-based cognitive flexibility training.

    Directory of Open Access Journals (Sweden)

    Renate M van de Ven

    Full Text Available Brain training is currently widely used in an attempt to improve cognitive functioning. Computer-based training can be performed at home and could therefore be an effective add-on to available rehabilitation programs aimed at improving cognitive functioning. Several studies have reported cognitive improvements after computer training, but most lacked proper active and passive control conditions.Our aim was to investigate whether computer-based cognitive flexibility training improves executive functioning after stroke. We also conducted within-group analyses similar to those used in previous studies, to assess inferences about transfer effects when comparisons to proper control groups are missing.We conducted a randomized controlled, double blind trial. Adults (30-80 years old who had suffered a stroke within the last 5 years were assigned to either an intervention group (n = 38, active control group (i.e., mock training; n = 35, or waiting list control group (n = 24. The intervention and mock training consisted of 58 half-hour sessions within a 12-week period. Cognitive functioning was assessed using several paper-and-pencil and computerized neuropsychological tasks before the training, immediately after training, and 4 weeks after training completion.Both training groups improved on training tasks, and all groups improved on several transfer tasks (three executive functioning tasks, attention, reasoning, and psychomotor speed. Improvements remained 4 weeks after training completion. However, the amount of improvement in executive and general cognitive functioning in the intervention group was similar to that of both control groups (active control and waiting list. Therefore, this improvement was likely due to training-unspecific effects. Our results stress the importance to include both active and passive control conditions in the study design and analyses. Results from studies without proper control conditions should be interpreted with care.

  14. Stroke rehabilitation.

    Science.gov (United States)

    Langhorne, Peter; Bernhardt, Julie; Kwakkel, Gert

    2011-05-14

    Stroke is a common, serious, and disabling global health-care problem, and rehabilitation is a major part of patient care. There is evidence to support rehabilitation in well coordinated multidisciplinary stroke units or through provision of early supported provision of discharge teams. Potentially beneficial treatment options for motor recovery of the arm include constraint-induced movement therapy and robotics. Promising interventions that could be beneficial to improve aspects of gait include fitness training, high-intensity therapy, and repetitive-task training. Repetitive-task training might also improve transfer functions. Occupational therapy can improve activities of daily living; however, information about the clinical effect of various strategies of cognitive rehabilitation and strategies for aphasia and dysarthria is scarce. Several large trials of rehabilitation practice and of novel therapies (eg, stem-cell therapy, repetitive transcranial magnetic stimulation, virtual reality, robotic therapies, and drug augmentation) are underway to inform future practice. Copyright © 2011 Elsevier Ltd. All rights reserved.

  15. Rehabilitation Engineering and Assistive Technology Society of North America

    Science.gov (United States)

    ... certification, how it has helped them in their careers, and what it means to them personally. #ATPproud ... and has been a steering force in my career as a rehabilitation engineer. ---Casmir Usiatynski, Rehabilitation Engineer ...

  16. Rehabilitation of gait after stroke: a review towards a top-down approach

    Science.gov (United States)

    2011-01-01

    This document provides a review of the techniques and therapies used in gait rehabilitation after stroke. It also examines the possible benefits of including assistive robotic devices and brain-computer interfaces in this field, according to a top-down approach, in which rehabilitation is driven by neural plasticity. The methods reviewed comprise classical gait rehabilitation techniques (neurophysiological and motor learning approaches), functional electrical stimulation (FES), robotic devices, and brain-computer interfaces (BCI). From the analysis of these approaches, we can draw the following conclusions. Regarding classical rehabilitation techniques, there is insufficient evidence to state that a particular approach is more effective in promoting gait recovery than other. Combination of different rehabilitation strategies seems to be more effective than over-ground gait training alone. Robotic devices need further research to show their suitability for walking training and their effects on over-ground gait. The use of FES combined with different walking retraining strategies has shown to result in improvements in hemiplegic gait. Reports on non-invasive BCIs for stroke recovery are limited to the rehabilitation of upper limbs; however, some works suggest that there might be a common mechanism which influences upper and lower limb recovery simultaneously, independently of the limb chosen for the rehabilitation therapy. Functional near infrared spectroscopy (fNIRS) enables researchers to detect signals from specific regions of the cortex during performance of motor activities for the development of future BCIs. Future research would make possible to analyze the impact of rehabilitation on brain plasticity, in order to adapt treatment resources to meet the needs of each patient and to optimize the recovery process. PMID:22165907

  17. Rehabilitation of gait after stroke: a review towards a top-down approach

    Directory of Open Access Journals (Sweden)

    Belda-Lois Juan-Manuel

    2011-12-01

    Full Text Available Abstract This document provides a review of the techniques and therapies used in gait rehabilitation after stroke. It also examines the possible benefits of including assistive robotic devices and brain-computer interfaces in this field, according to a top-down approach, in which rehabilitation is driven by neural plasticity. The methods reviewed comprise classical gait rehabilitation techniques (neurophysiological and motor learning approaches, functional electrical stimulation (FES, robotic devices, and brain-computer interfaces (BCI. From the analysis of these approaches, we can draw the following conclusions. Regarding classical rehabilitation techniques, there is insufficient evidence to state that a particular approach is more effective in promoting gait recovery than other. Combination of different rehabilitation strategies seems to be more effective than over-ground gait training alone. Robotic devices need further research to show their suitability for walking training and their effects on over-ground gait. The use of FES combined with different walking retraining strategies has shown to result in improvements in hemiplegic gait. Reports on non-invasive BCIs for stroke recovery are limited to the rehabilitation of upper limbs; however, some works suggest that there might be a common mechanism which influences upper and lower limb recovery simultaneously, independently of the limb chosen for the rehabilitation therapy. Functional near infrared spectroscopy (fNIRS enables researchers to detect signals from specific regions of the cortex during performance of motor activities for the development of future BCIs. Future research would make possible to analyze the impact of rehabilitation on brain plasticity, in order to adapt treatment resources to meet the needs of each patient and to optimize the recovery process.

  18. Controlling patient participation during robot-assisted gait training

    Science.gov (United States)

    2011-01-01

    Background The overall goal of this paper was to investigate approaches to controlling active participation in stroke patients during robot-assisted gait therapy. Although active physical participation during gait rehabilitation after stroke was shown to improve therapy outcome, some patients can behave passively during rehabilitation, not maximally benefiting from the gait training. Up to now, there has not been an effective method for forcing patient activity to the desired level that would most benefit stroke patients with a broad variety of cognitive and biomechanical impairments. Methods Patient activity was quantified in two ways: by heart rate (HR), a physiological parameter that reflected physical effort during body weight supported treadmill training, and by a weighted sum of the interaction torques (WIT) between robot and patient, recorded from hip and knee joints of both legs. We recorded data in three experiments, each with five stroke patients, and controlled HR and WIT to a desired temporal profile. Depending on the patient's cognitive capabilities, two different approaches were taken: either by allowing voluntary patient effort via visual instructions or by forcing the patient to vary physical effort by adapting the treadmill speed. Results We successfully controlled patient activity quantified by WIT and by HR to a desired level. The setup was thereby individually adaptable to the specific cognitive and biomechanical needs of each patient. Conclusion Based on the three successful approaches to controlling patient participation, we propose a metric which enables clinicians to select the best strategy for each patient, according to the patient's physical and cognitive capabilities. Our framework will enable therapists to challenge the patient to more activity by automatically controlling the patient effort to a desired level. We expect that the increase in activity will lead to improved rehabilitation outcome. PMID:21429200

  19. How assistive technology changes the brain: the critical role of hippocampal-striatal interactions during cognitive training.

    Science.gov (United States)

    Kéri, Szabolcs

    2015-01-01

    Recent studies found structural changes of the brain during cognitive training. These changes may be important when assistive technologies are used, for example, to boost memory and navigation abilities in patients with neurocognitive disorders. In this study, we show that extensive training with a platformer game simulating navigation and real-life spatial abilities, patients with Alzheimer's disease and amnestic mild cognitive impairmant exhibit an increased volume of the caudate nucleus in contrast to healthy individuals who display increased hippocampal volumes. These results raise the possibility that cognitive training and assistive technology may induce compensatory changes of brain structure in memory disorders.

  20. Effects of cancer rehabilitation on problem-solving, anxiety and depression : a RCT comparing physical and cognitive-behavioural training versus physical training

    NARCIS (Netherlands)

    Korstjens, Irene; Mesters, Ilse; May, Anne M; van Weert, Ellen; van den Hout, Johanna H C; Ros, Wynand; Hoekstra-Weebers, Josette E H M; van der Schans, Cees; van den Borne, Bart

    2011-01-01

    We tested the effects on problem-solving, anxiety and depression of 12-week group-based self-management cancer rehabilitation, combining comprehensive physical training (PT) and cognitive-behavioural problem-solving training (CBT), compared with PT. We expected that PT + CBT would outperform PT in

  1. Effects of cancer rehabilitation on problem-solving, anxiety and depression : A RCT comparing physical and cognitive-behavioural training versus physical training

    NARCIS (Netherlands)

    Korstjens, Irene; Mesters, Ilse; May, Anne M.; van Weert, Ellen; van den Hout, Johanna H. C.; Ros, Wynand; Hoekstra-Weebers, Josette E. H. M.; van der Schans, Cees P.; van den Borne, Bart

    2011-01-01

    We tested the effects on problem-solving, anxiety and depression of 12-week group-based self-management cancer rehabilitation, combining comprehensive physical training (PT) and cognitive-behavioural problem-solving training (CBT), compared with PT. We expected that PT + CBT would outperform PT in

  2. Computational models of music perception and cognition II: Domain-specific music processing

    Science.gov (United States)

    Purwins, Hendrik; Grachten, Maarten; Herrera, Perfecto; Hazan, Amaury; Marxer, Ricard; Serra, Xavier

    2008-09-01

    In Part I [Purwins H, Herrera P, Grachten M, Hazan A, Marxer R, Serra X. Computational models of music perception and cognition I: The perceptual and cognitive processing chain. Physics of Life Reviews 2008, in press, doi:10.1016/j.plrev.2008.03.004], we addressed the study of cognitive processes that underlie auditory perception of music, and their neural correlates. The aim of the present paper is to summarize empirical findings from music cognition research that are relevant to three prominent music theoretic domains: rhythm, melody, and tonality. Attention is paid to how cognitive processes like category formation, stimulus grouping, and expectation can account for the music theoretic key concepts in these domains, such as beat, meter, voice, consonance. We give an overview of computational models that have been proposed in the literature for a variety of music processing tasks related to rhythm, melody, and tonality. Although the present state-of-the-art in computational modeling of music cognition definitely provides valuable resources for testing specific hypotheses and theories, we observe the need for models that integrate the various aspects of music perception and cognition into a single framework. Such models should be able to account for aspects that until now have only rarely been addressed in computational models of music cognition, like the active nature of perception and the development of cognitive capacities from infancy to adulthood.

  3. Achieving Successful Employment Outcomes with the Use of Assistive Technology. Report from the Study Group, Institute on Rehabilitation Issues (24th, Washington, DC, May 1998).

    Science.gov (United States)

    Radtke, Jean, Ed.

    Developed as a result of an institute on rehabilitation issues, this document is a guide to assistive technology as it affects successful competitive employment outcomes for people with disabilities. Chapter 1 offers basic information on assistive technology including basic assumptions, service provider approaches, options for technology…

  4. Robot-Aided Upper-Limb Rehabilitation Based on Motor Imagery EEG

    Directory of Open Access Journals (Sweden)

    Baoguo Xu

    2011-09-01

    Full Text Available Stroke is a leading cause of disability worldwide. In this paper, a novel robot‐assisted rehabilitation system based on motor imagery electroencephalography (EEG is developed for regular training of neurological rehabilitation for upper limb stroke patients. Firstly, three‐dimensional animation was used to guide the patient image the upper limb movement and EEG signals were acquired by EEG amplifier. Secondly, eigenvectors were extracted by harmonic wavelet transform (HWT and linear discriminant analysis (LDA classifier was utilized to classify the pattern of the left and right upper limb motor imagery EEG signals. Finally, PC triggered the upper limb rehabilitation robot to perform motor therapy and gave the virtual feedback. Using this robot‐assisted upper limb rehabilitation system, the patientʹs EEG of upper limb movement imagination is translated to control rehabilitation robot directly. Consequently, the proposed rehabilitation system can fully explore the patientʹs motivation and attention and directly facilitate upper limb post‐stroke rehabilitation therapy. Experimental results on unimpaired participants were presented to demonstrate the feasibility of the rehabilitation system. Combining robot‐assisted training with motor imagery‐ based BCI will make future rehabilitation therapy more effective. Clinical testing is still required for further proving this assumption.

  5. Motor imagery based brain-computer interfaces: An emerging technology to rehabilitate motor deficits.

    Science.gov (United States)

    Alonso-Valerdi, Luz Maria; Salido-Ruiz, Ricardo Antonio; Ramirez-Mendoza, Ricardo A

    2015-12-01

    When the sensory-motor integration system is malfunctioning provokes a wide variety of neurological disorders, which in many cases cannot be treated with conventional medication, or via existing therapeutic technology. A brain-computer interface (BCI) is a tool that permits to reintegrate the sensory-motor loop, accessing directly to brain information. A potential, promising and quite investigated application of BCI has been in the motor rehabilitation field. It is well-known that motor deficits are the major disability wherewith the worldwide population lives. Therefore, this paper aims to specify the foundation of motor rehabilitation BCIs, as well as to review the recent research conducted so far (specifically, from 2007 to date), in order to evaluate the suitability and reliability of this technology. Although BCI for post-stroke rehabilitation is still in its infancy, the tendency is towards the development of implantable devices that encompass a BCI module plus a stimulation system. Copyright © 2015 Elsevier Ltd. All rights reserved.

  6. Effects of illness and hip fracture perceptions on coping strategies of elderly rehabilitation clients

    Directory of Open Access Journals (Sweden)

    Tone Brejc

    2006-12-01

    Full Text Available The objective of this pilot study was to evaluate, using Leventhal's self-regulatory model of illness perceptions, the effects of subjective representations of health and hip fracture on coping strategies in a sample of 52 clients more than 65 years old at the beginning of intensive hospital rehabilitation programme. The results revealed that rehabilitation clients suffering from hip fracture preserved their sense of good general and mental health. Negative representation of hip fracture was related only to perception of temporary decline in physical activity and not to perception of other personal, social and economic consequences neither to perception of their controllability. Perception of poor physical competence influenced the use of less preferred coping strategies of behavioural, mental and alcohol/drug based disengagement, and denial. Rehabilitation clients preferred those cognitive-behavioural and emotional strategies which confirmed their perception of self-efficiency and confidence in therapeutic assistance.Strategies were thus selected according to active and planned endeavour to cope, and were based on acceptance, turning to religion, focusing and venting emotions, and seeking instrumental and social support. The study confirmed the hypothesis that negative representation of hip fracture and poor sense of physical competence had a restraining effect on the use of coping strategies. There was no evidence that coping strategies of hip fracture in elderly rehabilitation clients created a specific pattern, depending on the perception of its consequences and the appraisal of possibility to regain health control. The validity of the findings is limited by a relatively small and selected sample of cognitive intact and motivated older rehabilitation clients, use of specific, non-standardised instruments, and a cross-sectional approach.

  7. Blackboard architecture and qualitative model in a computer aided assistant designed to define computers for HEP computing

    International Nuclear Information System (INIS)

    Nodarse, F.F.; Ivanov, V.G.

    1991-01-01

    Using BLACKBOARD architecture and qualitative model, an expert systm was developed to assist the use in defining the computers method for High Energy Physics computing. The COMEX system requires an IBM AT personal computer or compatible with than 640 Kb RAM and hard disk. 5 refs.; 9 figs

  8. Interactive Computer-Assisted Instruction in Acid-Base Physiology for Mobile Computer Platforms

    Science.gov (United States)

    Longmuir, Kenneth J.

    2014-01-01

    In this project, the traditional lecture hall presentation of acid-base physiology in the first-year medical school curriculum was replaced by interactive, computer-assisted instruction designed primarily for the iPad and other mobile computer platforms. Three learning modules were developed, each with ~20 screens of information, on the subjects…

  9. Computer assisted procedure maintenance

    International Nuclear Information System (INIS)

    Bisio, R.; Hulsund, J. E.; Nilsen, S.

    2004-04-01

    The maintenance of operating procedures in a NPP is a tedious and complicated task. Through the whole life cycle of the procedures they will be dynamic, 'living' documents. Several aspects of the procedure must be considered in a revision process. Pertinent details and attributes of the procedure must be checked. An organizational structure must be created and responsibilities allotted for drafting, revising, reviewing and publishing procedures. Available powerful computer technology provides solutions within document management and computerisation of procedures. These solutions can also support the maintenance of procedures. Not all parts of the procedure life cycle are equally amenable to computerized support. This report looks at the procedure life cycle in todays NPPs and discusses the possibilities associated with introduction of computer technology to assist the maintenance of procedures. (Author)

  10. Rehabilitation capital: a field-specific form of capital to understand rehabilitation in a Nordic welfare state

    DEFF Research Database (Denmark)

    Guldager, Rikke; Poulsen, Ingrid; Egerod, Ingrid

    2018-01-01

    resources in decision-making in a stroke unit. In particular, it focuses on the challenges in optimising the rehabilitation process faced by patients and relatives, and the strategies they use. Data were generated using participant observation and semi-structured interviews. Qualitative content analysis...... was applied to investigate the patients’ and relatives’ experiences of decision-making. We present a field-specific form of capital: An individual or a family’s resources that are valued in the field of rehabilitation as physical, behavioural and cognitively embedded attitudes and practices. Rehabilitation...... rehabilitation and may provide patients with an advantage, to ensure the best rehabilitation. The possession of Rehabilitation capital (high or low) contributes explanations for unequal practices and treatments at a micro-level in healthcare institutions....

  11. Non invasive Brain-Computer Interface system: towards its application as assistive technology

    Science.gov (United States)

    Cincotti, Febo; Mattia, Donatella; Aloise, Fabio; Bufalari, Simona; Schalk, Gerwin; Oriolo, Giuseppe; Cherubini, Andrea; Marciani, Maria Grazia; Babiloni, Fabio

    2010-01-01

    The quality of life of people suffering from severe motor disabilities can benefit from the use of current assistive technology capable of ameliorating communication, house-environment management and mobility, according to the user's residual motor abilities. Brain Computer Interfaces (BCIs) are systems that can translate brain activity into signals that control external devices. Thus they can represent the only technology for severely paralyzed patients to increase or maintain their communication and control options. Here we report on a pilot study in which a system was implemented and validated to allow disabled persons to improve or recover their mobility (directly or by emulation) and communication within the surrounding environment. The system is based on a software controller that offers to the user a communication interface that is matched with the individual's residual motor abilities. Patients (n=14) with severe motor disabilities due to progressive neurodegenerative disorders were trained to use the system prototype under a rehabilitation program carried out in a house-like furnished space. All users utilized regular assistive control options (e.g., microswitches or head trackers). In addition, four subjects learned to operate the system by means of a non-invasive EEG-based BCI. This system was controlled by the subjects' voluntary modulations of EEG sensorimotor rhythms recorded on the scalp; this skill was learnt even though the subjects have not had control over their limbs for a long time. We conclude that such a prototype system, which integrates several different assistive technologies including a BCI system, can potentially facilitate the translation from pre-clinical demonstrations to a clinical useful BCI. PMID:18394526

  12. The Combined Effects of Adaptive Control and Virtual Reality on Robot-Assisted Fine Hand Motion Rehabilitation in Chronic Stroke Patients: A Case Study.

    Science.gov (United States)

    Huang, Xianwei; Naghdy, Fazel; Naghdy, Golshah; Du, Haiping; Todd, Catherine

    2018-01-01

    Robot-assisted therapy is regarded as an effective and reliable method for the delivery of highly repetitive training that is needed to trigger neuroplasticity following a stroke. However, the lack of fully adaptive assist-as-needed control of the robotic devices and an inadequate immersive virtual environment that can promote active participation during training are obstacles hindering the achievement of better training results with fewer training sessions required. This study thus focuses on these research gaps by combining these 2 key components into a rehabilitation system, with special attention on the rehabilitation of fine hand motion skills. The effectiveness of the proposed system is tested by conducting clinical trials on a chronic stroke patient and verified through clinical evaluation methods by measuring the key kinematic features such as active range of motion (ROM), finger strength, and velocity. By comparing the pretraining and post-training results, the study demonstrates that the proposed method can further enhance the effectiveness of fine hand motion rehabilitation training by improving finger ROM, strength, and coordination. Copyright © 2018 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  13. Integrating eye tracking in virtual reality for stroke rehabilitation

    OpenAIRE

    Alves, Júlio Miguel Gomes Rebelo

    2014-01-01

    This thesis reports on research done for the integration of eye tracking technology into virtual reality environments, with the goal of using it in rehabilitation of patients who suffered from stroke. For the last few years, eye tracking has been a focus on medical research, used as an assistive tool  to help people with disabilities interact with new technologies  and as an assessment tool  to track the eye gaze during computer interactions. However, tracking more complex gaze behavio...

  14. 34 CFR 386.1 - What is the Rehabilitation Long-Term Training program?

    Science.gov (United States)

    2010-07-01

    ...; (5) Rehabilitation social work; (6) Rehabilitation psychiatry; (7) Rehabilitation psychology; (8...; (12) Physical education; (13) Therapeutic recreation; (14) Community rehabilitation program personnel...; (20) Independent living; (21) Client assistance; (22) Administration of community rehabilitation...

  15. Tele-rehabilitation using in-house wearable ankle rehabilitation robot.

    Science.gov (United States)

    Jamwal, Prashant K; Hussain, Shahid; Mir-Nasiri, Nazim; Ghayesh, Mergen H; Xie, Sheng Q

    2018-01-01

    This article explores wide-ranging potential of the wearable ankle robot for in-house rehabilitation. The presented robot has been conceptualized following a brief analysis of the existing technologies, systems, and solutions for in-house physical ankle rehabilitation. Configuration design analysis and component selection for ankle robot have been discussed as part of the conceptual design. The complexities of human robot interaction are closely encountered while maneuvering a rehabilitation robot. We present a fuzzy logic-based controller to perform the required robot-assisted ankle rehabilitation treatment. Designs of visual haptic interfaces have also been discussed, which will make the treatment interesting, and the subject will be motivated to exert more and regain lost functions rapidly. The complex nature of web-based communication between user and remotely sitting physiotherapy staff has also been discussed. A high-level software architecture appended with robot ensures user-friendly operations. This software is made up of three important components: patient-related database, graphical user interface (GUI), and a library of exercises creating virtual reality-specifically developed for ankle rehabilitation.

  16. The cognitive rehabilitation of limb apraxia in patients with stroke.

    Science.gov (United States)

    Cantagallo, Anna; Maini, Manuela; Rumiati, Raffaella Ida

    2012-01-01

    Apraxia is a higher level motor deficit that occurs when processing a goal-directed action. The apraxic deficit can manifest itself in absence of sensory input deficits or motor output deficits, neglect, frontal inertia or dementia. According to a clinical classification still largely in use, there are two main forms of limb apraxia: ideomotor (IMA) and ideational (IA), observed when a patient is required to imitate a gesture or use an object, respectively. In the present review, we examined only the cognitive treatments of both types of limb apraxia of a vascular aetiology. Despite the high prevalence of limb apraxia caused by left brain damage, and the fact that apraxia has been known for over a century, the literature regarding its rehabilitation is still very limited. This is partly due to the nature of the recovery from the deficit, and in part to the automatic-voluntary dissociation. Here we review those treatments that have proved most successful in helping patients to recover from limb apraxia.

  17. Computer-Based Cognitive Training in Aging.

    Science.gov (United States)

    Klimova, Blanka

    2016-01-01

    At present there is a rapid growth of aging population groups worldwide, which brings about serious economic and social problems. Thus, there is considerable effort to prolong the active life of these older people and keep them independent. The purpose of this mini review is to explore available clinical studies implementing computer-based cognitive training programs as intervention tools in the prevention and delay of cognitive decline in aging, with a special focus on their effectiveness. This was done by conducting a literature search in the databases Web of Science, Scopus, MEDLINE and Springer, and consequently by evaluating the findings of the relevant studies. The findings show that computerized cognitive training can lead to the improvement of cognitive functions such as working memory and reasoning skills in particular. However, this training should be performed over a longer time span since a short-term cognitive training mainly has an impact on short-term memory with temporary effects. In addition, the training must be intense to become effective. Furthermore, the results indicate that it is important to pay close attention to the methodological standards in future clinical studies.

  18. Rehabilitation Interventions to Promote Recovery from Schizophrenia: A Systematic Review

    Science.gov (United States)

    Morin, Laurent; Franck, Nicolas

    2017-01-01

    Only one out of seven patients recovers after a first episode of psychosis despite psychiatric care. Rehabilitation interventions have been developed to improve functional outcomes and to promote recovery. We conducted a systematic review of the effectiveness of the main psychiatric rehabilitation interventions following a search of the electronic databases Pubmed, ScienceDirect, and Google Scholar using combinations of terms relating to cognitive remediation, psychoeducation, cognitive-behavioral therapies, and schizophrenia. Eighty articles relevant to the topic of interest were found. According to results, cognitive remediation has been found to be effective in reducing the impact of cognitive impairment, social skills in the learning a variety of skills and to a lesser extent in reducing negative symptoms, psychoeducation in improving compliance and reducing relapses, and cognitive therapy in reducing the intensity of or distress related to positive symptoms. All psychosocial rehabilitation interventions should be considered as evidence-based practices for schizophrenia and need to become a major part of the standard treatment of the disease. PMID:28659832

  19. Rehabilitation Interventions to Promote Recovery from Schizophrenia: A Systematic Review

    Directory of Open Access Journals (Sweden)

    Laurent Morin

    2017-06-01

    Full Text Available Only one out of seven patients recovers after a first episode of psychosis despite psychiatric care. Rehabilitation interventions have been developed to improve functional outcomes and to promote recovery. We conducted a systematic review of the effectiveness of the main psychiatric rehabilitation interventions following a search of the electronic databases Pubmed, ScienceDirect, and Google Scholar using combinations of terms relating to cognitive remediation, psychoeducation, cognitive-behavioral therapies, and schizophrenia. Eighty articles relevant to the topic of interest were found. According to results, cognitive remediation has been found to be effective in reducing the impact of cognitive impairment, social skills in the learning a variety of skills and to a lesser extent in reducing negative symptoms, psychoeducation in improving compliance and reducing relapses, and cognitive therapy in reducing the intensity of or distress related to positive symptoms. All psychosocial rehabilitation interventions should be considered as evidence-based practices for schizophrenia and need to become a major part of the standard treatment of the disease.

  20. Comparison of focused cognitive training and portable "brain-games" on functional outcomes for vocational rehabilitation participants.

    Science.gov (United States)

    Bell, Morris D; Laws, Holly; Pittman, Brian; Johannesen, Jason K

    2018-01-29

    Cognitive remediation performed in a cognitive laboratory was compared with a sham control using portable brain games to study effects on vocational, neurocognitive, and functional outcomes for participants with psychotic disorders in vocational rehabilitation (VR). Seventy-seven participants (61% schizophrenia, 39% other psychosis) in transitional (45.5%) or supported employment (54.5%) were randomly assigned to 6 months of portable cognitive-games (CG) or cognitive remediation (CR) plus a weekly goal-setting group, and evaluated during training, post-training and at 12 months. Overall rates of employment did not differ significantly at 12-month follow-up; however, VR + CG attained employment more rapidly during training. A significant time by condition interaction favored VR + CR on Quality of Life Total Score and Instrumental Functioning over 12 months. Neurocognitive outcomes favored VR + CR, particularly on attention. Training hours related significantly to neurocognitive improvement regardless of condition. No differences were found in training adherence despite portability for VR + CG. Results indicate that VR + CR had significantly greater effect than VR + CG on neurocognition and community functioning, but not on employment outcome. Job attainment rates during the training period revealed a potential advantage for portable training raising new questions concerning how cognitive remediation can be most effectively integrated with VR.

  1. 75 FR 77624 - Office of Special Education and Rehabilitative Services Overview Information; National Institute...

    Science.gov (United States)

    2010-12-13

    ... DEPARTMENT OF EDUCATION Office of Special Education and Rehabilitative Services Overview... months. The Assistant Secretary for Special Education and Rehabilitative Services may change the maximum.... Alexa Posny, Assistant Secretary for Special Education and Rehabilitative Services. [FR Doc. 2010-31191...

  2. Prevalence of mild cognitive impairment in employable patients after acute coronary event in cardiac rehabilitation

    Directory of Open Access Journals (Sweden)

    Salzwedel A

    2017-02-01

    Full Text Available Annett Salzwedel,1 Maria-Dorothea Heidler,1,2 Kathrin Haubold,1 Martin Schikora,2 Rona Reibis,3 Karl Wegscheider,4 Michael Jöbges,2 Heinz Völler1,5 1Center for Rehabilitation Research, University of Potsdam, Potsdam, 2Brandenburg Klinik, Bernau, 3Cardiological Outpatient Clinic, Am Park Sanssouci, Potsdam, 4Institute for Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, 5Klinik am See, Rüdersdorf, Germany Introduction: Adequate cognitive function in patients is a prerequisite for successful implementation of patient education and lifestyle coping in comprehensive cardiac rehabilitation (CR programs. Although the association between cardiovascular diseases and cognitive impairments (CIs is well known, the prevalence particularly of mild CI in CR and the characteristics of affected patients have been insufficiently investigated so far. Methods: In this prospective observational study, 496 patients (54.5 ± 6.2 years, 79.8% men with coronary artery disease following an acute coronary event (ACE were analyzed. Patients were enrolled within 14 days of discharge from the hospital in a 3-week inpatient CR program. Patients were tested for CI using the Montreal Cognitive Assessment (MoCA upon admission to and discharge from CR. Additionally, sociodemographic, clinical, and physiological variables were documented. The data were analyzed descriptively and in a multivariate stepwise backward elimination regression model with respect to CI. Results: At admission to CR, the CI (MoCA score < 26 was determined in 182 patients (36.7%. Significant differences between CI and no CI groups were identified, and CI group was associated with high prevalence of smoking (65.9 vs 56.7%, P = 0.046, heavy (physically demanding workloads (26.4 vs 17.8%, P < 0.001, sick leave longer than 1 month prior to CR (28.6 vs 18.5%, P = 0.026, reduced exercise capacity (102.5 vs 118.8 W, P = 0.006, and a shorter 6-min walking distance

  3. User-centered virtual environment design for virtual rehabilitation

    Directory of Open Access Journals (Sweden)

    Rizzo Albert A

    2010-02-01

    Full Text Available Abstract Background As physical and cognitive rehabilitation protocols utilizing virtual environments transition from single applications to comprehensive rehabilitation programs there is a need for a new design cycle methodology. Current human-computer interaction designs focus on usability without benchmarking technology within a user-in-the-loop design cycle. The field of virtual rehabilitation is unique in that determining the efficacy of this genre of computer-aided therapies requires prior knowledge of technology issues that may confound patient outcome measures. Benchmarking the technology (e.g., displays or data gloves using healthy controls may provide a means of characterizing the "normal" performance range of the virtual rehabilitation system. This standard not only allows therapists to select appropriate technology for use with their patient populations, it also allows them to account for technology limitations when assessing treatment efficacy. Methods An overview of the proposed user-centered design cycle is given. Comparisons of two optical see-through head-worn displays provide an example of benchmarking techniques. Benchmarks were obtained using a novel vision test capable of measuring a user's stereoacuity while wearing different types of head-worn displays. Results from healthy participants who performed both virtual and real-world versions of the stereoacuity test are discussed with respect to virtual rehabilitation design. Results The user-centered design cycle argues for benchmarking to precede virtual environment construction, especially for therapeutic applications. Results from real-world testing illustrate the general limitations in stereoacuity attained when viewing content using a head-worn display. Further, the stereoacuity vision benchmark test highlights differences in user performance when utilizing a similar style of head-worn display. These results support the need for including benchmarks as a means of better

  4. User-centered virtual environment design for virtual rehabilitation.

    Science.gov (United States)

    Fidopiastis, Cali M; Rizzo, Albert A; Rolland, Jannick P

    2010-02-19

    As physical and cognitive rehabilitation protocols utilizing virtual environments transition from single applications to comprehensive rehabilitation programs there is a need for a new design cycle methodology. Current human-computer interaction designs focus on usability without benchmarking technology within a user-in-the-loop design cycle. The field of virtual rehabilitation is unique in that determining the efficacy of this genre of computer-aided therapies requires prior knowledge of technology issues that may confound patient outcome measures. Benchmarking the technology (e.g., displays or data gloves) using healthy controls may provide a means of characterizing the "normal" performance range of the virtual rehabilitation system. This standard not only allows therapists to select appropriate technology for use with their patient populations, it also allows them to account for technology limitations when assessing treatment efficacy. An overview of the proposed user-centered design cycle is given. Comparisons of two optical see-through head-worn displays provide an example of benchmarking techniques. Benchmarks were obtained using a novel vision test capable of measuring a user's stereoacuity while wearing different types of head-worn displays. Results from healthy participants who performed both virtual and real-world versions of the stereoacuity test are discussed with respect to virtual rehabilitation design. The user-centered design cycle argues for benchmarking to precede virtual environment construction, especially for therapeutic applications. Results from real-world testing illustrate the general limitations in stereoacuity attained when viewing content using a head-worn display. Further, the stereoacuity vision benchmark test highlights differences in user performance when utilizing a similar style of head-worn display. These results support the need for including benchmarks as a means of better understanding user outcomes, especially for patient

  5. An assistive controller for a lower-limb exoskeleton for rehabilitation after stroke, and preliminary assessment thereof.

    Science.gov (United States)

    Murray, Spencer A; Ha, Kevin H; Goldfarb, Michael

    2014-01-01

    This paper describes a novel controller, intended for use in a lower-limb exoskeleton, to aid gait rehabilitation in patients with hemiparesis after stroke. The controller makes use of gravity compensation, feedforward movement assistance, and reinforcement of isometric joint torques to achieve assistance without dictating the spatiotemporal nature of joint movement. The patient is allowed to self-select walking speed and is able to make trajectory adaptations to maintain balance without interference from the controller. The governing equations and the finite state machine which comprise the system are described herein. The control architecture was implemented in a lower-limb exoskeleton and a preliminary experimental assessment was conducted in which a patient with hemiparesis resulting from stroke walked with assistance from the exoskeleton. The patient exhibited improvements in fast gait speed, step length asymmetry, and stride length in each session, as measured before and after exoskeleton training, presumably as a result of using the exoskeleton.

  6. Rehabilitation Robots: Concepts and Applications in Stroke Rehabilitation

    OpenAIRE

    Mohammad Ali Ahmadi-Pajouh

    2017-01-01

    Robotics is a tool to assist human in different applications from industry to medicine. There are many reasons that human tends to use these machines. They are very reliable in repetitive, high precision, preprogrammed and high risk jobs in which human is not too good enough. In medicine, robotic applications are evolving so fast that in near future nobody can imagine a surgery without a robot involved. In Rehabilitation we have the same scenario; there are commercialized robots to assist dis...

  7. Computer assisted functional analysis. Computer gestuetzte funktionelle Analyse

    Energy Technology Data Exchange (ETDEWEB)

    Schmidt, H A.E.; Roesler, H

    1982-01-01

    The latest developments in computer-assisted functional analysis (CFA) in nuclear medicine are presented in about 250 papers of the 19th international annual meeting of the Society of Nuclear Medicine (Bern, September 1981). Apart from the mathematical and instrumental aspects of CFA, computerized emission tomography is given particular attention. Advances in nuclear medical diagnosis in the fields of radiopharmaceuticals, cardiology, angiology, neurology, ophthalmology, pulmonology, gastroenterology, nephrology, endocrinology, oncology and osteology are discussed.

  8. Place orientation and visual construction subdomains of the Mini Mental State Examination test as predictors of rehabilitation outcome of post-acute hip-fractured patients.

    Science.gov (United States)

    Hershkovitz, Avital; Kornyukov, Natalia; Brill, Shai

    2017-11-01

    construction may need more rehabilitation time as they lack planning and organizational capacity to follow instructions. Assessing MMSE subdomains may reveal subtle cognitive impairment in patients scored within the normal range on the MMSE test. Identifying subtle cognitive impairment may assist in coordinating the patients and their caregivers' expectations, efficiently allocating resources and help in advanced care planning.

  9. Connecting Neural Coding to Number Cognition: A Computational Account

    Science.gov (United States)

    Prather, Richard W.

    2012-01-01

    The current study presents a series of computational simulations that demonstrate how the neural coding of numerical magnitude may influence number cognition and development. This includes behavioral phenomena cataloged in cognitive literature such as the development of numerical estimation and operational momentum. Though neural research has…

  10. Cognitive computing and big data analytics

    CERN Document Server

    Hurwitz, Judith; Bowles, Adrian

    2015-01-01

    MASTER THE ABILITY TO APPLY BIG DATA ANALYTICS TO MASSIVE AMOUNTS OF STRUCTURED AND UNSTRUCTURED DATA Cognitive computing is a technique that allows humans and computers to collaborate in order to gain insights and knowledge from data by uncovering patterns and anomalies. This comprehensive guide explains the underlying technologies, such as artificial intelligence, machine learning, natural language processing, and big data analytics. It then demonstrates how you can use these technologies to transform your organization. You will explore how different vendors and different industries are a

  11. Toward computer-assisted diagnosis and telemedicine in ophthalmology

    Czech Academy of Sciences Publication Activity Database

    Marrugo, A.; Millán, M. S.; Cristóbal, G.; Gabarda, S.; Šorel, Michal; Šroubek, Filip

    2012-01-01

    Roč. 2012, č. 6 (2012), s. 1-3 ISSN 1818-2259 R&D Projects: GA MŠk 1M0572 Institutional research plan: CEZ:AV0Z10750506 Institutional support: RVO:67985556 Keywords : computer-aided diagnosis * medical and retinal image * deconvolution * telemedicine Subject RIV: JD - Computer Applications, Robotics http://library.utia.cas.cz/separaty/2012/ZOI/sorel-toward computer-assisted diagnosis and telemedicine in ophthalmology.pdf

  12. Cognitive behavioural therapy versus multidisciplinary rehabilitation treatment for patients with chronic fatigue syndrome: study protocol for a randomised controlled trial (FatiGo).

    Science.gov (United States)

    Vos-Vromans, Desirée C W M; Smeets, Rob J E M; Rijnders, Leonie J M; Gorrissen, René R M; Pont, Menno; Köke, Albère J A; Hitters, Minou W M G C; Evers, Silvia M A A; Knottnerus, André J

    2012-05-30

    Patients with chronic fatigue syndrome experience extreme fatigue, which often leads to substantial limitations of occupational, educational, social and personal activities. Currently, there is no consensus regarding the treatment. Patients try many different therapies to overcome their fatigue. Although there is no consensus, cognitive behavioural therapy is seen as one of the most effective treatments. Little is known about multidisciplinary rehabilitation treatment, a combination of cognitive behavioural therapy with principles of mindfulness, gradual increase of activities, body awareness therapy and pacing. The difference in effectiveness and cost-effectiveness between multidisciplinary rehabilitation treatment and cognitive behavioural therapy is as yet unknown. The FatiGo (Fatigue-Go) trial aims to compare the effects of both treatment approaches in outpatient rehabilitation on fatigue severity and quality of life in patients with chronic fatigue syndrome. One hundred twenty patients who meet the criteria of chronic fatigue syndrome, fulfil the inclusion criteria and sign the informed consent form will be recruited. Both treatments take 6 months to complete. The outcome will be assessed at 6 and 12 months after the start of treatment. Two weeks after the start of treatment, expectancy and credibility will be measured, and patients will be asked to write down their personal goals and score their current performance on these goals on a visual analogue scale. At 6 and 14 weeks after the start of treatment, the primary outcome and three potential mediators-self-efficacy, causal attributions and present-centred attention-awareness-will be measured. Primary outcomes are fatigue severity and quality of life. Secondary outcomes are physical activity, psychological symptoms, self-efficacy, causal attributions, impact of disease on emotional and physical functioning, present-centred attention-awareness, life satisfaction, patient personal goals, self-rated improvement

  13. A brain-computer interface to support functional recovery.

    Science.gov (United States)

    Kjaer, Troels W; Sørensen, Helge B

    2013-01-01

    Brain-computer interfaces (BCI) register changes in brain activity and utilize this to control computers. The most widely used method is based on registration of electrical signals from the cerebral cortex using extracranially placed electrodes also called electroencephalography (EEG). The features extracted from the EEG may, besides controlling the computer, also be fed back to the patient for instance as visual input. This facilitates a learning process. BCI allow us to utilize brain activity in the rehabilitation of patients after stroke. The activity of the cerebral cortex varies with the type of movement we imagine, and by letting the patient know the type of brain activity best associated with the intended movement the rehabilitation process may be faster and more efficient. The focus of BCI utilization in medicine has changed in recent years. While we previously focused on devices facilitating communication in the rather few patients with locked-in syndrome, much interest is now devoted to the therapeutic use of BCI in rehabilitation. For this latter group of patients, the device is not intended to be a lifelong assistive companion but rather a 'teacher' during the rehabilitation period. Copyright © 2013 S. Karger AG, Basel.

  14. Cardiovascular rehabilitation soon after stroke using feedback-controlled robotics-assisted treadmill exercise: study protocol of a randomised controlled pilot trial.

    Science.gov (United States)

    Stoller, Oliver; de Bruin, Eling D; Schuster-Amft, Corina; Schindelholz, Matthias; de Bie, Rob A; Hunt, Kenneth J

    2013-09-22

    After experiencing a stroke, most individuals also suffer from cardiac disease, are immobile and thus have low endurance for exercise. Aerobic capacity is seriously reduced in these individuals and does not reach reasonable levels after conventional rehabilitation programmes. Cardiovascular exercise is beneficial for improvement of aerobic capacity in mild to moderate stroke. However, less is known about its impact on aerobic capacity, motor recovery, and quality-of-life in severely impaired individuals. The aim of this pilot study is to explore the clinical efficacy and feasibility of cardiovascular exercise with regard to aerobic capacity, motor recovery, and quality-of-life using feedback-controlled robotics-assisted treadmill exercise in non-ambulatory individuals soon after experiencing a stroke. This will be a single-centred single blind, randomised control trial with a pre-post intervention design. Subjects will be recruited early after their first stroke (≤20 weeks) at a neurological rehabilitation clinic and will be randomly allocated to an inpatient cardiovascular exercise programme that uses feedback-controlled robotics-assisted treadmill exercise (experimental) or to conventional robotics-assisted treadmill exercise (control). Intervention duration depends on the duration of each subject's inpatient rehabilitation period. Aerobic capacity, as the primary outcome measure, will be assessed using feedback-controlled robotics-assisted treadmill-based cardiopulmonary exercise testing. Secondary outcome measures will include gait speed, walking endurance, standing function, and quality-of-life. Outcome assessment will be conducted at baseline, after each 4-week intervention period, and before clinical discharge. Ethical approval has been obtained. Whether cardiovascular exercise in non-ambulatory individuals early after stroke has an impact on aerobic capacity, motor recovery, and quality-of-life is not yet known. Feedback-controlled robotics-assisted

  15. Using data from Multidimensional Pain Inventory subscales to assess functioning in pain rehabilitation

    DEFF Research Database (Denmark)

    Harlacher, Uwe; Persson, Ann L; Rivano-Fischer, Marcelo

    2011-01-01

    The aim of this study was to examine whether Multidimensional Pain Inventory (MPI) subscale score changes can be used for monitoring interdisciplinary cognitive behavioural pain rehabilitation programmes, using the Psychological General Well-Being (PGWB) index as an independent variable...... of rehabilitation outcome. Data from 434 consecutively referred patients disabled by chronic pain were analysed. The intervention was a 4-week interdisciplinary pain rehabilitation group programme (5 h/day), based on biopsychosocial and cognitive behavioural principles. Mean PGWB total scores improved after...... rehabilitation (P...

  16. Predictors of change in life skills in schizophrenia after cognitive remediation.

    Science.gov (United States)

    Kurtz, Matthew M; Seltzer, James C; Fujimoto, Marco; Shagan, Dana S; Wexler, Bruce E

    2009-02-01

    Few studies have investigated predictors of response to cognitive remediation interventions in patients with schizophrenia. Predictor studies to date have selected treatment outcome measures that were either part of the remediation intervention itself or closely linked to the intervention with few studies investigating factors that predict generalization to measures of everyday life-skills as an index of treatment-related improvement. In the current study we investigated the relationship between four measures of neurocognitive function, crystallized verbal ability, auditory sustained attention and working memory, verbal learning and memory, and problem-solving, two measures of symptoms, total positive and negative symptoms, and the process variables of treatment intensity and duration, to change on a performance-based measure of everyday life-skills after a year of computer-assisted cognitive remediation offered as part of intensive outpatient rehabilitation treatment. Thirty-six patients with schizophrenia or schizoaffective disorder were studied. Results of a linear regression model revealed that auditory attention and working memory predicted a significant amount of the variance in change in performance-based measures of everyday life skills after cognitive remediation, even when variance for all other neurocognitive variables in the model was controlled. Stepwise regression revealed that auditory attention and working memory predicted change in everyday life-skills across the trial even when baseline life-skill scores, symptoms and treatment process variables were controlled. These findings emphasize the importance of sustained auditory attention and working memory for benefiting from extended programs of cognitive remediation.

  17. Rehabilitation robotics.

    Science.gov (United States)

    Krebs, H I; Volpe, B T

    2013-01-01

    This chapter focuses on rehabilitation robotics which can be used to augment the clinician's toolbox in order to deliver meaningful restorative therapy for an aging population, as well as on advances in orthotics to augment an individual's functional abilities beyond neurorestoration potential. The interest in rehabilitation robotics and orthotics is increasing steadily with marked growth in the last 10 years. This growth is understandable in view of the increased demand for caregivers and rehabilitation services escalating apace with the graying of the population. We provide an overview on improving function in people with a weak limb due to a neurological disorder who cannot properly control it to interact with the environment (orthotics); we then focus on tools to assist the clinician in promoting rehabilitation of an individual so that s/he can interact with the environment unassisted (rehabilitation robotics). We present a few clinical results occurring immediately poststroke as well as during the chronic phase that demonstrate superior gains for the upper extremity when employing rehabilitation robotics instead of usual care. These include the landmark VA-ROBOTICS multisite, randomized clinical study which demonstrates clinical gains for chronic stroke that go beyond usual care at no additional cost. Copyright © 2013 Elsevier B.V. All rights reserved.

  18. Cognitive rehabilitation and mindfulness in multiple sclerosis (REMIND-MS): a study protocol for a randomised controlled trial.

    Science.gov (United States)

    Nauta, Ilse M; Speckens, Anne E M; Kessels, Roy P C; Geurts, Jeroen J G; de Groot, Vincent; Uitdehaag, Bernard M J; Fasotti, Luciano; de Jong, Brigit A

    2017-11-21

    Cognitive problems frequently occur in patients with multiple sclerosis (MS) and profoundly affect their quality of life. So far, the best cognitive treatment options for MS patients are a matter of debate. Therefore, this study aims to investigate the effectiveness of two promising non-pharmacological treatments: cognitive rehabilitation therapy (CRT) and mindfulness-based cognitive therapy (MBCT). Furthermore, this study aims to gain additional knowledge about the aetiology of cognitive problems among MS patients, since this may help to develop and guide effective cognitive treatments. In a dual-centre, single-blind randomised controlled trial (RCT), 120 MS patients will be randomised into one of three parallel groups: CRT, MBCT or enhanced treatment as usual (ETAU). Both CRT and MBCT consist of a structured 9-week program. ETAU consists of one appointment with an MS specialist nurse. Measurements will be performed at baseline, post-intervention and 6 months after the interventions. The primary outcome measure is the level of subjective cognitive complaints. Secondary outcome measures are objective cognitive function, functional brain network measures (using magnetoencephalography), psychological symptoms, well-being, quality of life and daily life functioning. To our knowledge, this will be the first RCT that investigates the effect of MBCT on cognitive function among MS patients. In addition, studying the effect of CRT on cognitive function may provide direction to the contradictory evidence that is currently available. This study will also provide information on changes in functional brain networks in relation to cognitive function. To conclude, this study may help to understand and treat cognitive problems among MS patients. This trial was prospectively registered at the Dutch Trial Registration (number NTR6459 , registered on 31 May 2017).

  19. Using RFID Positioning Technology to Construct an Automatic Rehabilitation Scheduling Mechanism.

    Science.gov (United States)

    Wang, Ching-Sheng; Hung, Lun-Ping; Yen, Neil Y

    2016-01-01

    Accurately and efficiently identifying the location of patients during the course of rehabilitation is an important issue. Wireless transmission technology can reach this goal. Tracking technologies such as RFID (Radio frequency identification) can support process improvement and improve efficiencies of rehabilitation. There are few published models or methods to solve the problem of positioning and apply this technology in the rehabilitation center. We propose a mechanism to enhance the accuracy of positioning technology and provide information about turns and obstacles on the path; and user-centered services based on location-aware to enhanced quality care in rehabilitation environment. This paper outlines the requirements and the role of RFID in assisting rehabilitation environment. A prototype RFID hospital support tool is established. It is designed to provide assistance for monitoring rehabilitation patients. It can simultaneously calculate the rehabilitant's location and the duration of treatment, and automatically record the rehabilitation course of the rehabilitant, so as to improve the management efficiency of the rehabilitation program.

  20. An Overview of Recent Developments in Cognitive Diagnostic Computer Adaptive Assessments

    Directory of Open Access Journals (Sweden)

    Alan Huebner

    2010-01-01

    Full Text Available Cognitive diagnostic modeling has become an exciting new field of psychometric research. These models aim to diagnose examinees' mastery status of a group of discretely defined skills, or attributes, thereby providing them with detailed information regarding their specific strengths and weaknesses. Combining cognitive diagnosis with computer adaptive assessments has emerged as an important part of this new field. This article aims to provide practitioners and researchers with an introduction to and overview of recent developments in cognitive diagnostic computer adaptive assessments.

  1. [Intelligent operating room suite : From passive medical devices to the self-thinking cognitive surgical assistant].

    Science.gov (United States)

    Kenngott, H G; Wagner, M; Preukschas, A A; Müller-Stich, B P

    2016-12-01

    Modern operating room (OR) suites are mostly digitally connected but until now the primary focus was on the presentation, transfer and distribution of images. Device information and processes within the operating theaters are barely considered. Cognitive assistance systems have triggered a fundamental rethinking in the automotive industry as well as in logistics. In principle, tasks in the OR, some of which are highly repetitive, also have great potential to be supported by automated cognitive assistance via a self-thinking system. This includes the coordination of the entire workflow in the perioperative process in both the operating theater and the whole hospital. With corresponding data from hospital information systems, medical devices and appropriate models of the surgical process, intelligent systems could optimize the workflow in the operating theater in the near future and support the surgeon. Preliminary results on the use of device information and automatically controlled OR suites are already available. Such systems include, for example the guidance of laparoscopic camera systems. Nevertheless, cognitive assistance systems that make use of knowledge about patients, processes and other pieces of information to improve surgical treatment are not yet available in the clinical routine but are urgently needed in order to automatically assist the surgeon in situation-related activities and thus substantially improve patient care.

  2. Video games and rehabilitation: using design principles to enhance engagement in physical therapy.

    Science.gov (United States)

    Lohse, Keith; Shirzad, Navid; Verster, Alida; Hodges, Nicola; Van der Loos, H F Machiel

    2013-12-01

    Patient nonadherence with therapy is a major barrier to rehabilitation. Recovery is often limited and requires prolonged, intensive rehabilitation that is time-consuming, expensive, and difficult. We review evidence for the potential use of video games in rehabilitation with respect to the behavioral, physiological, and motivational effects of gameplay. In this Special Interest article, we offer a method to evaluate effects of video game play on motor learning and their potential to increase patient engagement with therapy, particularly commercial games that can be interfaced with adapted control systems. We take the novel approach of integrating research across game design, motor learning, neurophysiology changes, and rehabilitation science to provide criteria by which therapists can assist patients in choosing games appropriate for rehabilitation. Research suggests that video games are beneficial for cognitive and motor skill learning in both rehabilitation science and experimental studies with healthy subjects. Physiological data suggest that gameplay can induce neuroplastic reorganization that leads to long-term retention and transfer of skill; however, more clinical research in this area is needed. There is interdisciplinary evidence suggesting that key factors in game design, including choice, reward, and goals, lead to increased motivation and engagement. We maintain that video game play could be an effective supplement to traditional therapy. Motion controllers can be used to practice rehabilitation-relevant movements, and well-designed game mechanics can augment patient engagement and motivation in rehabilitation. We recommend future research and development exploring rehabilitation-relevant motions to control games and increase time in therapy through gameplay.Video Abstract available (see Video, Supplemental Digital Content 1, http://links.lww.com/JNPT/A61) for more insights from the authors.

  3.   Indirect versus direct feedback in computer-based Prism Adaptation Therapy

    DEFF Research Database (Denmark)

    Wilms, Inge Linda; Rytter, Hana Malá

    2010-01-01

      Prism Adaptation Therapy (PAT) is an intervention method in the treatment of the attention disorder neglect (Frassinetti, Angeli, Meneghello, Avanzi, & Ladavas, 2002; Rossetti, et al., 1998). The aim of this study was to investigate whether one session of PAT using a computer-attached touchscreen...... have direct implications for future implementations of computer-based methods of treatment of visuospatial disorders and computer-assisted rehabilitation in general....

  4. Indirect versus direct feedback in computer-based Prism Adaptation Therapy

    DEFF Research Database (Denmark)

    Wilms, Inge Linda; Rytter, Hana Malá

    2010-01-01

    Prism Adaptation Therapy (PAT) is an intervention method in the treatment of the attention disorder neglect (Frassinetti, Angeli, Meneghello, Avanzi, & Ladavas, 2002; Rossetti, et al., 1998). The aim of this study was to investigate whether one session of PAT using a computer-attached touchscreen...... in the aftereffect. The findings have direct implications for future implementations of computer-based methods of treatment of visuospatial disorders and computer-assisted rehabilitation in general....

  5. Not just fun and games: applications of virtual reality in the identification and rehabilitation of cognitive disorders of the elderly.

    Science.gov (United States)

    Cherniack, E Paul

    2011-01-01

    To outline the evidence in the published medical literature suggesting the potential applications of virtual reality (VR) for the identification and rehabilitation of cognitive disorders of the elderly. Non-systematic literature review. VR, despite its more common usage by younger persons, is a potentially promising source of techniques useful in the identification and rehabilitation of cognitive disorders of the elderly. Systems employing VR can include desktop and head-mounted visual displays among other devices. Thus far, published studies have described VR-based applications in the identification and treatment of deficits in navigational skills in ambulation and driving. In addition, VR has been utilised to enhance the ability to perform activities of daily living in patients with dementia, stroke, and Parkinson's Disease. Such investigations have thus far been small, and unblinded. VR-based applications can potentially offer more versatile, comprehensive, and safer assessments of function. However, they also might be more expensive, complex and more difficult to use by elderly patients. Side effects of head-mounted visual displays include nausea and disorientation, but, have not been reported specifically in older subjects.

  6. The Evolution of Computer Based Learning Software Design: Computer Assisted Teaching Unit Experience.

    Science.gov (United States)

    Blandford, A. E.; Smith, P. R.

    1986-01-01

    Describes the style of design of computer simulations developed by Computer Assisted Teaching Unit at Queen Mary College with reference to user interface, input and initialization, input data vetting, effective display screen use, graphical results presentation, and need for hard copy. Procedures and problems relating to academic involvement are…

  7. On the throughput of cognitive radio MIMO systems assisted with UAV relays

    KAUST Repository

    Sboui, Lokman; Ghazzai, Hakim; Rezki, Zouheir; Alouini, Mohamed-Slim

    2017-01-01

    We analyze the achievable rates of a cognitive radio MIMO system assisted by an unmanned aerial vehicle (UAV) relay. The primary user (PU) and the secondary user (SU) aim to communicate to the closest primary base station (BS) via a multi

  8. Computer-assisted indexing for the INIS database

    International Nuclear Information System (INIS)

    Nevyjel, A.

    2006-01-01

    INIS has identified computer-assisted indexing as areas where information technology could assist best in maintaining database quality and indexing consistency, while containing production costs. Subject analysis is a very important but also very expensive process in the production of the INIS database. Given the current necessity to process an increased number of records, including subject analysis, without additional staff, INIS as well as the member states need improvements in their processing efficiency. Computer assisted subject analysis is a promising way to achieve this. The quality of the INIS database is defined by its inputting rules. The Thesaurus is a terminological control device used in translating from the natural language of documents, indexers or users into a more constrained system language. It is a controlled and dynamic vocabulary of semantically and generically related terms. It is the essential tool for subject analysis as well as for advanced search engines. To support the identification of descriptors in the free text (title, abstract, free keywords) 'hidden terms' have been introduced as extension of the Thesaurus, which identify phrases or character strings of free text and point to the valid descriptor, which should be suggested. In the process of computer-assisted subject analysis the bibliographic records (including title and abstract) are analyzed by the software, resulting in a list of suggested descriptors. Within the working platform (graphical user interface) the suggested descriptors are sorted by importance (by their relevance for the content of the document) and the subject specialist clearly sees the highlighted context from which the terms were selected. The system allows the subject specialist to accept or reject descriptors from the suggested list and to assign additional descriptors when necessary. First experiences show that a performance enhancement of about 80-100% can be achieved in the subject analysis process. (author)

  9. Does reduced movement restrictions and use of assistive devices affect rehabilitation outcome after total hip replacement?

    DEFF Research Database (Denmark)

    Mikkelsen, Lone Ramer; Petersen, Annemette Krintel; Søballe, Kjeld

    2014-01-01

    slower recovery in patient-reported function after reduction in movement restrictions and use of assistive devices, but the difference was eliminated after 6 weeks. Reduced movement restrictions did not affect the other patient-reported outcomes and led to earlier return to work. CLINICAL REHABILITATION......). This group was compared to patients included the following 3 months with less restricted hip movement and use of assistive devices according to individual needs (unrestricted group). Questionnaires on function, pain, quality of life (HOOS), anxiety (HADS), working status and patient satisfaction were.......004). Return to work 6 weeks after THR for the unrestricted group compared to restricted group was: 53% versus 32% (P=0.045). No significant differences between groups in pain, symptoms, quality of life, anxiety/depression, hip dislocations and patient satisfaction. CONCLUSION: This study showed slightly...

  10. Neuropsychological rehabilitation for traumatic brain injury patients

    Directory of Open Access Journals (Sweden)

    Marzena Chantsoulis

    2015-05-01

    Full Text Available The aim of this review is to discuss the basic forms of neuropsychological rehabilitation for patients with traumatic brain injury (TBI. More broadly, we discussed cognitive rehabilitation therapy (CRT which constitutes a fundamental component in therapeutic interaction at many centres worldwide. Equally presented is a comprehensive model of rehabilitation, the fundamental component of which is CRT. It should be noted that the principles of this approach first arose in Poland in the 1970s, in other words, several decades before their appearance in other programmemes. Taken into consideration are four factors conditioning the effectiveness of such a process: comprehensiveness, earlier interaction, universality and its individualized character. A comprehensive programmeme of rehabilitation covers: cognitive rehabilitation, individual and group rehabilitation with the application of a therapeutic environment, specialist vocational rehabilitation, as well as family psychotherapy. These training programmemes are conducted within the scope of the ‘Academy of Life,’ which provides support for the patients in their efforts and shows them the means by which they can overcome existing difficulties. Equally emphasized is the close cooperation of the whole team of specialists, as well as the active participation of the family as an essential condition for the effectiveness of rehabilitation and, in effect, a return of the patient to a relatively normal life. Also presented are newly developing neurothechnologies and the neuromarkers of brain injuries. This enables a correct diagnosis to be made and, as a result, the selection of appropriate methods for neuropsychological rehabilitation, including neurotherapy.

  11. Characterizing speech and language pathology outcomes in stroke rehabilitation.

    Science.gov (United States)

    Hatfield, Brooke; Millet, Deborah; Coles, Janice; Gassaway, Julie; Conroy, Brendan; Smout, Randall J

    2005-12-01

    Hatfield B, Millet D, Coles J, Gassaway J, Conroy B, Smout RJ. Characterizing speech and language pathology outcomes in stroke rehabilitation. To describe a subset of speech-language pathology (SLP) patients in the Post-Stroke Rehabilitation Outcomes Project and to examine outcomes for patients with low admission FIM levels of auditory comprehension and verbal expression. Observational cohort study. Five inpatient rehabilitation hospitals. Patients (N=397) receiving post-stroke SLP with admission FIM cognitive components at levels 1 through 5. Not applicable. Increase in comprehension and expression FIM scores from admission to discharge. Cognitively and linguistically complex SLP activities (problem-solving and executive functioning skills) were associated with greater likelihood of success in low- to mid-level functioning communicators in the acute post-stroke rehabilitation period. The results challenge common clinical practice by suggesting that use of high-level cognitively and linguistically complex SLP activities early in a patient's stay may result in more efficient practice and better outcomes regardless of the patient's functional communication severity level on admission.

  12. HISTORY OF NEUROPSYCHOLOGICAL REHABILITATION

    Directory of Open Access Journals (Sweden)

    N. A. Varako

    2014-01-01

    Full Text Available ABSTRACT. The article reviews the history of neuropsychological rehabilitation. It begins with the description of first rehabilitation programs developed by Paul Broca and Shepherd Franz. Franz’s experimental work for motor recovery in monkeys and correlation between active movement or affected limb immobilization and rehabilitation outcomes are described in further details. Special focus is given on ideas of famous German neurologist and psychiatrist Kurt Goldstein, who laid the foundation for modern approach in rehabilitation. Goldstein developed the idea of connection between rehabilitation and patient’s daily life. He also pointed out the necessity of psychological care of patients with brain damage.Russian neuropsychological approach is presented by its founders L.S. Vygotskiy and A.R. Luriya. Aspects of higher mental processes structure and options of its correction such as “cognitive prosthesis” are described in the sense of the approach.Y. Ben-Yishay, G. Prigatano, B. Wilson represent neuropsychological rehabilitation of the second half of the 20th century. The idea of a holistic approach for rehabilitation consists of such important principles as patient’s active involvement in a process of rehabilitation, work of a special team of rehabilitation professionals, inclusion of patient’s family members. The short review of a new rehabilitation approach for patients in coma, vegetative states and critical patients under resuscitation is given. 

  13. The effectiveness of ICT-based neurocognitive and psychosocial rehabilitation programmes in people with mild dementia and mild cognitive impairment using GRADIOR and ehcoBUTLER: study protocol for a randomised controlled trial.

    Science.gov (United States)

    Vanova, Martina; Irazoki, Eider; García-Casal, J Antonio; Martínez-Abad, Fernando; Botella, Cristina; Shiells, Kate R; Franco-Martín, Manuel A

    2018-02-12

    Cognitive rehabilitation is a highly individualised, non-pharmacological intervention for people with mild cognitive impairment (MCI) and dementia, which in recent years has also been developed for various IT platforms. In this study, we aim to evaluate the effectiveness of the cognitive rehabilitation software GRADIOR in a multi-centre, single-blinded randomised controlled trial with people with MCI and mild dementia. A total of 400 people with MCI and mild dementia will be randomly allocated to one of four groups. This trial will compare the cognitive rehabilitation treatment using the GRADIOR programme with a psychosocial stimulation intervention (PSS) using the ehcoBUTLER platform, with a combined treatment consisting of GRADIOR and ehcoBUTLER, and with a group receiving treatment as usual during a period of 1 year. The outcomes of this clinical trial will be to determine any relevant changes in cognition, mood, quality of life, activities of daily living and quality of patient-carer relationship after 4 months and 1 year of intervention in a cross-sectional group comparison. Participants will be followed-up for 1 year to investigate potential long-term effects of the conducted treatments. Current Controlled Trials ISRCTN, ID: 15742788 . Registered on 12 June 2017.

  14. The Mini-Mental State Examination and Montreal Cognitive Assessment in persons with mild subacute stroke: relationship to functional outcome.

    Science.gov (United States)

    Toglia, Joan; Fitzgerald, Kerri A; O'Dell, Michael W; Mastrogiovanni, Andrea R; Lin, C David

    2011-05-01

    To compare Montreal Cognitive Assessment (MoCA) and Mini-Mental State Examination (MMSE) global and subscores in classifying cognitive impairment in persons with mild stroke and to explore the relationship between admission and discharge functional status and improvement. Retrospective analysis of data. Acute rehabilitation unit of a large urban university-affiliated hospital. Inpatients with stroke (N=72; mean age, 70y; median time poststroke, 8.5d) and mild neurologic (median National Institutes of Health Stroke Scale score, 4) and cognitive deficits (median MMSE score, 25). Not applicable. Admission cognitive status was assessed by using the MMSE and MoCA. The motor subscale of the FIM instrument (mFIM) and motor relative functional efficiency was used to assess discharge functional status and improvement. The MoCA classified more persons as cognitively impaired than the MMSE (89% vs 63%, respectively; using a cutoff score of 27 on the MMSE and 26 on the MoCA). The MoCA also showed less of a ceiling effect than the MMSE, higher internal reliability (Cronbach α=.78 compared with α=.60), and marginally stronger associations with discharge functional status (r=.40; P<.001) than the MMSE (r=0.30; P<.05). The MoCA visuoexecutive subscore was the strongest predictor of functional status (P=.01) and improvement (P=.02) in global and subscores for both tests. The MoCA may be an important cognitive screening tool for persons with stroke and mild cognitive dysfunction on an acute rehabilitation unit. Lower visuoexecutive subscores may assist in identifying persons at risk for decreased functional gains in self-care and mobility (mFIM) during inpatient rehabilitation. The findings justify further validation studies of the MoCA in persons with subacute stroke. Copyright © 2011 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  15. Innovative Partnerships Assist Community College Computing Programs.

    Science.gov (United States)

    O'Banion, Terry

    1987-01-01

    Relates efforts of major corporations in providing assistance to community college computing programs. Explains the goals of the League for Innovation in the Community College, a consortium of 19 community colleges, and cites examples of collaborative projects. (ML)

  16. Influence of complementing a robotic upper limb rehabilitation system with video games on the engagement of the participants: a study focusing on muscle activities.

    Science.gov (United States)

    Li, Chong; Rusák, Zoltán; Horváth, Imre; Ji, Linhong

    2014-12-01

    Efficacious stroke rehabilitation depends not only on patients' medical treatment but also on their motivation and engagement during rehabilitation exercises. Although traditional rehabilitation exercises are often mundane, technology-assisted upper-limb robotic training can provide engaging and task-oriented training in a natural environment. The factors that influence engagement, however, are not fully understood. This paper therefore studies the relationship between engagement and muscle activities as well as the influencing factors of engagement. To this end, an experiment was conducted using a robotic upper limb rehabilitation system with healthy individuals in three training exercises: (a) a traditional exercise, which is typically used for training the grasping function, (b) a tracking exercise, currently used in robot-assisted stroke patient rehabilitation for fine motor movement, and (c) a video game exercise, which is a proliferating approach of robot-assisted rehabilitation enabling high-level active engagement of stroke patients. These exercises differ not only in the characteristics of the motion that they use but also in their method of triggering engagement. To measure the level of engagement, we used facial expressions, motion analysis of the arm movements, and electromyography. The results show that (a) the video game exercise could engage the participants for a longer period than the other two exercises, (b) the engagement level decreased when the participants became too familiar with the exercises, and (c) analysis of normalized root mean square in electromyographic data indicated that muscle activities were more intense when the participants are engaged. This study shows that several sub-factors on engagement, such as versatility of feedback, cognitive tasks, and competitiveness, may influence engagement more than the others. To maintain a high level of engagement, the rehabilitation system needs to be adaptive, providing different exercises to

  17. Utility of functional status for classifying community versus institutional discharges after inpatient rehabilitation for stroke.

    Science.gov (United States)

    Reistetter, Timothy A; Graham, James E; Deutsch, Anne; Granger, Carl V; Markello, Samuel; Ottenbacher, Kenneth J

    2010-03-01

    To evaluate the ability of patient functional status to differentiate between community and institutional discharges after rehabilitation for stroke. Retrospective cross-sectional design. Inpatient rehabilitation facilities contributing to the Uniform Data System for Medical Rehabilitation. Patients (N=157,066) receiving inpatient rehabilitation for stroke from 2006 and 2007. Not applicable. Discharge FIM rating and discharge setting (community vs institutional). Approximately 71% of the sample was discharged to the community. Receiver operating characteristic curve analyses revealed that FIM total performed as well as or better than FIM motor and FIM cognition subscales in differentiating discharge settings. Area under the curve for FIM total was .85, indicating very good ability to identify persons discharged to the community. A FIM total rating of 78 was identified as the optimal cut point for distinguishing between positive (community) and negative (institution) tests. This cut point yielded balanced sensitivity and specificity (both=.77). Discharge planning is complex, involving many factors. Identifying a functional threshold for classifying discharge settings can provide important information to assist in this process. Additional research is needed to determine if the risks and benefits of classification errors justify shifting the cut point to weight either sensitivity or specificity of FIM ratings. Copyright 2010 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  18. Sit to stand activity during stroke rehabilitation.

    Science.gov (United States)

    Kerr, Andy; Dawson, Jesse; Robertson, Chris; Rowe, Philip; Quinn, Terence J

    2017-12-01

    Objectives The sit to stand (STS) movement is key to independence and commonly affected by stroke. Repetitive practice is likely to improve STS ability during rehabilitation, however current practice levels are unknown. The objective of this study was simply to count the number of STS movements performed during the rehabilitation period of stroke patients using a physical activity monitor (PAM) and test whether being observed altered outcome. Methods Participants were medically stable patients referred for rehabilitation following stroke. Participants were randomly allocated to either wear or not wear the PAM for 14 days. STS ability and general mobility were recorded before and after. Results Sixty-one patients was recruited; aged 68.4 ± 13.15 years, weight 77.12 ± 22.73 Kg, Height 1.67 ± 0.1 m, within 9 ± 9 days of their stroke and an NIHSS score of 6.4 ± 3.3. The monitored group (n = 38) performed 25.00 ± 17.24 daily STS movements. Those requiring assistance achieved 14.29 ± 16.10 per day while those independent in the movement achieved 34.10 ± 12.44. There was an overall improvement in mobility (p = 0.002) but not STS performance (p = 0.053) neither outcome was affected by group allocation (p = 0.158). Cognition and mobility at baseline explained around 50% of daily STS variability. Discussion Low levels of STS activity were recorded during the rehabilitation period of stroke patient. The mean daily STS activity was lower than reports for frail older people receiving rehabilitation, and substantially below levels recorded by community living older adults. STS repetitions may represent general physical activity and these low levels support previous reports of sedentary behavior during rehabilitation.

  19. The Computational and Neural Basis of Cognitive Control: Charted Territory and New Frontiers

    Science.gov (United States)

    Botvinick, Matthew M.; Cohen, Jonathan D.

    2014-01-01

    Cognitive control has long been one of the most active areas of computational modeling work in cognitive science. The focus on computational models as a medium for specifying and developing theory predates the PDP books, and cognitive control was not one of the areas on which they focused. However, the framework they provided has injected work on…

  20. Accurate measurement of surface areas of anatomical structures by computer-assisted triangulation of computed tomography images

    Energy Technology Data Exchange (ETDEWEB)

    Allardice, J.T.; Jacomb-Hood, J.; Abulafi, A.M.; Williams, N.S. (Royal London Hospital (United Kingdom)); Cookson, J.; Dykes, E.; Holman, J. (London Hospital Medical College (United Kingdom))

    1993-05-01

    There is a need for accurate surface area measurement of internal anatomical structures in order to define light dosimetry in adjunctive intraoperative photodynamic therapy (AIOPDT). The authors investigated whether computer-assisted triangulation of serial sections generated by computed tomography (CT) scanning can give an accurate assessment of the surface area of the walls of the true pelvis after anterior resection and before colorectal anastomosis. They show that the technique of paper density tessellation is an acceptable method of measuring the surface areas of phantom objects, with a maximum error of 0.5%, and is used as the gold standard. Computer-assisted triangulation of CT images of standard geometric objects and accurately-constructed pelvic phantoms gives a surface area assessment with a maximum error of 2.5% compared with the gold standard. The CT images of 20 patients' pelves have been analysed by computer-assisted triangulation and this shows the surface area of the walls varies from 143 cm[sup 2] to 392 cm[sup 2]. (Author).

  1. 77 FR 39498 - Guidances for Industry and Food and Drug Administration Staff: Computer-Assisted Detection...

    Science.gov (United States)

    2012-07-03

    ...] Guidances for Industry and Food and Drug Administration Staff: Computer-Assisted Detection Devices Applied... Clinical Performance Assessment: Considerations for Computer-Assisted Detection Devices Applied to... guidance, entitled ``Computer-Assisted Detection Devices Applied to Radiology Images and Radiology Device...

  2. Computer-Assisted Instruction and Continuing Motivation.

    Science.gov (United States)

    Mosley, Mary Lou; And Others

    Effects of two feedback conditions--comment and no comment--on the motivation of sixth grade students to continue with computer assisted instruction (CAI) were investigated, and results for boys and for girls were compared. Subjects were 62 students--29 boys and 33 girls--from a suburban elementary school who were randomly assigned to the comment…

  3. Cognitively oriented behavioral rehabilitation in combination with Qigong for patients on long-term sick leave because of burnout: REST--a randomized clinical trial.

    Science.gov (United States)

    Stenlund, Therese; Ahlgren, Christina; Lindahl, Bernt; Burell, Gunilla; Steinholtz, Katarina; Edlund, Curt; Nilsson, Leif; Knutsson, Anders; Birgander, Lisbeth Slunga

    2009-01-01

    Despite an increase in the occurrence of burnout, there is no agreement on what kind of rehabilitation these patients should be offered. Primary aim of this study was to evaluate effects on psychological variables and sick leave rates by two different group rehabilitation programs for patients on long-term sick leave because of burnout. Rehabilitation program A (Cognitively oriented Behavioral Rehabilitation (CBR) and Qigong) was compared with rehabilitation program B (Qigong only). In a randomized clinical trial, 96 women and 40 men with a mean age of 41.6 +/- 7.4 years were allocated to one of the two rehabilitation programs. A per-protocol analysis showed no significant difference in treatment efficacy between the groups. Both groups improved significantly over time with reduced levels of burnout, self-rated stress behavior, fatigue, depression, anxiety, obsessive-compulsive symptoms, and sick leave rates. In an intention-to-treat analysis, patients in program A had fewer obsessive-compulsive symptoms and larger effect sizes in self-rated stress behavior and obsessive-compulsive symptoms compared to patients in program B. This study showed no differences in effect between CBR and Qigong compared with Qigong only in a per-protocol analysis. Both rehabilitation programs showed positive effect for patients with burnout.

  4. Enhancing Assisted Living Technology with Extended Visual Memory

    Directory of Open Access Journals (Sweden)

    Joo-Hwee Lim

    2011-05-01

    Full Text Available Human vision and memory are powerful cognitive faculties by which we understand the world. However, they are imperfect and further, subject to deterioration with age. We propose a cognitive-inspired computational model, Extended Visual Memory (EVM, within the Computer-Aided Vision (CAV framework, to assist human in vision-related tasks. We exploit wearable sensors such as cameras, GPS and ambient computing facilities to complement a user's vision and memory functions by answering four types of queries central to visual activities, namely, Retrieval, Understanding, Navigation and Search. Learning of EVM relies on both frequency-based and attention-driven mechanisms to store view-based visual fragments (VF, which are abstracted into high-level visual schemas (VS, both in the visual long-term memory. During inference, the visual short-term memory plays a key role in visual similarity computation between input (or its schematic representation and VF, exemplified from VS when necessary. We present an assisted living scenario, termed EViMAL (Extended Visual Memory for Assisted Living, targeted at mild dementia patients to provide novel functions such as hazard-warning, visual reminder, object look-up and event review. We envisage EVM having the potential benefits in alleviating memory loss, improving recall precision and enhancing memory capacity through external support.

  5. Rehabilitation technology services and employment outcomes among consumers using division of rehabilitation services.

    Science.gov (United States)

    Sprong, Matthew Evan; Dallas, Bryan; Paul, Erina; Xia, Michelle

    2018-05-03

    The primary goal of the study was to evaluate how the use of rehabilitation technology impacted closure status for consumers receiving services in fiscal year (FY) 2014. Rehabilitation Service Administration (RSA-911) Case Service Report FY 2014 archival dataset was obtained from the U.S. Department of Education (2014) and secondary analyses was performed for this study. RSA-911 archival data is updated on an annual basis and consists of all state-federal rehabilitation consumers who were served in the specific fiscal year. The dataset contains information related to each consumer's demographic information (e.g. age, gender, race) and other supplemental information (e.g. weekly earnings at closure, cause of disability, services provided). A multiple logistic regression analysis was utilized and revealed that white consumers receiving rehabilitation technology (RT) services have significantly higher closure rate than consumers of other races, RT services differ by the employment status at application, RT services differ by the type of disability, educational level at application for people receiving RT services did predict closure status (i.e. exiting with an employment outcome), IEP status did not predict closure status, weekly earnings at application did predict closure status and the interaction effect between IEP and RT services is statistically significant. The odds ratio (ORs) were presented at the 95% confidence interval (CI). Vocational rehabilitation counselors needs training to correctly identify appropriate RT services for consumers, so that the likelihood of exiting with an employment outcome is obtained. Implications for Rehabilitation RT services significantly improved their chances of successful employment compared to those who did not receive RT services. Education at closure would also have some significant impact on employment outcomes. Training in Assistive Technology (AT) for Vocational Rehabilitation counselors will assist in the proper

  6. The Effects of Computer-Assisted Instruction Designed According to 7E Model of Constructivist Learning on Physics Student Teachers' Achievement, Concept Learning, Self-Efficacy Perceptions and Attitudes

    Science.gov (United States)

    Kocakaya, Serhat; Gonen, Selahattin

    2010-01-01

    The purpose of this study was to investigate the effects of a Computer-Assisted Instruction designed according to 7E model of constructivist learning(CAI7E) related to "electrostatic'' topic on physics student teachers' cognitive development, misconceptions, self-efficacy perceptions and attitudes. The study was conducted in 2006-2007…

  7. Computer-Assisted Periodical Routing and Renewal Audit

    Science.gov (United States)

    Yerkey, A. Neil

    1973-01-01

    A computer-assisted periodical control system was designed to reduce clerical time required to maintain records in three areas: renewal audit, routing, and records-keeping. The renewal audit features are unusual and are described in detail. (3 references) (Author/DH)

  8. Rehabilitation after stroke: predictive power of Barthel Index versus a cognitive and a motor index

    DEFF Research Database (Denmark)

    Engberg, A; Bentzen, L; Garde, B

    1995-01-01

    The aim of the present study was to investigate the predictive power of ratings of Barthel Index at Day 40 post stroke, compared with and/or combined with simultaneous ratings from a mobility scale (EG motor index) and a rather simple cognitive test scale (CT50). The parameter to be individually...... predicted was the need for special living facilities and support at discharge from a rehabilitation hospital, as well as six months later; 53 stroke patients with age median 68 years were included in this prospective study. It was shown that a combination of Barthel Index and CT50 had a stronger predictive...

  9. Cognitive engineering in the design of human-computer interaction and expert systems

    International Nuclear Information System (INIS)

    Salvendy, G.

    1987-01-01

    The 68 papers contributing to this book cover the following areas: Theories of Interface Design; Methodologies of Interface Design; Applications of Interface Design; Software Design; Human Factors in Speech Technology and Telecommunications; Design of Graphic Dialogues; Knowledge Acquisition for Knowledge-Based Systems; Design, Evaluation and Use of Expert Systems. This demonstrates the dual role of cognitive engineering. On the one hand cognitive engineering is utilized to design computing systems which are compatible with human cognition and can be effectively and be easily utilized by all individuals. On the other hand, cognitive engineering is utilized to transfer human cognition into the computer for the purpose of building expert systems. Two papers are of interest to INIS

  10. An EMG-Controlled Robotic Hand Exoskeleton for Bilateral Rehabilitation.

    Science.gov (United States)

    Leonardis, Daniele; Barsotti, Michele; Loconsole, Claudio; Solazzi, Massimiliano; Troncossi, Marco; Mazzotti, Claudio; Castelli, Vincenzo Parenti; Procopio, Caterina; Lamola, Giuseppe; Chisari, Carmelo; Bergamasco, Massimo; Frisoli, Antonio

    2015-01-01

    This paper presents a novel electromyography (EMG)-driven hand exoskeleton for bilateral rehabilitation of grasping in stroke. The developed hand exoskeleton was designed with two distinctive features: (a) kinematics with intrinsic adaptability to patient's hand size, and (b) free-palm and free-fingertip design, preserving the residual sensory perceptual capability of touch during assistance in grasping of real objects. In the envisaged bilateral training strategy, the patient's non paretic hand acted as guidance for the paretic hand in grasping tasks. Grasping force exerted by the non paretic hand was estimated in real-time from EMG signals, and then replicated as robotic assistance for the paretic hand by means of the hand-exoskeleton. Estimation of the grasping force through EMG allowed to perform rehabilitation exercises with any, non sensorized, graspable objects. This paper presents the system design, development, and experimental evaluation. Experiments were performed within a group of six healthy subjects and two chronic stroke patients, executing robotic-assisted grasping tasks. Results related to performance in estimation and modulation of the robotic assistance, and to the outcomes of the pilot rehabilitation sessions with stroke patients, positively support validity of the proposed approach for application in stroke rehabilitation.

  11. Structural brain changes after traditional and robot-assisted multi-domain cognitive training in community-dwelling healthy elderly.

    Directory of Open Access Journals (Sweden)

    Geon Ha Kim

    Full Text Available The purpose of this study was to investigate if multi-domain cognitive training, especially robot-assisted training, alters cortical thickness in the brains of elderly participants. A controlled trial was conducted with 85 volunteers without cognitive impairment who were 60 years old or older. Participants were first randomized into two groups. One group consisted of 48 participants who would receive cognitive training and 37 who would not receive training. The cognitive training group was randomly divided into two groups, 24 who received traditional cognitive training and 24 who received robot-assisted cognitive training. The training for both groups consisted of daily 90-min-session, five days a week for a total of 12 weeks. The primary outcome was the changes in cortical thickness. When compared to the control group, both groups who underwent cognitive training demonstrated attenuation of age related cortical thinning in the frontotemporal association cortices. When the robot and the traditional interventions were directly compared, the robot group showed less cortical thinning in the anterior cingulate cortices. Our results suggest that cognitive training can mitigate age-associated structural brain changes in the elderly.ClnicalTrials.gov NCT01596205.

  12. Occupational, Physical, and Speech Therapy Treatment Activities During Inpatient Rehabilitation for Traumatic Brain Injury.

    Science.gov (United States)

    Beaulieu, Cynthia L; Dijkers, Marcel P; Barrett, Ryan S; Horn, Susan D; Giuffrida, Clare G; Timpson, Misti L; Carroll, Deborah M; Smout, Randy J; Hammond, Flora M

    2015-08-01

    To describe the use of occupational therapy (OT), physical therapy (PT), and speech therapy (ST) treatment activities throughout the acute rehabilitation stay of patients with traumatic brain injury. Multisite prospective observational cohort study. Inpatient rehabilitation settings. Patients (N=2130) admitted for initial acute rehabilitation after traumatic brain injury. Patients were categorized on the basis of admission FIM cognitive scores, resulting in 5 fairly homogeneous cognitive groups. Not applicable. Percentage of patients engaged in specific activities and mean time patients engaged in these activities for each 10-hour block of time for OT, PT, and ST combined. Therapy activities in OT, PT, and ST across all 5 cognitive groups had a primary focus on basic activities. Although advanced activities occurred in each discipline and within each cognitive group, these advanced activities occurred with fewer patients and usually only toward the end of the rehabilitation stay. The pattern of activities engaged in was both similar to and different from patterns seen in previous practice-based evidence studies with different rehabilitation diagnostic groups. Copyright © 2015 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  13. Visual and Motor Recovery After "Cognitive Therapeutic Exercises" in Cortical Blindness: A Case Study.

    Science.gov (United States)

    De Patre, Daniele; Van de Winckel, Ann; Panté, Franca; Rizzello, Carla; Zernitz, Marina; Mansour, Mariam; Zordan, Lara; Zeffiro, Thomas A; OʼConnor, Erin E; Bisson, Teresa; Lupi, Andrea; Perfetti, Carlo

    2017-07-01

    Spontaneous visual recovery is rare after cortical blindness. While visual rehabilitation may improve performance, no visual therapy has been widely adopted, as clinical outcomes are variable and rarely translate into improvements in activities of daily living (ADLs). We explored the potential value of a novel rehabilitation approach "cognitive therapeutic exercises" for cortical blindness. The subject of this case study was 48-year-old woman with cortical blindness and tetraplegia after cardiac arrest. Prior to the intervention, she was dependent in ADLs and poorly distinguished shapes and colors after 19 months of standard visual and motor rehabilitation. Computed tomographic images soon after symptom onset demonstrated acute infarcts in both occipital cortices. The subject underwent 8 months of intensive rehabilitation with "cognitive therapeutic exercises" consisting of discrimination exercises correlating sensory and visual information. Visual fields increased; object recognition improved; it became possible to watch television; voluntary arm movements improved in accuracy and smoothness; walking improved; and ADL independence and self-reliance increased. Subtraction of neuroimaging acquired before and after rehabilitation showed that focal glucose metabolism increases bilaterally in the occipital poles. This study demonstrates feasibility of "cognitive therapeutic exercises" in an individual with cortical blindness, who experienced impressive visual and sensorimotor recovery, with marked ADL improvement, more than 2 years after ischemic cortical damage.Video Abstract available for additional insights from the authors (see Video, Supplemental Digital Content 1, available at: http://links.lww.com/JNPT/A173).

  14. Computer-assisted learning and simulation systems in dentistry--a challenge to society.

    Science.gov (United States)

    Welk, A; Splieth, Ch; Wierinck, E; Gilpatrick, R O; Meyer, G

    2006-07-01

    Computer technology is increasingly used in practical training at universities. However, in spite of their potential, computer-assisted learning (CAL) and computer-assisted simulation (CAS) systems still appear to be underutilized in dental education. Advantages, challenges, problems, and solutions of computer-assisted learning and simulation in dentistry are discussed by means of MEDLINE, open Internet platform searches, and key results of a study among German dental schools. The advantages of computer-assisted learning are seen for example in self-paced and self-directed learning and increased motivation. It is useful for both objective theoretical and practical tests and for training students to handle complex cases. CAL can lead to more structured learning and can support training in evidence-based decision-making. The reasons for the still relatively rare implementation of CAL/CAS systems in dental education include an inability to finance, lack of studies of CAL/CAS, and too much effort required to integrate CAL/CAS systems into the curriculum. To overcome the reasons for the relative low degree of computer technology use, we should strive for multicenter research and development projects monitored by the appropriate national and international scientific societies, so that the potential of computer technology can be fully realized in graduate, postgraduate, and continuing dental education.

  15. Research on the Use of Computer-Assisted Instruction.

    Science.gov (United States)

    Craft, C. O.

    1982-01-01

    Reviews recent research studies related to computer assisted instruction (CAI). The studies concerned program effectiveness, teaching of psychomotor skills, tool availability, and factors affecting the adoption of CAI. (CT)

  16. Exercise rehabilitation for smartphone addiction.

    Science.gov (United States)

    Kim, Hyunna

    2013-12-31

    Internet addiction after launching smartphone is becoming serious. Therefore this paper has attempted to sketch out the diverse addiction treatment and then check the feasibility of exercise rehabilitation. The reason to addict the internet or smartphone is personalized individual characters related personal psychological and emotional factors and social environmental factors around them. We have shown that 2 discernible approaches due to 2 different addiction causes: that is behavioral treatment and complementary treatment. In the behavioral treatment, cognitive behavioral approach (CBT) is representative methods for changing additive thoughts and behaviors. Motivational interviewing (MI) is also the brief approach for persons not ready to change their behavior. Mindfulness behavioral cognitive treatment (MBCT) also the adapted treatment based on CBT. There are different types following the emphatic point, mindfulness-based relapse prevention (MBRP) or mindfulness oriented recovery enhancement (MORE). It is apparent that therapeutic recreation, music therapy using drumming activity, and art therapy are useful complementary treatment. Exercise rehabilitation contained the systematic procedures and comprehensive activities compared to previous addiction treatments by contents and techniques. Exercise rehabilitation can treat both physical symptoms at first and mental problems in the next step. So more evidence-based exercise rehabilitation researches need to do, but it is highly probable that exercise rehab can apply for smartphone addiction.

  17. L'Enseignement des langues assiste par ordinateur: nouvelle pedagogie? (Computer Assisted Language Instruction: New Pedagogy?).

    Science.gov (United States)

    Elkabas, Charles

    1989-01-01

    Recent second language instruction computer software focuses almost exclusively on the structures and forms of language, and on programed learning instead of developing communicative skills. Until artificial intelligence changes these old behavioristic principles, computer-assisted language instruction can only play a minor role in language…

  18. Nurses' assessment of patients' cognitive orientation in a rehabilitation setting.

    Science.gov (United States)

    Alverzo, J P; Galski, T

    1999-01-01

    Orientation is a critical determinant of a patient's neurological status and an indicator of change in condition during hospitalization. The ways rehabilitation nurses assess orientation and the manner in which findings are interpreted and reported can have significant implications for the care of neurologically compromised patients. This study used a questionnaire to examine how 52 nurses appraised and reported the results of orientation evaluations. Analyses produced descriptive statistics and correlational measures for determining nurses' tendencies and consistency in evaluating orientation. Most respondents, regardless of their education and experience, used a clinical interview, rather than psychometric tests, as a basis for forming opinions about orientation. Although most evaluations included assessments in terms of person, time, place, and circumstance, no consistent pattern emerged regarding questioning or in the ways results were reported. Findings revealed a significant lack of consensus in terms of assessing and reporting orientation results, which could reflect insufficient awareness about the importance of maintaining consistency in evaluations, the relevance of using standardized evaluations and comparing measures over time, and the necessity of agreeing on how to report cognitive disturbances.

  19. Case-based fMRI analysis after cognitive rehabilitation in MS: A Novel Approach

    Directory of Open Access Journals (Sweden)

    Martina eHubacher

    2015-04-01

    Full Text Available Background: Cognitive decline in Multiple Sclerosis (MS negatively impacts patients’ everyday functioning and quality of life. Since symptomatic pharmacological treatment is not yet available alternative treatment strategies such as cognitive rehabilitation are of particular interest. Objectives: To analyse the ways in which MS patients respond to cognitive training, by combining behavioural and fMRI data in a case-based triangulation approach.Methods: Ten relapsing-remitting (RR MS patients aged between 39 and 58 years and between one and eight years post MS diagnosis were included. EDSS ranged from 1 to 3.5. Participants had normal to high intelligence levels. Six patients were assigned to the training group (TG and four to the control group (CG without intervention. The training group received a 4-weeks computerized working memory (WM training, consisting of 16 training sessions of 45 minutes duration each. Before and after the training a neuropsychological examination and fMRI investigation by using an N-Back task of different complexity was applied. Results: Patients in the TG responded differently to cognitive training. Four participants did not meet the triangulation criteria for being treatment responders. The two responders showed two distinct changes regarding activation patterns after training: I decreased brain activation associated with increased processing speed and II increased brain activation associated with higher processing speed and WM performance. Conclusion: The occurrence of different and opposed response patterns after the same training indicates a risk in applying classical group statistics. Different and especially opposed patterns within the same sample may distort results of classical statistical comparisons. Thus, underlying processes may not be discovered and lead to misinterpretation of results.

  20. Cognitive rehabilitation of amnesia after virus encephalitis: a case report.

    Science.gov (United States)

    Miotto, Eliane Correa

    2007-01-01

    A number of memory rehabilitation techniques have targeted people with various degrees of memory impairments. However, few studies have shown the contribution of preserved non-declarative memory capacity and errorless learning in the treatment of amnesic patients. The current case report describes the memory rehabilitation of a 44-year-old man with amnesia following viral encephalitis. The patient's procedural memory capacity had an important role in the use of a motor imagery strategy to remember people's names. It was further demonstrated that the application of a verbal learning technique was helpful in recalling new verbal information. These different memory rehabilitation techniques are discussed in terms of alternative possibilities in the rehabilitation of amnesic patients.