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

A study on operators' cognitive response characteristics to the computerized working environment

International Nuclear Information System (INIS)

Lee, Yong Hee; Lee, Jang Soo; Suh, Sang Moon; Lee, Hyun Cheol; Jung, Kwang Tae; Lee, Dhong Ha

1998-12-01

Although the introduction of computerized working environment to the nuclear facilities, the study on the human factors impacts of computers and automation has not been enough like the other industries. It is necessary to prepare the way to cope with the negative aspects in spite of many positive aspects of computerization in nuclear. This study is an empirical study including the survey of the human factor concerning, especially to the cognitive response of operators' and the experiments on the error proneness. At first, we survey the design and its changes of operator interface and interaction in nuclear power plants, and conclude five human factor issues. We discuss situation awareness issues as one of the major human factor concerning, and the assessment method. Secondly, a questionnaire and interviews survey to the operator's response characteristics are performed for possible criterion measures tot he in-depth study on the cognitive characteristics. Finally, several experiments are conducted to test the error proneness. The issues and findings of this study could be utilized to any further study on the cognitive characteristic of operators to the computerized work environment

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.

Computerized Respiratory Sounds: Novel Outcomes for Pulmonary Rehabilitation in COPD.

Science.gov (United States)

Jácome, Cristina; Marques, Alda

2017-02-01

Computerized respiratory sounds are a simple and noninvasive measure to assess lung function. Nevertheless, their potential to detect changes after pulmonary rehabilitation (PR) is unknown and needs clarification if respiratory acoustics are to be used in clinical practice. Thus, this study investigated the short- and mid-term effects of PR on computerized respiratory sounds in subjects with COPD. Forty-one subjects with COPD completed a 12-week PR program and a 3-month follow-up. Secondary outcome measures included dyspnea, self-reported sputum, FEV 1 , exercise tolerance, self-reported physical activity, health-related quality of life, and peripheral muscle strength. Computerized respiratory sounds, the primary outcomes, were recorded at right/left posterior chest using 2 stethoscopes. Air flow was recorded with a pneumotachograph. Normal respiratory sounds, crackles, and wheezes were analyzed with validated algorithms. There was a significant effect over time in all secondary outcomes, with the exception of FEV 1 and of the impact domain of the St George Respiratory Questionnaire. Inspiratory and expiratory median frequencies of normal respiratory sounds in the 100-300 Hz band were significantly lower immediately (-2.3 Hz [95% CI -4 to -0.7] and -1.9 Hz [95% CI -3.3 to -0.5]) and at 3 months (-2.1 Hz [95% CI -3.6 to -0.7] and -2 Hz [95% CI -3.6 to -0.5]) post-PR. The mean number of expiratory crackles (-0.8, 95% CI -1.3 to -0.3) and inspiratory wheeze occupation rate (median 5.9 vs 0) were significantly lower immediately post-PR. Computerized respiratory sounds were sensitive to short- and mid-term effects of PR in subjects with COPD. These findings are encouraging for the clinical use of respiratory acoustics. Future research is needed to strengthen these findings and explore the potential of computerized respiratory sounds to assess the effectiveness of other clinical interventions in COPD. Copyright © 2017 by Daedalus Enterprises.

[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

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.

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

A Multisite, Randomized Controlled Clinical Trial of Computerized Cognitive Remediation Therapy for Schizophrenia.

Science.gov (United States)

Gomar, Jesús J; Valls, Elia; Radua, Joaquim; Mareca, Celia; Tristany, Josep; del Olmo, Francisco; Rebolleda-Gil, Carlos; Jañez-Álvarez, María; de Álvaro, Francisco J; Ovejero, María R; Llorente, Ana; Teixidó, Cristina; Donaire, Ana M; García-Laredo, Eduardo; Lazcanoiturburu, Andrea; Granell, Luis; Mozo, Cristina de Pablo; Pérez-Hernández, Mónica; Moreno-Alcázar, Ana; Pomarol-Clotet, Edith; McKenna, Peter J

2015-11-01

The effectiveness of cognitive remediation therapy (CRT) for the neuropsychological deficits seen in schizophrenia is supported by meta-analysis. However, a recent methodologically rigorous trial had negative findings. In this study, 130 chronic schizophrenic patients were randomly assigned to computerized CRT, an active computerized control condition (CC) or treatment as usual (TAU). Primary outcome measures were 2 ecologically valid batteries of executive function and memory, rated under blind conditions; other executive and memory tests and a measure of overall cognitive function were also employed. Carer ratings of executive and memory failures in daily life were obtained before and after treatment. Computerized CRT was found to produce improvement on the training tasks, but this did not transfer to gains on the primary outcome measures and most other neuropsychological tests in comparison to either CC or TAU conditions. Nor did the intervention result in benefits on carer ratings of daily life cognitive failures. According to this study, computerized CRT is not effective in schizophrenia. The use of both active and passive CCs suggests that nature of the control group is not an important factor influencing results. © The Author 2015. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center.

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...

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.

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...

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.

A study on operators' cognitive response characteristics to the computerized working environment

Energy Technology Data Exchange (ETDEWEB)

Lee, Yong Hee; Lee, Jang Soo; Suh, Sang Moon; Lee, Hyun Cheol; Jung, Kwang Tae; Lee, Dhong Ha

1998-12-01

Although the introduction of computerized working environment to the nuclear facilities, the study on the human factors impacts of computers and automation has not been enough like the other industries. It is necessary to prepare the way to cope with the negative aspects in spite of many positive aspects of computerization in nuclear. This study is an empirical study including the survey of the human factor concerning, especially to the cognitive response of operators' and the experiments on the error proneness. At first, we survey the design and its changes of operator interface and interaction in nuclear power plants, and conclude five human factor issues. We discuss situation awareness issues as one of the major human factor concerning, and the assessment method. Secondly, a questionnaire and interviews survey to the operator's response characteristics are performed for possible criterion measures to the in-depth study on the cognitive characteristics. Finally, several experiments are conducted to test the error proneness. The issues and findings of this study could be utilized to any further study on the cognitive characteristic of operators to the computerized work environment.

[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.

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.

A Newly Designed Mobile-Based Computerized Cognitive Addiction Therapy App for the Improvement of Cognition Impairments and Risk Decision Making in Methamphetamine Use Disorder: Randomized Controlled Trial.

Science.gov (United States)

Zhu, Youwei; Jiang, Haifeng; Su, Hang; Zhong, Na; Li, Runji; Li, Xiaotong; Chen, Tianzhen; Tan, Haoye; Du, Jiang; Xu, Ding; Yan, Huan; Xu, Dawen; Zhao, Min

2018-06-20

Cognitive rehabilitation therapy has been found to improve cognitive deficits and impulse control problems in methamphetamine use disorder (MUD). However, there is limited research regarding this therapy's feasibility when using mobile-based health technologies in supporting recovery from MUD in China. The main aim of this study was to test whether 4 weeks of a newly designed computerized cognitive addiction therapy (CCAT) app can improve cognitive impairments, eliminate drug-related attention bias, and attenuate risk decision-making behaviors in participants with MUD. Forty MUD participants were assigned randomly to either the CCAT group (n=20), who received 4 weeks of CCAT plus regular detoxification treatment as usual, or the control group (n=20), who only received the regular detoxification treatment as usual, in drug rehabilitation centers in Shanghai. The CCAT was designed by combine methamphetamine use-related picture stimuli with cognitive training with the aim of improving cognitive function and eliminating drug-related attention bias. The CogState Battery, Delay Discounting Task (DDT), Iowa Gambling Task (IGT), and Balloon Analog Risk Task (BART) were administered face-to-face to all participants before and after CCAT interventions. Forty male patients were recruited. The mean age was 32.70 (SD 5.27) years in the CCAT group and mean 35.05 (SD 8.02) years in the control group. Compared to the control group, CCAT improved working memory in the CCAT group (P=.01). Group×time interactions were observed among DDT, IGT, and BART tasks, with rates of discounting delayed rewards, IGT, and BART scores (Pcognitive impairment and impulsive control in MUD. Further study is needed to understand the underlying brain mechanisms of the cognitive therapy. ClinicalTrials.gov NCT03318081; https://clinicaltrials.gov/ct2/show/NCT03318081 (Archived by WebCite at https://clinicaltrials.gov/ct2/show/NCT03318081). ©Youwei Zhu, Haifeng Jiang, Hang Su, Na Zhong, Runji Li

The ECO computerized cognitive battery: collection of normative data using elderly New Zealanders.

Science.gov (United States)

Merrick, Paul I; Secker, David I; Fright, Renee; Melding, Pamela

2004-03-01

Computerized testing in the elderly has multiple advantages, including increased time-efficiency, a wider range of stimulus options and response forms, and increased psychometric reliability. The French-language ECO (Examen Cognitif par Ordinateur, Ritchie et al., 1993) computerized cognitive battery is investigated in this study. The purpose of the study was to yield normative data for an English-language version of the ECO, test the effects of age and education on test scores, to observe individual subtest sensitivity to cognitive impairment, and to examine participants' receptivity to this form of testing. A sample of 129 community-dwelling elderly with normal cognitive functioning and 56 cognitively impaired older adults living in both independent and supported accommodation were tested using the ECO at either their own residence or an outpatient facility. Standardized scores for three different age bands are given for both impaired and non-impaired groups. Age and education effects varied between subtests. A discriminant analysis of subtest-sensitivity to group prediction is reported using a stepwise regression model. The English version of the ECO appears to be a sensitive and practical cognitive battery that is highly acceptable to older people.

A longitudinal study of computerized cognitive training in stroke patients - effects on cognitive function and white matter.

Science.gov (United States)

Nyberg, Claudia Kim; Nordvik, Jan Egil; Becker, Frank; Rohani, Darius A; Sederevicius, Donatas; Fjell, Anders M; Walhovd, Kristine B

2018-05-01

Background Computerized cognitive training is suggested to enhance attention and working memory functioning following stroke, but effects on brain and behavior are not sufficiently studied and longitudinal studies assessing brain and behavior relationships are scarce. Objective The study objectives were to investigate relations between neuropsychological performance post-stroke and white matter microstructure measures derived from diffusion tensor imaging (DTI), including changes after 6 weeks of working memory training. Methods In this experimental training study, 26 stroke patients underwent DTI and neuropsychological tests at 3 time points - before and after a passive phase of 6 weeks, and again after 6 weeks of working memory training (Cogmed QM). Fractional anisotropy (FA) was extracted from stroke-free brain areas to assess the white matter microstructure. Twenty-two participants completed the majority of training (≥18/25 sessions) and were entered into longitudinal analyses. Results Significant correlations between FA and baseline cognitive functions were observed (r = 0.58, p = 0.004), however, no evidence was found of generally improved cognitive functions following training or of changes in white matter microstructure. Conclusions While white matter microstructure related to baseline cognitive function in stroke patients, the study revealed no effect on cognitive functions or microstructural changes in white matter in relation to computerized working memory training.

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.

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.

How to Train an Injured Brain? A Pilot Feasibility Study of Home-Based Computerized Cognitive Training.

Science.gov (United States)

Verhelst, Helena; Vander Linden, Catharine; Vingerhoets, Guy; Caeyenberghs, Karen

2017-02-01

Computerized cognitive training programs have previously shown to be effective in improving cognitive abilities in patients suffering from traumatic brain injury (TBI). These studies often focused on a single cognitive function or required expensive hardware, making it difficult to be used in a home-based environment. This pilot feasibility study aimed to evaluate the feasibility of a newly developed, home-based, computerized cognitive training program for adolescents who suffered from TBI. Additionally, feasibility of study design, procedures, and measurements were examined. Case series, longitudinal, pilot, feasibility intervention study with one baseline and two follow-up assessments. Nine feasibility outcome measures and criteria for success were defined, including accessibility, training motivation/user experience, technical smoothness, training compliance, participation willingness, participation rates, loss to follow-up, assessment timescale, and assessment procedures. Five adolescent patients (four boys, mean age = 16 years 7 months, standard deviation = 9 months) with moderate to severe TBI in the chronic stage were recruited and received 8 weeks of cognitive training with BrainGames. Effect sizes (Cohen's d) were calculated to determine possible training-related effects. The new cognitive training intervention, BrainGames, and study design and procedures proved to be feasible; all nine feasibility outcome criteria were met during this pilot feasibility study. Estimates of effect sizes showed small to very large effects on cognitive measures and questionnaires, which were retained after 6 months. Our pilot study shows that a longitudinal intervention study comprising our novel, computerized cognitive training program and two follow-up assessments is feasible in adolescents suffering from TBI in the chronic stage. Future studies with larger sample sizes will evaluate training-related effects on cognitive functions and underlying brain structures.

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...

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.

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.

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.

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.

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.

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...

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.

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....

Feasibility and validity of the self-administered computerized assessment of mild cognitive impairment with older primary care patients.

Science.gov (United States)

Tierney, Mary C; Naglie, Gary; Upshur, Ross; Moineddin, Rahim; Charles, Jocelyn; Jaakkimainen, R Liisa

2014-01-01

We investigated whether a validated computerized cognitive test, the Computerized Assessment of Mild Cognitive Impairment (CAMCI), could be independently completed by older primary care patients. We also determined the optimal cut-off for the CAMCI global risk score for mild cognitive impairment against an independent neuropsychological reference standard. All eligible patients aged 65 years and older, seen consecutively over 2 months by 1 family practice of 13 primary care physicians, were invited to participate. Patients with a diagnosis or previous work-up for dementia were excluded. Primary care physicians indicated whether they, the patient, or family had concerns about each patient's cognition. A total of 130 patients with cognitive concerns and a matched sample of 133 without cognitive concerns were enrolled. The CAMCI was individually administered after instructions to work independently. Comments were recorded verbatim. A total of 259 (98.5%) completed the entire CAMCI. Two hundred and forty-one (91.6%) completed it without any questions or after simple acknowledgment of their question. Lack of computer experience was the only patient characteristic that decreased the odds of independent CAMCI completion. These results support the feasibility of using self-administered computerized cognitive tests with older primary care patients, given the increasing reliance on computers by people of all ages. The optimal cut-off score had a sensitivity of 80% and specificity of 74%.

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

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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.

A computerized method of estimation of sensor motor reaction, complicated with additional cognitive component

Directory of Open Access Journals (Sweden)

Gennadij V. Ganin

2011-05-01

Full Text Available This article is related to new integrated approach to objective computerizing evaluation of cognitive-component which delays the latent period of the sensor-motor reaction on specific visual stimuli, which carried different semantic information. It is recommended to use this method for clinical diagnostic of pathologies associated with disorders of cognitive human activity and for assessment of mental fatigue.

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

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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.

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

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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.

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...

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

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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.

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

A new computerized cognitive and social cognition training specifically designed for patients with schizophrenia/schizoaffective disorder in early stages of illness: A pilot study.

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Fernandez-Gonzalo, Sol; Turon, Marc; Jodar, Merce; Pousa, Esther; Hernandez Rambla, Carla; García, Rebeca; Palao, Diego

2015-08-30

People with schizophrenia/schizoaffective disorders at early stages of the illness present cognitive and social cognition deficits that have a great impact in functional outcomes. Cognitive Remediation Therapy (CRT) has demonstrated consistent effect in cognitive performance, symptoms and psychosocial functioning. However, any CRT intervention or social cognition training have been specifically designed for patients in the early stages of psychosis. The aim of this pilot study is to assess the efficacy of a new computerized cognitive and social cognition program for patients with schizophrenia/schizoaffective disorder with recent diagnosis. A comprehensive assessment of clinical, social and non-social cognitive and functional measures was carried out in 53 randomized participants before and after the 4-months treatment. Significant results were observed in Spatial Span Forwards, Immediate Logical Memory and Pictures of Facial Affect (POFA) total score. None of these results were explained by medication, premorbid social functioning or psychopathological symptoms. No impact of the intervention was observed in other cognitive and social cognition outcome neither in clinical and functional outcomes. This new computerized intervention may result effective ameliorating visual attention, logical memory and emotional processing in patients in the early stages of schizophrenia/schizoaffective disorder. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

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

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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.

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

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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

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.

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.

Computerized tests to evaluate recovery of cognitive function after deep sedation with propofol and remifentanil for colonoscopy.

Science.gov (United States)

Borrat, Xavier; Ubre, Marta; Risco, Raquel; Gambús, Pedro L; Pedroso, Angela; Iglesias, Aina; Fernandez-Esparrach, Gloria; Ginés, Àngels; Balust, Jaume; Martínez-Palli, Graciela

2018-03-27

The use of sedation for diagnostic procedures including gastrointestinal endoscopy is rapidly growing. Recovery of cognitive function after sedation is important because it would be important for most patients to resume safe, normal life soon after the procedure. Computerized tests have shown being accurate descriptors of cognitive function. The purpose of the present study was to evaluate the time course of cognitive function recovery after sedation with propofol and remifentanil. A prospective observational double blind clinical study conducted in 34 young healthy adults undergoing elective outpatient colonoscopy under sedation with the combination of propofol and remifentanil using a target controlled infusion system. Cognitive function was measured using a validated battery of computerized cognitive tests (Cogstate™, Melbourne, Australia) at different predefined times: prior to starting sedation (Tbaseline), and then 10 min (T10), 40 min (T40) and 120 min (T120) after the end of colonoscopy. Tests included the assessment of psychomotor function, attention, visual memory and working memory. All colonoscopies were completed (median time: 26 min) without significant adverse events. Patients received a median total dose of propofol and remifentanil of 149 mg and 98 µg, respectively. Psychomotor function and attention declined at T10 but were back to baseline values at T40 for all patients. The magnitude of psychomotor task reduction was large (d = 0.81) however 100% of patients were recovered at T40. Memory related tasks were not affected 10 min after ending sedation. Cognitive impairment in attention and psychomotor function after propofol and remifentanil sedation was significant and large and could be easily detected by computerized cognitive tests. Even though, patients were fully recovered 40 min after ending the procedure. From a cognitive recovery point of view, larger studies should be undertaken to propose adequate criteria for discharge

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

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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.

The effects of an 8-week computerized cognitive training program in older adults: a study protocol for a randomized controlled trial.

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Ten Brinke, Lisanne F; Best, John R; Crockett, Rachel A; Liu-Ambrose, Teresa

2018-01-30

Given the world's aging population, it is important to identify strategies that promote healthy cognitive aging and minimize cognitive decline. Currently, no curative pharmaceutical therapy exists for cognitive impairment and dementia. As a result, there is much interest in lifestyle approaches. Specifically, complex mental activity, such as cognitive training, may be a promising method to combat cognitive decline in older adults. As such, the industry of commercial computerized cognitive training (CCT) applications has rapidly grown in the last decade. However, the efficacy of these commercial products is largely not established. Moreover, exercise is a recognized strategy for promoting cognitive outcomes in older adults and may augment the efficacy of computerized cognitive training applications. Therefore, we propose a proof-of-concept randomized controlled trial (RCT) to examine the effect of a commercial CCT program in community-dwelling older adults. An 8-week RCT to examine the effect of a commercial CCT program, alone and preceded by a 15-min brisk walk, on cognitive function and explore the underlying neural mechanisms in adults aged 65-85 years old. Participants will be randomized to one of three intervention groups: 1) Computerized cognitive training (FBT); 2) A 15-min brisk walk followed by computerized cognitive training (Ex-FBT); or 3) A combination of educational classes, sham cognitive training, and balanced and tone exercises (active control, BAT). Participants in all intervention groups will attend three one-hour classes per week over the course of the intervention. Participants will be assessed at baseline, trial completion, and 1-year post study completion (1-year follow-up). If results from this study show benefits for cognition at trial completion, CCT programs, alone or in combination with walking, might be a strategy to promote healthy cognitive aging in older adults. In addition, results from the 1-year follow-up measurement could provide

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

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.

Computerized cognitive training during physical inactivity improves executive functioning in older adults.

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Marusic, Uros; Giordani, Bruno; Moffat, Scott D; Petrič, Mojca; Dolenc, Petra; Pišot, Rado; Kavcic, Voyko

2018-01-01

The hippocampus is closely tied to spatial navigation, a central component in cognitive functioning, and critically involved in age-associated cognitive decline and dementia. This study evaluated a novel, cognitive computerized spatial navigation training (CSNT) program targeting the hippocampus, with expectation of mitigating possible cognitive decline with bed rest (BR). During a 14-day BR study with 16 healthy, older men (mean age = 60 ± 3, range = 55-65 years), half received CSNT for 12 days in 50-min sessions and half were controls (watching documentaries). This design uniquely controlled diet, sleep, and other personal and environmental activities. Although there were no cognitive declines in controls post-BR, CSNT participants demonstrated significant increases in executive/attention ability and processing speed, and continued spatial navigation testing showed improvement to 400 days post-BR. This intervention may prove useful to mitigate cognitive declines known to occur in long periods of immobilization and could have broader implications in protecting against age-related cognitive decline.

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.

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.

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.

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

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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.

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

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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

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

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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.

Effects of peer social interaction on performance during computerized cognitive remediation therapy in patients with early course schizophrenia: A pilot study.

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Sandoval, Luis R; González, Betzamel López; Stone, William S; Guimond, Synthia; Rivas, Cristina Torres; Sheynberg, David; Kuo, Susan S; Eack, Shaun; Keshavan, Matcheri S

2017-09-04

Recent studies show that computer-based training enhances cognition in schizophrenia; furthermore, socialization has also been found to improve cognitive functions. It is generally believed that non-social cognitive remediation using computer exercises would be a pre-requisite for therapeutic benefits from social cognitive training. However, it is also possible that social interaction by itself enhances non-social cognitive functions; this possibility has scarcely been explored in schizophrenia patients. This pilot study examined the effects of computer-based neurocognitive training, along with social interaction either with a peer (PSI) or without one (N-PSI). We hypothesized that PSI will enhance cognitive performance during computerized exercises in schizophrenia, as compared with N-PSI. Sixteen adult participants diagnosed with schizophrenia or schizoaffective disorder participating in an ongoing trial of Cognitive Enhancement Therapy completed several computerized neurocognitive remediation training sessions (the Orientation Remedial Module©, or ORM), either with a peer or without a peer. We observed a significant interaction between the effect of PSI and performance on the different cognitive exercises (p<0.05). More precisely, when patients performed the session with PSI, they demonstrated better cognitive performances than with N-PSI in the ORM exercise that provides training in processing speed, alertness, and reaction time (the standard Attention Reaction Conditioner, or ARC) (p<0.01, corrected). PSI did not significantly affect other cognitive domains such as target detection and spatial attention. Our findings suggest that PSI could improve cognitive performance, such as processing speed, during computerized cognitive training in schizophrenia. Additional studies investigating the effect of PSI during cognitive remediation are needed to further evaluate this hypothesis. Copyright © 2017. Published by Elsevier B.V.

Spatial cognitive rehabilitation and motor recovery after stroke

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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

Cognitive performance in relapsing remitting multiple sclerosis: A longitudinal study in daily practice using a brief computerized cognitive battery

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Jacquerye Philippe

2011-06-01

Full Text Available Abstract Background There is need for a cognitive test battery that can be easily used in clinical practice to detect or monitor cognitive performance in patients with multiple sclerosis (MS. In order to conduct, in this patient group, a preliminary investigation of the validity and utility of a brief computerized battery, the Cognitive Drug Research (CDR battery, we longitudinally assessed cognition in patients with relapsing remitting (RR MS. Methods Forty-three mildly disabled, clinically active RRMS patients were repeatedly assessed with the Digit Symbol Substitution Test (DSST, Paced Auditory Serial Addition Test (PASAT and five composite scores derived from the CDR computerized cognitive test system (CDR System: Power of Attention, Continuity of Attention, Quality of Working Memory, Quality of Episodic Memory and Speed of Memory. The Multiple Sclerosis Functional Composite (MSFC and Expanded Disability Status Scale (EDSS measured disability. Results The composite scores from the CDR battery generally showed excellent test-retest reliability over the repeated assessments, though was low on occasions for the Quality of Working Memory and Quality of Episodic Memory measures. The CDR measures tended to be highly correlated with other measures of cognition (DSST and PASAT and were also strongly related to disability (EDSS and MSFC. Baseline scores indicated large impairments to visual information processing speed and attention (DSST, Cohen's d 1.1; Power of Attention d 1.4 [reaction time on tasks of focussed and sustained attention], and a moderate impairment both to sustained attention (Continuity of Attention d 0.6 and complex information processing speed (Speed of memory d 0.7 [reaction time on tasks of working and episodic Memory], when compared to normative data derived from healthy volunteers enrolled in a series of separate, prior clinical trials. Working memory (Quality of Working Memory and episodic memory (Quality of Episodic Memory

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

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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.

Predicting Outcome in Computerized Cognitive Behavioral Therapy for Depression in Primary Care: A Randomized Trial

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de Graaf, L. Esther; Hollon, Steven D.; Huibers, Marcus J. H.

2010-01-01

Objective: To explore pretreatment and short-term improvement variables as potential moderators and predictors of 12-month follow-up outcome of unsupported online computerized cognitive behavioral therapy (CCBT), usual care, and CCBT combined with usual care for depression. Method: Three hundred and three depressed patients were randomly allocated…

Technology-assisted rehabilitation interventions following pediatric brain injury.

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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.

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

Cognitive rehabilitation in epilepsy: An evidence-based review.

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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.

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

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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.

A new Brief computerized cognitive screening battery (CompCogs for early diagnosis of Alzheimer's disease

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Helenice Charchat Fichman

Full Text Available Abstract Screening tests for early diagnosis of dementia are of great clinical relevance. The ideal test set must be brief and reliable, and should probe cognitive components impaired in Alzheimer's disease (AD. Objectives: To develop a new Computerized Cognitive Screening test (CompCogs, and to investigate its validity for the early diagnosis of AD, and evaluate its heuristic value in understanding the processing of information in AD. Methods: The computerized neuropsychological performance battery, originally including six tests, was applied in forty seven patients with probable mild AD and 97 controls matched for age and education. This computerized neuropsychological test battery, developed with MEL Professional, allows control of timing and order of stimuli presentation, as well as recording of response type and latency. A brief-screening version, CompCogs, was selected using the most discriminative neuropsychological test variables derived from logistic regression analysis. Full battery administration lasted about 40 minutes, while the CompCogs took only 15 minutes. Results: CompCogs included the Face test (correct response and Word and Forms with Short term memory tests (reaction time. CompCogs presented 91.8% sensitivity and 93.6% specificity for the diagnosis of AD using ROC analyses of AD diagnosis probability derived by logistic regression. Conclusions: CompCogs showed high validity for AD early diagnosis and, therefore, may be a useful alternative screening instrument.

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.

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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.

Utilizing Computerized Cognitive Training to Improve Working Memory and Encoding: Piloting a School-Based Intervention

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Wiest, Dudley J.; Wong, Eugene H.; Minero, Laura P.; Pumaccahua, Tessy T.

2014-01-01

Working memory has been well documented as a significant predictor of academic outcomes (e.g., reading and math achievement as well as general life outcomes). The purpose of this study was to investigate the effectiveness of computerized cognitive training to improve both working memory and encoding abilities in a school setting. Thirty students…

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...

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...

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

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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

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

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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

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).

Effect of computerized cognitive training with virtual spatial navigation task during bed rest immobilization and recovery on vascular function: A pilot study

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Goswami N

2015-02-01

Full Text Available Nandu Goswami,1 Voyko Kavcic,2 Uros Marusic,3 Bostjan Simunic,3 Andreas Rössler,1 Helmut Hinghofer-Szalkay,1 Rado Pisot3 1Institute of Physiology, Medical University of Graz, Graz, Austria; 2Institute of Gerontology, Wayne State University, Detroit, MI, USA; 3Institute for Kinesiology Research, University of Primorska, Ankaran, Slovenia Abstract: We investigated the effects of bed rest (BR immobilization, with and without computerized cognitive training with virtual spatial navigation task (CCT, on vascular endothelium on older subjects. The effects of 14-day BR immobilization in healthy older males (n=16 of ages 53–65 years on endothelial function were studied using EndoPAT®, a noninvasive and user-independent method. From the group of 16 older men, 8 randomly received CCT during the BR, using virtual navigation tasks in a virtual environment with joystick device. In all the cases, EndoPAT assessments were done at pre- and post-BR immobilization as well as following 28 days of ambulatory recovery. The EndoPAT index increased from 1.53±0.09 (mean ± standard error of the mean at baseline to 1.61±0.16 following immobilization (P=0.62 in the group with CCT. The EndoPAT index decreased from 2.06±0.13 (mean ± standard error of the mean at baseline to 1.70±0.09 at the last day of BR study, day 14 (BR14 (P=0.09 in the control group. Additionally, there were no statistically significant differences between BR14 and at 28 days of follow-up (rehabilitation program (R28. Our results show a trend of immobilization in older persons affecting the vasoconstrictory endothelial response. As the control subjects had a greater increase in EndoPAT index after R28 (+0.018 compared to subjects who had cognitive training (+0.11 (calculated from the first day of BR study, it is possible that cognitive training during BR does not improve endothelial function but rather contributes to slowing down the impairment of endothelial function. Finally, our results

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

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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.

Computerized cognitive training in prostate cancer patients on androgen deprivation therapy: a pilot study.

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Wu, Lisa M; Amidi, Ali; Tanenbaum, Molly L; Winkel, Gary; Gordon, Wayne A; Hall, Simon J; Bovbjerg, Katrin; Diefenbach, Michael A

2018-06-01

Prostate cancer patients who have undergone androgen deprivation therapy (ADT) may experience cognitive impairment, yet there is an unmet need for nonpharmacological interventions to address cognitive impairment in this population. This study examines the feasibility, acceptability, and preliminary efficacy of a home-based computerized cognitive training (CCT) program to treat cancer-related cognitive impairment. Sixty men who had received ≥ 3 months of ADT were screened for at least mild cognitive or neurobehavioral impairment and randomized to 8 weeks of CCT or usual care. Follow-up assessments occurred immediately post-intervention or equivalent (T2) and 8 weeks later (T3). The acceptability of CCT was also assessed. Feasibility:A priori feasibility thresholds were partially met (i.e., randomization rate > 50%, retention rate > 70% excluding CCT drop-outs, but cognitive functioning, neurobehavioral functioning, nor quality of life. This study provides tentative support for the feasibility and acceptability of CCT to treat mild cognitive impairment in ADT patients. CCT had a beneficial effect on reaction time, but temporarily suppressed memory. CCT's benefits may be limited to a narrow area of functioning. Larger-scale studies are needed.

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

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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

Computerized training improves verbal working memory in patients with myalgic encephalomyelitis/chronic fatigue syndrome: A pilot study.

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Maroti, Daniel; Westerberg, Annika Fryxell; Saury, Jean-Michel; Bileviciute-Ljungar, Indre

2015-08-18

Patients with myalgic encephalomyelitis/chronic fatigue syndrome experience cognitive difficulties. The aim of this study was to evaluate the effect of computerized training on working memory in this syndrome. Non-randomized (quasi-experimental) study with no-treatment control group and non-equivalent dependent variable design in a myalgic encephalomyelitis/chronic fatigue syndrome-cohort. Patients with myalgic encephalomyelitis/chronic fatigue syndrome who participated in a 6-month outpatient rehabilitation programme were included in the study. Eleven patients who showed signs of working memory deficit were recruited for additional memory training and 12 patients with no working memory deficit served as controls. Cognitive training with computerized working memory tasks of increasing difficulty was performed 30-45 min/day, 5 days/week over a 5-week period. Short-term and working memory tests (Digit Span - forward, backward, total) were used as primary outcome measures. Nine of the 11 patients were able to complete the training. Cognitive training increased working memory (p = 0.003) and general attention (p = 0.004) to the mean level. Short-term memory was also improved, but the difference was not statistically significant (p = 0.052) vs prior training. The control group did not show any significant improvement in primary outcome measures. Cognitive training may be a new treatment for patients with myalgic encephalomyelitis/chronic fatigue syndrome.

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

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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.

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.

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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.

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

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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

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

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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.

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

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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.

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

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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.

Computerization of the standard corsi block-tapping task affects its underlying cognitive concepts: a pilot study.

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Claessen, Michiel H G; van der Ham, Ineke J M; van Zandvoort, Martine J E

2015-01-01

The tablet computer initiates an important step toward computerized administration of neuropsychological tests. Because of its lack of standardization, the Corsi Block-Tapping Task could benefit from advantages inherent to computerization. This task, which requires reproduction of a sequence of movements by tapping blocks as demonstrated by an examiner, is widely used as a representative of visuospatial attention and working memory. The aim was to validate a computerized version of the Corsi Task (e-Corsi) by comparing recall accuracy to that on the standard task. Forty university students (Mage = 22.9 years, SD = 2.7 years; 20 female) performed the standard Corsi Task and the e-Corsi on an iPad 3. Results showed higher accuracy in forward reproduction on the standard Corsi compared with the e-Corsi, whereas backward performance was comparable. These divergent performance patterns on the 2 versions (small-to-medium effect sizes) are explained as a result of motor priming and interference effects. This finding implies that computerization has serious consequences for the cognitive concepts that the Corsi Task is assumed to assess. Hence, whereas the e-Corsi was shown to be useful with respect to administration and registration, these findings also stress the need for reconsideration of the underlying theoretical concepts of this task.

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

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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. 

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

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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…

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

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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

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

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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.

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

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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.

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

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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.

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

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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.

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

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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.

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

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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.

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

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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.

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

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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.

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

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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.

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

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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.

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

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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.

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

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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...

Cognitive spectrum of the social mission of the rehabilitation park

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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.

Computerized cognitive behavioural therapy at work: a randomized controlled trial in employees with recent stress-related absenteeism.

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Grime, Paul R

2004-08-01

Emotional distress has major implications for employees and employers. Cognitive behavioural therapy (CBT) is a recommended treatment, but demand outstrips supply. CBT is well suited to computerization. Most employee assistance programmes have not been systematically evaluated and computerized CBT has not previously been studied in the workplace. To evaluate the effect of an 8 week computerized cognitive behavioural therapy programme, 'Beating The Blues', on emotional distress in employees with recent stress-related absenteeism, and to explore the reasons for non-participation. An open, randomized trial in a London NHS occupational health department. Forty-eight public sector employees, with 10 or more cumulative days stress-related absenteeism in the last 6 months, randomized equally to 'Beating The Blues' plus conventional care, or conventional care alone. Main outcome measures were Hospital Anxiety and Depression Scale and Attributional Style Questionnaire scores at end of treatment and 1, 3 and 6 months later; and reasons for non-participation. At end of treatment and 1 month later, adjusted mean depression scores and adjusted mean negative attributional style scores were significantly lower in the intervention group. One month post-treatment, adjusted mean anxiety scores were also significantly lower in the intervention group. The differences were not statistically significant at 3 and 6 months post-treatment. Non-participation was common and related to access problems, preference for other treatments, time commitment, scepticism about the intervention and the employer connection. 'Beating The Blues' may accelerate psychological recovery in employees with recent stress-related absenteeism. Greater flexibility and accessibility might improve uptake.

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

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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…

The effectiveness of computerized cognitive training on the working memory performance of children with dyslexia

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Mohsen Shokoohi-Yekta

2014-08-01

Full Text Available Background and Aim: Auditory and visual processing along with phonological and visual spatial working memory are the problems that patients with dyslexia struggle with. So, the aim of this project was to investigate the effectiveness of computerized cognitive training on the working memory performance of children with dyslexia.Methods: The study conducted under the quasi-experimental method with pre- and post-test along with the control group. 25 children with dyslexia aged 7 to 12 years in grades 1-5 assigned to the experimental (15 and control (10 groups; the experimental group received 30 sessions of the Brain Ware Safari intervention program. NAMA scale and Working Memory Test Battery for Children (WMTB-C were conducted to assess reading and working memory performance of the subjects. MANCOVA, ANCOVA and effect sizes were utilized to analyze the data.Results: There were significant differences between pre- and post-tests of the experimental and control groups on the forward and backward block recall subtests of WMTB-C and not the mazes memory. Regarding the subscales of NAMA scale, we found no significant differences in the reading performance; but analysis of effect sizes showed positive effects at least on the 6 subscales.Conclusion: The Brain Ware Safari computerized cognitive training can improve visual spatial working memory of children with dyslexia and probably may affect the reading performance.

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

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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

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.

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

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.

Technologic advances in aural rehabilitation: applications and innovative methods of service delivery.

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Sweetow, Robert W; Sabes, Jennifer Henderson

2007-06-01

The level of interest in aural rehabilitation has increased recently, both in clinical use and in research presentations and publications. Advances in aural rehabilitation have seen previous techniques such as speech tracking and analytic auditory training reappear in computerized forms. These new delivery methods allow for a consistent, cost-effective, and convenient training program. Several computerized aural rehabilitation programs for hearing aid wearers and cochlear implant recipients have recently been developed and were reported on at the 2006 State of the Science Conference of the Rehabilitation Engineering Research Center on Hearing Enhancement at Gallaudet University. This article reviews these programs and outlines the similarities and differences in their design. Another promising area of aural rehabilitation research is the use of pharmaceuticals in the rehabilitation process. The results from a study of the effect of d-amphetamine in conjunction with intensive aural rehabilitation with cochlear implant patients are also described.

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.

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

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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.

A pilot study and brief overview of rehabilitation via virtual environment in patients suffering from dementia.

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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

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...

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

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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.

Computerized axial tomography : the tool in osseointegrated dental implants

International Nuclear Information System (INIS)

Fernandez-Lopez, Otton

2002-01-01

Failure rates in rehabilitations with osseointegrated implants are handled through appropriate radiographic preoperative planning. The appropriate length of the implant without running the risk of a perforation of vital structures, has been determined by a radiographic diagnosis. Computerized and conventional axial tomography have proved to be invaluable elements for pre-surgical evaluation. A radiologic guidance is elaborated to perform a computerized axial tomography (CT) of maxillary bones in totally edentulous patients. Surgical guides are constructed from a wax-up emanated from the information of the CT. The CT has proven to be an radiographic indispensable element to achieve the surgical-prosthetic success in osseointegrated dental implants. The CT has allowed the realization of a precise wax-up for making of surgical guide and a precise temporary prostheses in positioning of osseointegrated implants, with the consequent saving time and money for the rehabilitator and patient [es

"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

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

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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).

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.

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...

Effect of Computerized Gloss Presentation Format on Reading Comprehension: A Cognitive Load Perspective

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Farid Naserieh

2016-09-01

Full Text Available In recent years, gloss presentation format or the location where a gloss appears with respect to its related target word has received renewed attention. Research suggested that different gloss presentation formats could have differential effects on reading comprehension and/or vocabulary learning. This study hypothesized that the effectiveness of different computerized gloss presentation formats in reading comprehension could be explained by drawing on the split-attention effect within the framework of cognitive load theory. The effect predicts that when two related sources of information are physically separated (e.g., a target word and the respective gloss, cognitive resources are unnecessarily wasted, and learning is hindered. To test this hypothesis, 39 Persian-speaking L2 learners of English were divided into two experimental conditions, each being exposed to a text enhanced with either in-text or marginal glosses. Two measures of reading comprehension and three measures of cognitive load were employed. The participants’ initial differences in terms of grammatical knowledge and vocabulary size were balanced out, and their look-up behavior was also tracked. The results revealed that the participants with access to in-text glosses, compared with those with marginal glosses, experienced lower levels of cognitive load due to the elimination of split-attention and, accordingly, performed better on the reading com-prehension measures. Given the participants’ L2 proficiency level, the findings suggested that a text enhanced with in-text glosses tends to be instructionally more efficient.

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

Science.gov (United States)

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.

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…

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.

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.

Advances in the Treatment of MELAS Syndrome: Could Cognitive Rehabilitation Have a Role?

Science.gov (United States)

De Luca, Rosaria; Russo, Margherita; Leonardi, Simona; Spadaro, Letteria; Cicero, Cettina; Naro, Antonino; Bramanti, Placido; Calabrò, Rocco Salvatore

2016-01-01

Mitochondrial encephalomyopathy, lactic acidosis, and strokelike episodes syndrome (MELAS) is a rare inherited mitochondrial disorder, commonly due to the m.3243A>G mutation, which typically presents with seizures, headaches, and acute neurological stroke-mimicking deficits. At onset, there is often no general intellectual deterioration in these patients, although specific cognitive deficits in peculiar language domains, visual construction, attention, abstraction, or flexibility may be present. To date, there is no evidence for an effective treatment in individuals with MELAS. Herein, we describe the case of young woman affected by MELAS who underwent an intensive cognitive training by means of the following methods: (a) traditional cognitive training, (b) computerized cognitive training (CCT), and (c) CCT plus a low-intensity aerobic motor exercise. We compared her cognitive and psychological profile at baseline (T0) and at the end of each training (i.e., (Time 1, Time 2, and Time 3 [T3]) using a proper psychometric battery, and we found a greater improvement at T3. Our findings support the idea that the combined CCT with motor training could represent a valuable therapeutic opportunity in MELAS.

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.

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

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.

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.

A Computerized Version of the Scrambled Sentences Test

Directory of Open Access Journals (Sweden)

Roberto Viviani

2018-01-01

Full Text Available The scrambled sentences test (SST, an experimental procedure that involves participants writing down their cognitions, has been used to elicit individual differences in depressiveness and vulnerability to depression. We describe here a modification of the SST to adapt it to computerized administration, with a particular view of its use in large samples and functional neuroimaging applications. In a first study with the computerized version, we reproduce the preponderance of positive cognitions in the healthy and the inverse association of these cognitions with individual measures of depressiveness. We also report a tendency of self-referential cognitions to elicit higher positive cognition rates. In a second study, we describe the patterns of neural activations elicited by emotional and neutral sentences in a functional neuroimaging study, showing that it replicates and extends previous findings obtained with the original version of the SST. During the formation of emotional cognitions, ventral areas such as the ventral anterior cingulus and the supramarginal gyrus were relatively activated. This activation pattern speaks for the recruitment of mechanisms coordinating motivational and associative processes in the formation of value-based decisions.

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

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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.

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

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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.

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

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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.

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

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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

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

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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.

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

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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.

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

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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.

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

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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

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

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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.

Multi-domain computerized cognitive training program improves performance of bookkeeping tasks: a matched-sampling active-controlled trial.

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Lampit, Amit; Ebster, Claus; Valenzuela, Michael

2014-01-01

Cognitive skills are important predictors of job performance, but the extent to which computerized cognitive training (CCT) can improve job performance in healthy adults is unclear. We report, for the first time, that a CCT program aimed at attention, memory, reasoning and visuo-spatial abilities can enhance productivity in healthy younger adults on bookkeeping tasks with high relevance to real-world job performance. 44 business students (77.3% female, mean age 21.4 ± 2.6 years) were assigned to either (a) 20 h of CCT, or (b) 20 h of computerized arithmetic training (active control) by a matched sampling procedure. Both interventions were conducted over a period of 6 weeks, 3-4 1-h sessions per week. Transfer of skills to performance on a 60-min paper-based bookkeeping task was measured at three time points-baseline, after 10 h and after 20 h of training. Repeated measures ANOVA found a significant Group X Time effect on productivity (F = 7.033, df = 1.745; 73.273, p = 0.003) with a significant interaction at both the 10-h (Relative Cohen's effect size = 0.38, p = 0.014) and 20-h time points (Relative Cohen's effect size = 0.40, p = 0.003). No significant effects were found on accuracy or on Conners' Continuous Performance Test, a measure of sustained attention. The results are discussed in reference to previous findings on the relationship between brain plasticity and job performance. Generalization of results requires further study.

Effects of computerized cognitive training on neuroimaging outcomes in older adults: a systematic review.

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Ten Brinke, Lisanne F; Davis, Jennifer C; Barha, Cindy K; Liu-Ambrose, Teresa

2017-07-10

Worldwide, the population is aging and the number of individuals diagnosed with dementia is rising rapidly. Currently, there are no effective pharmaceutical cures. Hence, identifying lifestyle approaches that may prevent, delay, or treat cognitive impairment and dementia in older adults is becoming increasingly important. Computerized Cognitive Training (CCT) is a promising strategy to combat cognitive decline. Yet, the underlying mechanisms of the effect of CCT on cognition remain poorly understood. Hence, the primary objective of this systematic review was to examine peer-reviewed literature ascertaining the effect of CCT on both structural and functional neuroimaging measures among older adults to gain insight into the underlying mechanisms by which CCT may benefit cognitive function. In accordance with PRISMA guidelines, we used the following databases: MEDLINE, EMBASE, and CINAHL. Two independent reviewers abstracted data using pre-defined terms. These included: main study characteristics such as the type of training (i.e., single- versus multi-domain), participant demographics (age ≥ 50 years; no psychiatric conditions), and the inclusion of neuroimaging outcomes. The Physiotherapy Evidence Database (PEDro) scale was used to assess quality of all studies included in this systematic review. Nine studies were included in this systematic review, with four studies including multiple MRI sequences. Results of this systematic review are mixed: CCT was found to increase and decrease both brain structure and function in older adults. In addition, depending on region of interest, both increases and decreases in structure and function were associated with behavioural performance. Of all studies included in this systematic review, results from the highest quality studies, which were two randomized controlled trials, demonstrated that multi-domain CCT could lead to increases in hippocampal functional connectivity. Further high quality studies that include an active

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

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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.

Computerized cognitive training in cognitively healthy older adults: a systematic review and meta-analysis of effect modifiers.

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Amit Lampit

2014-11-01

Full Text Available BACKGROUND: New effective interventions to attenuate age-related cognitive decline are a global priority. Computerized cognitive training (CCT is believed to be safe and can be inexpensive, but neither its efficacy in enhancing cognitive performance in healthy older adults nor the impact of design factors on such efficacy has been systematically analyzed. Our aim therefore was to quantitatively assess whether CCT programs can enhance cognition in healthy older adults, discriminate responsive from nonresponsive cognitive domains, and identify the most salient design factors. METHODS AND FINDINGS: We systematically searched Medline, Embase, and PsycINFO for relevant studies from the databases' inception to 9 July 2014. Eligible studies were randomized controlled trials investigating the effects of ≥ 4 h of CCT on performance in neuropsychological tests in older adults without dementia or other cognitive impairment. Fifty-two studies encompassing 4,885 participants were eligible. Intervention designs varied considerably, but after removal of one outlier, heterogeneity across studies was small (I(2 = 29.92%. There was no systematic evidence of publication bias. The overall effect size (Hedges' g, random effects model for CCT versus control was small and statistically significant, g = 0.22 (95% CI 0.15 to 0.29. Small to moderate effect sizes were found for nonverbal memory, g = 0.24 (95% CI 0.09 to 0.38; verbal memory, g = 0.08 (95% CI 0.01 to 0.15; working memory (WM, g = 0.22 (95% CI 0.09 to 0.35; processing speed, g = 0.31 (95% CI 0.11 to 0.50; and visuospatial skills, g = 0.30 (95% CI 0.07 to 0.54. No significant effects were found for executive functions and attention. Moderator analyses revealed that home-based administration was ineffective compared to group-based training, and that more than three training sessions per week was ineffective versus three or fewer. There was no evidence for the effectiveness of WM training, and only weak

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

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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

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

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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

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

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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

Computerized evaluation of deambulatory pattern before and after visual rehabilitation treatment performed with biofeedback in visually impaired patients suffering from macular degeneration

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Fernanda Pacella

2016-09-01

Full Text Available Aims: The aim of this study was double: the primary endpoint was to evaluate the efficacy of visual rehabilitation of visually impaired patients with macular degeneration (AMD. The secondary endpoint was to assess the effect of rehabilitation treatment on the ambulatory pattern using a computerized evaluation of walking, focusing the attention on space-time parameters that are influenced in patients with visual impairment. Methods: 10 patients with AMD were enrolled, 6 males and 4 females, and examined 15 eyes, at Department of Sense Organs, Faculty of Medicine and Dentistry Sapienza University of Rome, Italy. Visual rehabilitation was carried out with the use of a microperimeter MP1 using the examination of biofeedback. Patients are asked to move their eyes in coordination with an audible feedback that alerts the patient when he is setting properly the fixation target previously selected. All patients were subjected to 10 sessions lasting 15 minutes each for each eye, 1 time per week. The best corrected visual acuity (BCVA was assessed by far with the ETDRS optotype IN LOG MAR, and by close to 25 cm by adding + 4 ball (addition to near to the BCVA. For each eye the PB ( print body on the distance of 25 cm was measured; It fixation stability for 30 seconds was examined by microperimeter. Gait Analysis was performed with system ELITE BTS SpA (Milan, Italy. Results: At the end of the rehabilitation treatment with biofeedback it was found a marked improvement in BCVA. The BCVA before the rehabilitation treatment was ETDRS 12 LETTERS = 0.86 logMAR. At the end of the visual rehabilitation 16 LETTERS = 0.78 logMAR. The near visual acuity presented a decrease of the printer body measurement (PB and a statistically significant improvement in the fixation stability. Analysis of the spatial and temporal parameters of gait cycle, aimed at assessing the global aspects of gait (speed, rhythm, symmetry, fluidity, dynamic balance showed no significant changes

Cognitive task analysis and the design of computerized operator aids

International Nuclear Information System (INIS)

Andersson, H.

1985-01-01

The new technological possibilities have led to the initiation of many projects for the design and evaluation of computerized operator support systems to be implemented in nuclear power plant control rooms. A typical finding so far has been that operators often have a positive attitude towards such systems but still don't use them very much, mostly because they find almost the same information on the conventional control boards which they are accustomed to use. Still, however, there is a widely shared belief that conventional control rooms have short-comings that make the use of computerized aids necessary. One reason for the limited success so far is that the new systems often are poorly integrated with the existing conventional instrumentation and with the working procedures. The reluctance to use new computer based aids, despite their nice features, is therefore probably caused by an inadequate task analysis made prior to the design of these computerized operator support systems

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

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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.

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

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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

Protecting cognition from aging and Alzheimer's disease: a computerized cognitive training combined with reminiscence therapy.

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Barban, Francesco; Annicchiarico, Roberta; Pantelopoulos, Stelios; Federici, Alessia; Perri, Roberta; Fadda, Lucia; Carlesimo, Giovanni Augusto; Ricci, Claudia; Giuli, Simone; Scalici, Francesco; Turchetta, Chiara Stella; Adriano, Fulvia; Lombardi, Maria Giovanna; Zaccarelli, Chiara; Cirillo, Giulio; Passuti, Simone; Mattarelli, Paolo; Lymperopoulou, Olga; Sakka, Paraskevi; Ntanasi, Eva; Moliner, Reyes; Garcia-Palacios, Azucena; Caltagirone, Carlo

2016-04-01

The aim of this paper was to assess the efficacy of process-based cognitive training (pb-CT) combined with reminiscence therapy (RT) in patients with mild Alzheimer's disease (mAD) and mild cognitive impairment (MCI) and in healthy elderly (HE) subjects. This multicenter, randomized, controlled trial involved 348 participants with mAD, MCI, and HE from four European countries. Participants were randomly assigned to two arms of a crossover design: those in arm A underwent 3 months of computerized pb-CT for memory and executive functions combined with RT and 3 months of rest; those in arm B underwent the reverse. The primary outcome was the effect of the training on memory and executive functions performance. The secondary outcome was the effect of the training on functional abilities in mAD assessed with the instrumental activities of daily living. We found a significant effect of the training for memory in all three groups on delayed recall of the Rey Auditory Verbal Learning Test and for executive functions in HE on the phonological fluency test. MCI and HE participants maintained these effects at follow-up. MCI and mAD participants also showed a significant effect of the training on the Mini-mental state examination scale. Participants with mAD showed more stable instrumental activities of daily living during the training versus the rest period. Our results corroborate the positive effect of pb-CT and its maintenance primarily on memory in HE and MCI participants that did not seem to be potentiated by RT. Moreover, our results are very promising for the mAD participants. Copyright © 2015 John Wiley & Sons, Ltd.

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

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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.

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

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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

Multi-domain computerized cognitive training program improves performance of bookkeeping tasks: a matched-sampling active-controlled trial

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Amit eLampit

2014-07-01

Full Text Available Cognitive skills are important predictors of job performance, but the extent to which Computerized Cognitive Training (CCT can improve job performance in healthy adults is unclear. We report, for the first time, that a CCT program aimed at attention, memory, reasoning and visuo-spatial abilities can enhance productivity in healthy younger adults on bookkeeping tasks with high relevance to real-world job performance. 44 business students (77.3% female, mean age 21.4 ± 2.6 years were assigned to either (a 20 hours of CCT, or (b 20 hours of computerized arithmetic training (active control by a matched sampling procedure. Both interventions were conducted over a period of six weeks, 3-4 one-hour sessions per week. Transfer of skills to performance on a 60-minute paper-based bookkeeping task was measured at three time points – baseline, after 10 hours and after 20 hours of training. Repeated measures ANOVA found a significant Group X Time effect on productivity (F=7.033, df=1.745; 73.273, p=0.003 with a significant interaction at both the 10-hour (Relative Cohen’s effect size = 0.38, p=0.014 and 20-hour time points (Relative Cohen’s effect size = 0.40, p=0.003. No significant effects were found on accuracy or on Conners’ Continuous Performance Test, a measure of sustained attention. The results are discussed in reference to previous findings on the relationship between brain plasticity and job performance. Generalization of results requires further study.

[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].

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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.

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

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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.

The relative contributions of processing speed and cognitive load to working memory accuracy in multiple sclerosis.

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Leavitt, Victoria M; Lengenfelder, Jean; Moore, Nancy B; Chiaravalloti, Nancy D; DeLuca, John

2011-06-01

Cognitive symptoms of multiple sclerosis (MS) include processing-speed deficits and working memory impairment. The precise manner in which these deficits interact in individuals with MS remains to be explicated. We hypothesized that providing more time on a complex working memory task would result in performance benefits for individuals with MS relative to healthy controls. Fifty-three individuals with clinically definite MS and 36 matched healthy controls performed a computerized task that systematically manipulated cognitive load. The interval between stimuli presentations was manipulated to provide increasing processing time. The results confirmed that individuals with MS who have processing-speed deficits significantly improve in performance accuracy when given additional time to process the information in working memory. Implications of these findings for developing appropriate cognitive rehabilitation interventions are discussed.

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

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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.

A double-blind randomized pilot trial comparing computerized cognitive exercises to Tetris in adolescents with attention-deficit/hyperactivity disorder.

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Bikic, Aida; Christensen, Torben Østergaard; Leckman, James F; Bilenberg, Niels; Dalsgaard, Søren

2017-08-01

The purpose of this trial was to examine the feasibility and efficacy of computerized cognitive exercises from Scientific Brain Training (SBT), compared to the computer game Tetris as an active placebo, in a pilot study of adolescents with attention-deficit/hyperactivity disorder (ADHD). Eighteen adolescents with ADHD were randomized to treatment or control intervention for 7 weeks. Outcome measures were cognitive test, symptom, and motivation questionnaires. SBT and Tetris were feasible as home-based interventions, and participants' compliance was high, but participants perceived both interventions as not very interesting or helpful. There were no significant group differences on cognitive and ADHD-symptom measures after intervention. Pre-post intra-group measurement showed that the SBT had a significant beneficial effect on sustained attention, while the active placebo had significant beneficial effects on working memory, both with large effect sizes. Although no significant differences were found between groups on any measure, there were significant intra-group changes for each group.

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

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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.

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

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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...

Cognitive Function Before and After Left Heart Catheterization.

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Scott, David A; Evered, Lisbeth; Maruff, Paul; MacIsaac, Andrew; Maher, Sarah; Silbert, Brendan S

2018-03-10

Hospital procedures have been associated with cognitive change in older patients. This study aimed to document the prevalence of mild cognitive impairment in individuals undergoing left heart catheterization (LHC) before the procedure and the incidence of cognitive decline to 3 months afterwards. We conducted a prospective, observational, clinical investigation of elderly participants undergoing elective LHC. Cognition was assessed using a battery of written tests and a computerized cognitive battery before the LHC and then at 3 months afterwards. The computerized tests were also administered at 24 hours (or discharge) and 7 days after LHC. A control group of 51 community participants was recruited to calculate cognitive decline using the Reliable Change Index. Of 437 participants, mild cognitive impairment was identified in 226 (51.7%) before the procedure. Computerized tests detected an incidence of cognitive decline of 10.0% at 24 hours and 7.5% at 7 days. At 3 months, written tests detected an incidence of cognitive decline of 13.1% and computerized tests detected an incidence of 8.5%. Cognitive decline at 3 months using written tests was associated with increasing age, whereas computerized tests showed cognitive decline was associated with baseline amnestic mild cognitive impairment, diabetes mellitus, and prior coronary stenting. More than half the patients aged >60 years presenting for LHC have mild cognitive impairment. LHC is followed by cognitive decline in 8% to 13% of individuals at 3 months after the procedure. Subtle cognitive decline both before and after LHC is common and may have important clinical implications. URL: www.anzctr.org.au. Unique identifier: ACTRN12607000051448. © 2018 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.

Cognitive Training Improves Sleep Quality and Cognitive Function among Older Adults with Insomnia

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Haimov, Iris; Shatil, Evelyn

2013-01-01

Study Objectives To investigate the effect of an eight-week, home-based, personalized, computerized cognitive training program on sleep quality and cognitive performance among older adults with insomnia. Design Participants (n = 51) were randomly allocated to a cognitive training group (n = 34) or to an active control group (n = 17). The participants in the cognitive training group completed an eight-week, home-based, personalized, computerized cognitive training program, while the participants in the active control group completed an eight-week, home-based program involving computerized tasks that do not engage high-level cognitive functioning. Before and after training, all participants' sleep was monitored for one week by an actigraph and their cognitive performance was evaluated. Setting Community setting: residential sleep/performance testing facility. Participants Fifty-one older adults with insomnia (aged 65–85). Interventions Eight weeks of computerized cognitive training for older adults with insomnia. Results Mixed models for repeated measures analysis showed between-group improvements for the cognitive training group on both sleep quality (sleep onset latency and sleep efficiency) and cognitive performance (avoiding distractions, working memory, visual memory, general memory and naming). Hierarchical linear regressions analysis in the cognitive training group indicated that improved visual scanning is associated with earlier advent of sleep, while improved naming is associated with the reduction in wake after sleep onset and with the reduction in number of awakenings. Likewise the results indicate that improved “avoiding distractions” is associated with an increase in the duration of sleep. Moreover, the results indicate that in the active control group cognitive decline observed in working memory is associated with an increase in the time required to fall asleep. Conclusions New learning is instrumental in promoting initiation and

Cognitive training improves sleep quality and cognitive function among older adults with insomnia.

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Iris Haimov

Full Text Available To investigate the effect of an eight-week, home-based, personalized, computerized cognitive training program on sleep quality and cognitive performance among older adults with insomnia.Participants (n = 51 were randomly allocated to a cognitive training group (n = 34 or to an active control group (n = 17. The participants in the cognitive training group completed an eight-week, home-based, personalized, computerized cognitive training program, while the participants in the active control group completed an eight-week, home-based program involving computerized tasks that do not engage high-level cognitive functioning. Before and after training, all participants' sleep was monitored for one week by an actigraph and their cognitive performance was evaluated.COMMUNITY SETTING: residential sleep/performance testing facility.Fifty-one older adults with insomnia (aged 65-85.Eight weeks of computerized cognitive training for older adults with insomnia.Mixed models for repeated measures analysis showed between-group improvements for the cognitive training group on both sleep quality (sleep onset latency and sleep efficiency and cognitive performance (avoiding distractions, working memory, visual memory, general memory and naming. Hierarchical linear regressions analysis in the cognitive training group indicated that improved visual scanning is associated with earlier advent of sleep, while improved naming is associated with the reduction in wake after sleep onset and with the reduction in number of awakenings. Likewise the results indicate that improved "avoiding distractions" is associated with an increase in the duration of sleep. Moreover, the results indicate that in the active control group cognitive decline observed in working memory is associated with an increase in the time required to fall asleep.New learning is instrumental in promoting initiation and maintenance of sleep in older adults with insomnia. Lasting and personalized

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

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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

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

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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.

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

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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.

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.

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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.

Efficacy of group cognitive rehabilitation therapy in multiple sclerosis.

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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

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

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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.

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

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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.

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

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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.

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

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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

Virtual reality in rehabilitation after stroke

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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

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

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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.

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

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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.

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

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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

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

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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

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.

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...

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.

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...

Computerized tomography

International Nuclear Information System (INIS)

Rubashov, I.B.

1985-01-01

Operating principle is described for the devices of computerized tomography used in medicine for diagnosis of brain diseases. Computerized tomography is considered as a part of computerized diagnosis, as a part of information science. It is shown that computerized tomography is a real existed field of investigations in medicine and industrial production

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

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.

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.

Does Computerized Cognitive Behavioral Therapy Help People with Inflammatory Bowel Disease? A Randomized Controlled Trial.

Science.gov (United States)

McCombie, Andrew; Gearry, Richard; Andrews, Jane; Mulder, Roger; Mikocka-Walus, Antonina

2016-01-01

Cognitive behavioral therapy may be useful for improving health-related quality of life (HRQOL) of at least some patients with inflammatory bowel disease (IBD), especially those with psychiatric comorbidities. However, cognitive behavioral therapy can be difficult to access. These difficulties can be overcome by computerized cognitive behavioral therapy (CCBT). This is a randomized controlled trial of a self-administered CCBT intervention for patients with IBD focused on improving HRQOL. It is hypothesized that CCBT completers will have an improved HRQOL relative to people not allocated to CCBT. Patients with IBD were randomly allocated to CCBT (n = 113) versus treatment as usual (n = 86). The IBD Questionnaire at 12 weeks after baseline was the primary outcome, while generic HRQOL, anxiety, depression, coping strategies, perceived stress, and IBD symptoms were secondary outcomes. Outcomes were also measured at 6 months after baseline. Predictors of dropout were also determined. Twenty-nine CCBT participants (25.7%) completed the CCBT. The IBD Questionnaire was significantly increased at 12 weeks in CCBT completers compared with treatment-as-usual patients (F = 6.38, P = 0.01). Short Form-12 mental score (F = 5.00, P = 0.03) was also significantly better in CCBT compared with treatment-as-usual patients at 12 weeks. These outcomes were not maintained at 6 months. The predictors of dropout were baseline depression, biological use, lower IBD Questionnaire scores, and not having steroids. Improvements at 12 weeks after baseline were not maintained at 6 months. Future research should aim to improve adherence rates. Moreover, CCBT may not work for patients with IBD with comorbid depression.

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.

[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.

Measuring outcomes in children's rehabilitation: a decision protocol.

Science.gov (United States)

Law, M; King, G; Russell, D; MacKinnon, E; Hurley, P; Murphy, C

1999-06-01

To develop and test the feasibility and clinical utility of a computerized self-directed software program designed to enable service providers in children's rehabilitation to make decisions about the most appropriate outcome measures to use in client and program evaluation. A before-and-after design was used to test the feasibility and initial impact of the decision-making outcome software in improving knowledge and use of clinical outcome measures. A children's rehabilitation center in a city of 50,000. All service providers in the children's rehabilitation center. Disciplines represented included early childhood education, occupational therapy, physical therapy, speech and language pathology, audiology, social work, and psychology. Using a conceptual framework based on the International Classification of Impairment, Disability, and Handicap (ICIDH), an outcome measurement decision-making protocol was developed. The decision-making protocol was computerized in an educational software program with an attached database of critically appraised measures. Participants learned about outcome measures through the program and selected outcome measures that met their specifications. The computer software was tested for feasibility in the children's rehabilitation center for 6 months. Knowledge and use of clinical outcome measures were determined before and after the feasibility testing using a survey of all service providers currently at the centre and audits of 30 randomly selected rehabilitation records (at pretest, posttest, and follow-up). Service providers indicated that the outcomes software was easy to follow and believed that the use of the ICIDH framework helped them in making decisions about selecting outcome measures. Results of the survey indicated that there were significant changes in the service providers' level of comfort with selecting measures and knowing what measures were available. Use of outcome measures as identified through the audit did not change

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.

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.

Computerized tabletop games as a form of a video game training for old-old.

Science.gov (United States)

Cujzek, Marina; Vranic, Andrea

2017-11-01

This research aimed at investigating the utility of a computerized version of a cognitively stimulating activity as a video game intervention for elderly. The study focused on the effect of a 6-week extensive practice intervention on aspects of cognitive functioning (vigilance, working memory (WM), inhibition, reasoning) of old-old participants (N = 29), randomly assigned to trained or active control group. The difference between groups was in the content of the extended video game practice - cognitively complex card game for trained and computerized version of a simple dice-game of chance for control participants. A pretest, posttest and a 4-month follow-up measurement was conducted. Results revealed improvements in both groups, except for improved reasoning found only in trained participants. These results suggest that: (1) improvements are dependent on the complexity of the program, (2) cognitively stimulating activity are a valid training procedure for old-old, (3) novelty of computer use is an important factor in determining training efficacy.

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

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.

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.

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.

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.

Cognitive and cognitive-motor interventions affecting physical functioning: A systematic review

Directory of Open Access Journals (Sweden)

Murer Kurt

2011-06-01

Full Text Available Abstract Background Several types of cognitive or combined cognitive-motor intervention types that might influence physical functions have been proposed in the past: training of dual-tasking abilities, and improving cognitive function through behavioral interventions or the use of computer games. The objective of this systematic review was to examine the literature regarding the use of cognitive and cognitive-motor interventions to improve physical functioning in older adults or people with neurological impairments that are similar to cognitive impairments seen in aging. The aim was to identify potentially promising methods that might be used in future intervention type studies for older adults. Methods A systematic search was conducted for the Medline/Premedline, PsycINFO, CINAHL and EMBASE databases. The search was focused on older adults over the age of 65. To increase the number of articles for review, we also included those discussing adult patients with neurological impairments due to trauma, as these cognitive impairments are similar to those seen in the aging population. The search was restricted to English, German and French language literature without any limitation of publication date or restriction by study design. Cognitive or cognitive-motor interventions were defined as dual-tasking, virtual reality exercise, cognitive exercise, or a combination of these. Results 28 articles met our inclusion criteria. Three articles used an isolated cognitive rehabilitation intervention, seven articles used a dual-task intervention and 19 applied a computerized intervention. There is evidence to suggest that cognitive or motor-cognitive methods positively affects physical functioning, such as postural control, walking abilities and general functions of the upper and lower extremities, respectively. The majority of the included studies resulted in improvements of the assessed functional outcome measures. Conclusions The current evidence on the

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…

[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

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

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

Detection of Acute and Long-Term Effects of Concussion: Dual-Task Gait Balance Control Versus Computerized Neurocognitive Test.

Science.gov (United States)

Howell, David R; Osternig, Louis R; Chou, Li-Shan

2018-02-16

To examine the acute (within 72h of injury) and long-term (2mo postinjury) independent associations between objective dual-task gait balance and neurocognitive measurements among adolescents and young adults with a concussion and matched controls. Longitudinal case-control. Motion analysis laboratory. A total of 95 participants completed the study: 51 who sustained a concussion (mean age, 17.5±3.3y; 71% men) and 44 controls (mean age, 17.7±2.9y; 72% men). Participants who sustained a concussion underwent a dual-task gait analysis and computerized neurocognitive testing within 72 hours of injury and again 2 months later. Uninjured controls also completed the same test protocol in similar time increments. Not applicable. We compared dual-task gait balance control and computerized neurocognitive test performance between groups using independent samples t tests. Multivariable binary logistic regression models were then constructed for each testing time to determine the association between group membership (concussion vs control), dual-task gait balance control, and neurocognitive function. Medial-lateral center-of-mass displacement during dual-task gait was independently associated with group membership at the initial test (adjusted odds ratio [aOR], 2.432; 95% confidence interval [CI], 1.269-4.661) and 2-month follow-up test (aOR, 1.817; 95% CI, 1.014-3.256) tests. Visual memory composite scores were significantly associated with group membership at the initial hour postinjury time point (aOR, .953; 95% CI, .833-.998). However, the combination of computerized neurocognitive test variables did not predict dual-task gait balance control for participants with concussion, and no single neurocognitive variable was associated with dual-task gait balance control at either testing time. Dual-task assessments concurrently evaluating gait and cognitive performance may allow for the detection of persistent deficits beyond those detected by computerized neurocognitive deficits

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

Virtual rehabilitation--benefits and challenges.

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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.

Assessment of Selective Attention with CSCWT (Computerized Stroop Color-Word Test) among Children and Adults

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Afsaneh, Zarghi; Alireza, Zali; Mehdi, Tehranidost; Farzad, Ashrafi; Reza, Zarindast Mohammad; Mehdi, Moazzezi; Mojtaba, Khodadadi Seyed

2012-01-01

The SCWT (Stroop Color-Word Test) is a quick and frequently used measure for assessing selective attention and cognitive flexibility. This study determines age, sex and education level influence on attention and cognitive flexibility by CSCWT (Computerized Stroop Color-Word Test) among healthy Iranian children and adults. There were 78 healthy…

Cognition, behaviour and academic skills after cognitive rehabilitation in Ugandan children surviving severe malaria: a randomised trial

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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

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

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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.

The effect of a therapeutic regimen of Traditional Chinese Medicine rehabilitation for post-stroke cognitive impairment: study protocol for a randomized controlled trial.

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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.

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.

Computerization of the standard corsi block-tapping task affects its underlying cognitive concepts : A pilot study

NARCIS (Netherlands)

Claessen, Michiel H G; Van Der Ham, Ineke J M; Van Zandvoort, Martine J E

2015-01-01

The tablet computer initiates an important step toward computerized administration of neuropsychological tests. Because of its lack of standardization, the Corsi Block-Tapping Task could benefit from advantages inherent to computerization. This task, which requires reproduction of a sequence of

Computerization of the Standard Corsi Block-Tapping Task Affects Its Underlying Cognitive Concepts : A Pilot Study

NARCIS (Netherlands)

Claessen, Michiel H G; Van Der Ham, Ineke J M; Van Zandvoort, Martine J E

2014-01-01

The tablet computer initiates an important step toward computerized administration of neuropsychological tests. Because of its lack of standardization, the Corsi Block-Tapping Task could benefit from advantages inherent to computerization. This task, which requires reproduction of a sequence of

Human factor engineering analysis for computerized human machine interface design issues

International Nuclear Information System (INIS)

Wang Zhifang; Gu Pengfei; Zhang Jianbo

2010-01-01

The application of digital I and C technology in nuclear power plants is a significant improvement in terms of functional performances and flexibility, and it also poses a challenge to operation safety. Most of the new NPPs under construction are adopting advanced control room design which utilizes the computerized human machine interface (HMI) as the main operating means. Thus, it greatly changes the way the operators interact with the plant. This paper introduces the main challenges brought out by computerized technology on the human factor engineering aspect and addresses the main issues to be dealt with in the computerized HMI design process. Based on a operator task-resources-cognitive model, it states that the root cause of human errors is the mismatch between resources demand and their supply. And a task-oriented HMI design principle is discussed. (authors)

Augmented Cognitive Behavioral Therapy for Poststroke Depressive Symptoms: A Randomized Controlled Trial.

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Kootker, Joyce A; Rasquin, Sascha M C; Lem, Frederik C; van Heugten, Caroline M; Fasotti, Luciano; Geurts, Alexander C H

2017-04-01

To evaluate the effectiveness of individually tailored cognitive behavioral therapy (CBT) for reducing depressive symptoms with or without anxiety poststroke. Multicenter, assessor-blinded, randomized controlled trial. Ambulatory rehabilitation setting. Patients who had a Hospital Anxiety and Depression Scale-depression subscale (HADS-D) score >7 at least 3 months poststroke (N=61). Participants were randomly allocated to either augmented CBT or computerized cognitive training (CCT). The CBT intervention was based on the principles of recognizing, registering, and altering negative thoughts and cognitions. CBT was augmented with goal-directed real-life activity training given by an occupational or movement therapist. HADS-D was the primary outcome, and measures of participation and quality of life were secondary outcomes. Outcome measurements were performed at baseline, immediately posttreatment, and at 4- and 8-month follow-up. Analysis was performed with linear mixed models using group (CBT vs CCT) as the between-subjects factor and time (4 assessments) as the within-subjects factor. Mixed model analyses showed a significant and persistent time effect for HADS-D (mean difference, -4.6; 95% confidence interval, -5.7 to -3.6; P<.001) and for participation and quality of life in both groups. There was no significant group × time effect for any of the outcome measures. Our augmented CBT intervention was not superior to CCT for the treatment of mood disorders after stroke. Future studies should determine whether both interventions are better than natural history. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Stroke rehabilitation.

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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.

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

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

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

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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

Visualization in the age of computerization

CERN Document Server

Carusi, Annamaria; Webmoor, Timothy; Woolgar, Steve

2014-01-01

Digitalization and computerization are now pervasive in science. This has deep consequences for our understanding of scientific knowledge and of the scientific process, and challenges longstanding assumptions and traditional frameworks of thinking of scientific knowledge. Digital media and computational processes challenge our conception of the way in which perception and cognition work in science, of the objectivity of science, and the nature of scientific objects. They bring about new relationships between science, art and other visual media, and new ways of practicing science and organizing

Cognitive Screening Tests Versus Comprehensive Neuropsychological Test Batteries: A National Academy of Neuropsychology Education Paper†.

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Roebuck-Spencer, Tresa M; Glen, Tannahill; Puente, Antonio E; Denney, Robert L; Ruff, Ronald M; Hostetter, Gayle; Bianchini, Kevin J

2017-06-01

The American Medical Association Current Procedural Panel developed a new billing code making behavioral health screening a reimbursable healthcare service. The use of computerized testing as a means for cognitive screening and brief cognitive testing is increasing at a rapid rate. The purpose of this education paper is to provide information to clinicians, healthcare administrators, and policy developers about the purpose, strengths, and limitations of cognitive screening tests versus comprehensive neuropsychological evaluations. Screening tests are generally brief and narrow in scope, they can be administered during a routine clinical visit, and they can be helpful for identifying individuals in need of more comprehensive assessment. Some screening tests can also be helpful for monitoring treatment outcomes. Comprehensive neuropsychological assessments are multidimensional in nature and used for purposes such as identifying primary and secondary diagnoses, determining the nature  and severity of a person's cognitive difficulties, determining functional limitations, and planning treatment and rehabilitation. Cognitive screening tests are expected to play an increasingly important role in identifying individuals with cognitive impairment and in determining which individuals should be referred for further neuropsychological assessment. However, limitations of existing cognitive screening tests are present and cognitive screening tests should not be used as a replacement for comprehensive neuropsychological testing. © The Author 2017. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Cognitive neuroscience of cognitive retraining for addiction medicine : From mediating mechanisms to questions of efficacy

NARCIS (Netherlands)

Gladwin, T.E.; Wiers, C.E.; Wiers, R.W.

2016-01-01

Cognitive retraining or cognitive bias modification (CBM) involves having subjects repeatedly perform a computerized task designed to reduce the impact of automatic processes that lead to harmful behavior. We first discuss the theory underlying CBM and provide a brief overview of important research

Drug Stroop: Mechanisms of response to computerized cognitive behavioral therapy for cocaine dependence in a randomized clinical trial.

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DeVito, Elise E; Kiluk, Brian D; Nich, Charla; Mouratidis, Maria; Carroll, Kathleen M

2018-02-01

Poor performance on Drug Stroop tasks, which could indicate attentional bias to drug-related cues, craving, poor cognitive control (including poor response inhibition), has been associated with substance use severity, treatment retention and substance use treatment outcomes. Cognitive Behavioral Therapy (CBT) focuses on training in appraisal and coping strategies, including strategies to minimize the negative impact of triggers and coping with drug-cue-induced craving. One mechanism of action of CBT may be the strengthening of cognitive control processes and reduction of attentional bias to drug-related stimuli. Methadone-maintained individuals with cocaine-use disorders, participating in a randomized controlled trial of treatment as usual (TAU) versus TAU plus access to computer-based CBT (CBT4CBT), completed a computerized Drug Stroop task at pre- and post-treatment. Analyses determined whether attentional bias toward drug-related stimuli changed differentially by treatment group or cocaine use outcomes across the treatment period and whether engagement in components of CBT4CBT or TAU treatment related to changes in attentional bias toward drug-related stimuli at post- versus pre-treatment. Participants achieving a longer duration of cocaine abstinence during treatment (3+ weeks) showed greater reductions in Drug Stroop Effect than those with shorter maximum continuous abstinence. Reductions in Drug Stroop Effect across treatment were associated with greater engagement with CBT4CBT-specific treatment components, but not TAU-specific treatment components. Reduction in attentional bias to drug-related cues and craving and/or improved executive cognitive control and response inhibition may contribute to the mechanism of action of CBT4CBT. Copyright © 2017 Elsevier B.V. All rights reserved.

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....

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.

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

Rehabilitation Interventions to Promote Recovery from Schizophrenia: A Systematic Review

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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.

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.

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

A combination of physical activity and computerized brain training improves verbal memory and increases cerebral glucose metabolism in the elderly.

Science.gov (United States)

Shah, T; Verdile, G; Sohrabi, H; Campbell, A; Putland, E; Cheetham, C; Dhaliwal, S; Weinborn, M; Maruff, P; Darby, D; Martins, R N

2014-12-02

Physical exercise interventions and cognitive training programs have individually been reported to improve cognition in the healthy elderly population; however, the clinical significance of using a combined approach is currently lacking. This study evaluated whether physical activity (PA), computerized cognitive training and/or a combination of both could improve cognition. In this nonrandomized study, 224 healthy community-dwelling older adults (60-85 years) were assigned to 16 weeks home-based PA (n=64), computerized cognitive stimulation (n=62), a combination of both (combined, n=51) or a control group (n=47). Cognition was assessed using the Rey Auditory Verbal Learning Test, Controlled Oral Word Association Test and the CogState computerized battery at baseline, 8 and 16 weeks post intervention. Physical fitness assessments were performed at all time points. A subset (total n=45) of participants underwent [(18)F] fluorodeoxyglucose positron emission tomography scans at 16 weeks (post-intervention). One hundred and ninety-one participants completed the study and the data of 172 participants were included in the final analysis. Compared with the control group, the combined group showed improved verbal episodic memory and significantly higher brain glucose metabolism in the left sensorimotor cortex after controlling for age, sex, premorbid IQ, apolipoprotein E (APOE) status and history of head injury. The higher cerebral glucose metabolism in this brain region was positively associated with improved verbal memory seen in the combined group only. Our study provides evidence that a specific combination of physical and mental exercises for 16 weeks can improve cognition and increase cerebral glucose metabolism in cognitively intact healthy older adults.

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

Computerized cognitive training to improve mood in senior living settings: design of a randomized controlled trial

Directory of Open Access Journals (Sweden)

Smith M

2018-04-01

Full Text Available Marianne Smith,1 Michael P Jones,2 Megan M Dotson,1 Fredric D Wolinsky3 1College of Nursing, The University of Iowa, Iowa City, IA, USA; 2Department of Biostatistics, College of Public Health, The University of Iowa, Iowa City, IA, USA; 3Department of Health, Management and Policy, College of Public Health, the University of Iowa, Iowa City, IA, USA Purpose: This two-arm, randomized controlled trial was designed to evaluate a computerized cognitive speed of processing (SOP training known as Road Tour in the generally older group of adults residing in assisted living (AL and related senior housing. Study aims focused on depression-related outcomes that were observed in earlier SOP studies using Road Tour with younger, home-dwelling seniors. Study design and baseline outcomes are discussed. Participants and methods: A community-based design engaged AL and related senior living settings as partners in research. Selected staff served as on-site research assistants who were trained to recruit, consent, and train a target of 300 participants from AL and independent living (IL programs to use the intervention and attention control computerized training. Ten hours of initial computerized training was followed by two booster sessions at 5 and 11 months. Outcome measures included Useful Field of View, 9-item Patient Health Questionnaire, 12-item Centers for Epidemiological Studies Depression scale, 7-item Generalized Anxiety Disorders, Brief Pain Inventory, and SF-36 Health Survey. Assessments occurred before randomization (pretraining and posttraining, 26 and 52 weeks. Results: A total of 351 participants were randomized to the intervention (n = 173 and attention control (n = 178 groups. There were no significant differences between groups in demographic characteristics, with the exception of education and reported osteoporosis. There were no significant differences in study outcomes between groups at baseline. Participants in AL had significantly lower

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...

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).

Computerization and skill bifurcation: the role of of task complexity in creating skill gains and losses

OpenAIRE

Ben-Ner, Avner; Urtasun Alonso, Ainhoa

2013-01-01

Does computerization increase or reduce the extent of skills that workers are required to have? Autor, Levy and Murnane (2003) show empirically that adoption of computer-based technologies (CBT) was greater in industries historically intensive in routine tasks, and that computerization increased complex problem-solving and communication activities and reduced routine cognitive and manual activities. We extend this argument and argue that the effects of CBT are neither universal nor uniform, b...

Some performance effects of age and low blood alcohol levels on a computerized neuropsychological test.

Science.gov (United States)

1995-02-01

COGSCREEN is a computerized test battery developed for the Federal Aviation Administration as an airman neuropsychological screening instrument for cognitive functioning. This study explored a multifaceted application of the sensitivity of the batter...

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.

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.

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.

HISTORY OF NEUROPSYCHOLOGICAL REHABILITATION

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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. 

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.

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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.

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...

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.

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...

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.

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

Neurological patients after stroke usually present cognitive deficits that cause dependencies in their daily living. These deficits mainly affect the performance of some of their daily activities. For that reason, stroke patients need long-term processes for their cognitive rehabilitation. Considering that classical techniques are focused on acting as guides and are dependent on help from therapists, significant efforts are being made to improve current methodologies and to use eHealth and Web-based architectures to implement information and communication technology (ICT) systems that achieve reliable, personalized, and home-based platforms to increase efficiency and level of attractiveness for patients and carers. The goal of this work was to provide an overview of the practices implemented for the assessment of stroke patients and cognitive rehabilitation. This study puts together traditional methods and the most recent personalized platforms based on ICT technologies and Internet of Things. A literature review has been distributed to a multidisciplinary team of researchers from engineering, psychology, and sport science fields. The systematic review has been focused on published scientific research, other European projects, and the most current innovative large-scale initiatives in the area. A total of 3469 results were retrieved from Web of Science, 284 studies from Journal of Medical Internet Research, and 15 European research projects from Community Research and Development Information Service from the last 15 years were reviewed for classification and selection regarding their relevance. A total of 7 relevant studies on the screening of stroke patients have been presented with 6 additional methods for the analysis of kinematics and 9 studies on the execution of goal-oriented activities. Meanwhile, the classical methods to provide cognitive rehabilitation have been classified in the 5 main techniques implemented. Finally, the review has been finalized with

Computerized cognitive training in children and adolescents with attention deficit/hyperactivity disorder as add-on treatment to stimulants: feasibility study and protocol description.

Science.gov (United States)

Rosa, Virginia de Oliveira; Schmitz, Marcelo; Moreira-Maia, Carlos Roberto; Wagner, Flavia; Londero, Igor; Bassotto, Caroline de Fraga; Moritz, Guilherme; de Souza, Caroline Dos Santos; Rohde, Luis Augusto Paim

2017-01-01

Cognitive training has received increasing attention as a non-pharmacological approach for the treatment of attention deficit/hyperactivity disorder (ADHD) in children and adolescents. Few studies have assessed cognitive training as add-on treatment to medication in randomized placebo controlled trials. The purpose of this preliminary study was to explore the feasibility of implementing a computerized cognitive training program for ADHD in our environment, describe its main characteristics and potential efficacy in a small pilot study. Six ADHD patients aged 10-12-years old receiving stimulants and presenting residual symptoms were enrolled in a randomized clinical trial to either a standard cognitive training program or a controlled placebo condition for 12 weeks. The primary outcome was core ADHD symptoms measured using the Swanson, Nolan and Pelham Questionnaire (SNAP-IV scale). We faced higher resistance than expected to patient enrollment due to logistic issues to attend face-to-face sessions in the hospital and to fill the requirement of medication status and absence of some comorbidities. Both groups showed decrease in parent reported ADHD symptoms without statistical difference between them. In addition, improvements on neuropsychological tests were observed in both groups - mainly on trained tasks. This protocol revealed the need for new strategies to better assess the effectiveness of cognitive training such as the need to implement the intervention in a school environment to have an assessment with more external validity. Given the small sample size of this pilot study, definitive conclusions on the effects of cognitive training as add-on treatment to stimulants would be premature.

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.

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.

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.

The relationship between gait variability and cognitive functions differs between fallers and non-fallers in MS.

Science.gov (United States)

Kalron, Alon; Aloni, Roy; Dolev, Mark; Frid, Lior; Givon, Uri; Menascu, Shay

2018-01-19

The objective of the study was to determine if cognitive function is associated with step time variability in people with multiple sclerosis (PwMS). The study included 355 PwMS (218 women), average age 41.1 (SD = 13.5), disease duration 5.9 (SD = 7.3) years, and a median expanded disability status scale score of 2.5. We separately analyzed the sample group of fallers and non-fallers based on their fall history. Gait variability was measured by an electronic walkway and all participants completed a computerized cognitive test battery designed to evaluate multiple cognitive domains. Fallers (43.7%) demonstrated elevated step time variability (%CV), 5.0 (SD = 3.4) vs. 3.5 (SD = 1.6), P < 0.001 compared to the non-faller subjects. According to the regression analysis in the non-fallers' group, step time variability was found significantly associated with the global cognitive score (P = 0.001), executive function subcategory (P = 0.038), and motor skills subcategory (P < 0.001). No relationship between step time variability and any cognitive domain was demonstrated in the faller group. This study illustrated that the association between gait variability and cognition occurs only in PwMS without a fall history. From a clinical standpoint, these findings might help medical professionals to create improved assessment tests and rehabilitation strategies in the MS population.

Rehabilitation in Managing MS

Science.gov (United States)

... at home and in the office. They recommend strategic modifications to the home and workplace to ensure accessibility, safety and convenience. Occupational therapists also evaluate and treat problems with thinking and memory . Cognitive rehabilitation Neuropsychologists — as well as ...

Cognitive behavioural therapy versus multidisciplinary rehabilitation treatment for patients with chronic fatigue syndrome: study protocol for a randomised controlled trial (FatiGo

Directory of Open Access Journals (Sweden)

Vos-Vromans Desirée CWM

2012-05-01

Full Text Available Abstract Background 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. Methods 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

Crossroads in aphasia rehabilitation

NARCIS (Netherlands)

W.M.E. van de Sandt-Koenderman (Mieke)

2007-01-01

textabstractThis thesis focusses on two types of aphasia rehabilitation, cognitive linguistic treatment (CLT) and AAC (Augmentative and Alternative Communication) training. In a study of the effect of nonlinguistic variables on the outcome of CLT, it was shown, that neuropsychological data

Current trends in stroke rehabilitation. A review with focus on brain plasticity.

Science.gov (United States)

Johansson, B B

2011-03-01

Current understanding of brain plasticity has lead to new approaches in ischemic stroke rehabilitation. Stroke units that combine good medical and nursing care with task-oriented intense training in an environment that provides confidence, stimulation and motivation significantly improve outcome. Repetitive trans-cranial magnetic stimulation (rTMS), and trans-cranial direct current stimulation (tDCS) are applied in rehabilitation of motor function. The long-term effect, optimal way of stimulation and possibly efficacy in cognitive rehabilitation need evaluation. Methods based on multisensory integration of motor, cognitive, and perceptual processes including action observation, mental training, and virtual reality are being tested. Different approaches of intensive aphasia training are described. Recent data on intensive melodic intonation therapy indicate that even patients with very severe non-fluent aphasia can regain speech through homotopic white matter tract plasticity. Music therapy is applied in motor and cognitive rehabilitation. To avoid the confounding effect of spontaneous improvement, most trials are preformed ≥3 months post stroke. Randomized controlled trials starting earlier after strokes are needed. More attention should be given to stroke heterogeneity, cognitive rehabilitation, and social adjustment and to genetic differences, including the role of BDNF polymorphism in brain plasticity. © 2010 John Wiley & Sons A/S.

User Acceptance of Computerized Cognitive Behavioral Therapy for Depression: Systematic Review.

Science.gov (United States)

Rost, Theresia; Stein, Janine; Löbner, Margrit; Kersting, Anette; Luck-Sikorski, Claudia; Riedel-Heller, Steffi G

2017-09-13

Computerized cognitive behavioral therapy (cCBT) has been proven to be effective in depression care. Moreover, cCBT packages are becoming increasingly popular. A central aspect concerning the take-up and success of any treatment is its user acceptance. The aim of this study was to update and expand on earlier work on user acceptance of cCBT for depression. This paper systematically reviewed quantitative and qualitative studies regarding the user acceptance of cCBT for depression. The initial search was conducted in January 2016 and involved the following databases: Web of Science, PubMed, the Cochrane Library, and PsycINFO. Studies were retained if they described the explicit examination of the user acceptance, experiences, or satisfaction related to a cCBT intervention, if they reported depression as a primary outcome, and if they were published in German or English from July 2007 onward. A total of 1736 studies were identified, of which 29 studies were eligible for review. User acceptance was operationalized and analyzed very heterogeneously. Eight studies reported a very high level of acceptance, 17 indicated a high level of acceptance, and one study showed a moderate level of acceptance. Two qualitative studies considered the positive and negative aspects concerning the user acceptance of cCBT. However, a substantial proportion of reviewed studies revealed several methodical shortcomings. In general, people experience cCBT for depression as predominantly positive, which supports the potential role of these innovative treatments. However, methodological challenges do exist in terms of defining user acceptance, clear operationalization of concepts, and measurement. ©Theresia Rost, Janine Stein, Margrit Löbner, Anette Kersting, Claudia Luck-Sikorski, Steffi G Riedel-Heller. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 13.09.2017.

Non-declarative memory in the rehabilitation of amnesia.

Science.gov (United States)

Cavaco, S; Malec, J F; Bergquist, T

2005-09-01

The ability of amnesic patients to learn and retain non-declarative information has been consistently demonstrated in the literature. This knowledge provided by basic cognitive neuroscience studies has been widely neglected in neuropsychological rehabilitation of memory impaired patients. This study reports the case of a 43 year old man with severe amnesia following an anterior communicating artery (ACoA) aneurysm rupture. The patient integrated a comprehensive (holistic) day treatment programme for rehabilitation of brain injury. The programme explored the advantages of using preserved non-declarative memory capacities, in the context of commonly used rehabilitation approaches (i.e. compensation for lost function and domain-specific learning). The patient's ability to learn and retain new cognitive and perceptual-motor skills was found to be critical for the patient's improved independence and successful return to work.

Computerized adaptive testing item selection in computerized adaptive learning systems

NARCIS (Netherlands)

Eggen, Theodorus Johannes Hendrikus Maria; Eggen, T.J.H.M.; Veldkamp, B.P.

2012-01-01

Item selection methods traditionally developed for computerized adaptive testing (CAT) are explored for their usefulness in item-based computerized adaptive learning (CAL) systems. While in CAT Fisher information-based selection is optimal, for recovering learning populations in CAL systems item

The cognitive conception of human being – with reference to social rehabilitation, how to change the under age crimminal into independent person

Directory of Open Access Journals (Sweden)

Justyna Siemionow

2012-12-01

Full Text Available Social rehabilitation has been changed for many years; it has become a dynamic science. The educators are still looking for new methods and techniques. They put purposes and they are going to achieve them within individual plan of resocialization. But they are agree that the most effective way of changing the bad behavior is to change the cognitive structures. The main purpose of social rehabilitation is to make an independent person. It is necessary to help under age criminals to make their new identity. They have to participate and act in new situations which can supply them new information and knowledge.

Regional brain morphometry predicts memory rehabilitation outcome after traumatic brain injury

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Gary E Strangman

2010-10-01

Full Text Available Cognitive deficits following traumatic brain injury (TBI commonly include difficulties with memory, attention, and executive dysfunction. These deficits are amenable to cognitive rehabilitation, but optimally selecting rehabilitation programs for individual patients remains a challenge. Recent methods for quantifying regional brain morphometry allow for automated quantification of tissue volumes in numerous distinct brain structures. We hypothesized that such quantitative structural information could help identify individuals more or less likely to benefit from memory rehabilitation. Fifty individuals with TBI of all severities who reported having memory difficulties first underwent structural MRI scanning. They then participated in a 12 session memory rehabilitation program emphasizing internal memory strategies (I-MEMS. Primary outcome measures (HVLT, RBMT were collected at the time of the MRI scan, immediately following therapy, and again at one month post-therapy. Regional brain volumes were used to predict outcome, adjusting for standard predictors (e.g., injury severity, age, education, pretest scores. We identified several brain regions that provided significant predictions of rehabilitation outcome, including the volume of the hippocampus, the lateral prefrontal cortex, the thalamus, and several subregions of the cingulate cortex. The prediction range of regional brain volumes were in some cases nearly equal in magnitude to prediction ranges provided by pretest scores on the outcome variable. We conclude that specific cerebral networks including these regions may contribute to learning during I-MEMS rehabilitation, and suggest that morphometric measures may provide substantial predictive value for rehabilitation outcome in other cognitive interventions as well.

Computerized cognitive training in children and adolescents with attention deficit/hyperactivity disorder as add-on treatment to stimulants: feasibility study and protocol description

Directory of Open Access Journals (Sweden)

Virginia de Oliveira Rosa

Full Text Available Abstract Background Cognitive training has received increasing attention as a non-pharmacological approach for the treatment of attention deficit/hyperactivity disorder (ADHD in children and adolescents. Few studies have assessed cognitive training as add-on treatment to medication in randomized placebo controlled trials. The purpose of this preliminary study was to explore the feasibility of implementing a computerized cognitive training program for ADHD in our environment, describe its main characteristics and potential efficacy in a small pilot study. Methods Six ADHD patients aged 10-12-years old receiving stimulants and presenting residual symptoms were enrolled in a randomized clinical trial to either a standard cognitive training program or a controlled placebo condition for 12 weeks. The primary outcome was core ADHD symptoms measured using the Swanson, Nolan and Pelham Questionnaire (SNAP-IV scale. Results We faced higher resistance than expected to patient enrollment due to logistic issues to attend face-to-face sessions in the hospital and to fill the requirement of medication status and absence of some comorbidities. Both groups showed decrease in parent reported ADHD symptoms without statistical difference between them. In addition, improvements on neuropsychological tests were observed in both groups – mainly on trained tasks. Conclusions This protocol revealed the need for new strategies to better assess the effectiveness of cognitive training such as the need to implement the intervention in a school environment to have an assessment with more external validity. Given the small sample size of this pilot study, definitive conclusions on the effects of cognitive training as add-on treatment to stimulants would be premature.

Rehabilitation after traumatic brain injury.

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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.

Therapies for Cognitive Deficits Associated With Chemotherapy for Breast Cancer: A Systematic Review of Objective Outcomes.

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Morean, Diane F; O'Dwyer, Linda; Cherney, Leora R

2015-10-01

To systematically review evidence of treatments for cognitive impairments experienced by at least 20% of all women who undergo chemotherapy for breast cancer. Searches of 5 databases (PubMed, Embase, Cochrane CENTRAL, PsycINFO, CINAHL), with no date or language restrictions, identified 1701 unique results. Search terms included breast cancer, chemotherapy, chemobrain, chemofog, and terms on cognition and language deficits. Included only peer-reviewed journal articles that described therapies for cognitive dysfunction in women undergoing (or who had undergone) chemotherapy for breast cancer and provided objective measurements of cognition or language. Data were extracted according to Cochrane recommendations, including characteristics of participants, interventions, outcomes, and studies. Quality assessment of all 12 eligible studies was performed using the Physiotherapy Evidence Database scale and treatment fidelity criteria. Screening, data extraction, and quality assessment reliability were performed. Six articles described interventions for cognition that took place during cancer treatment; 6, afterward. Five interventions were medical (including a strength-training program), 2 were restorative, and 5 were cognitive. Medicinal treatments were ineffective; restorative and exercise treatments had mixed results; cognitive therapy had success in varying cognitive domains. The domains most tested and most successfully treated were verbal memory, attention, and processing speed. Cognitive therapy protocols delivered after chemotherapy and aimed at improving verbal memory, attention, and processing speed hold the most promise. Future research is needed to clarify whether computerized cognitive training can be effective in treating this population, and to identify objective assessment tools that are sensitive to this disorder. Copyright © 2015 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

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

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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

The Impact of a Home-Based Computerized Cognitive Training Intervention on Fall Risk Measure Performance in Community Dwelling Older Adults, a Pilot Study.

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Blackwood, J; Shubert, T; Fogarty, K; Chase, C

2016-02-01

Cognitive intervention studies have reported improvements in various domains of cognition as well as a transfer effect of improved function post training. Despite the availability of web based cognitive training programs, most intervention studies have been performed under the supervision of researchers. Therefore, the purpose of this study was to first, examine the feasibility of a six week home based computerized cognitive training (CCT) program in a group of community dwelling older adults and, second, to determine if a CCT program which focused on set shifting, attention, and visual spatial ability impacted fall risk measure performance. This pilot study used a pretest/posttest experimental design with randomization by testing site to an intervention or control group. Community dwelling older adults (mean age = 74.6 years) participated in either the control (N=25) or the intervention group (N=19). Intervention group subjects participated in 6 weeks of home based CCT 3x/week for an average of 23 minutes/session, using an online CCT program. Comparisons of mean scores on three measures of physical function (usual gait speed, five times sit to stand, timed up and go) were completed at baseline and week 7. Following the completion of an average of 18 sessions of CCT at home with good adherence (86%) and retention (92%) rates, a statistically significant difference in gait speed was found between groups with an average improvement of 0.14 m/s in the intervention group. A home based CCT program is a feasible approach to targeting cognitive impairments known to influence fall risk and changes in gait in older adults.

[Cognitive remediation in addictions treatment].

Science.gov (United States)

Pedrero-Perez, E J; Rojo-Mota, G; Ruiz-Sanchez de Leon, J M; Llanero-Luque, M; Puerta-Garcia, C

2011-02-01

More recent theories of addiction suggest that neurocognitive mechanisms, such as attentional processing, cognitive control, and reward processing play a key role in the development or maintenance of addiction. Ultimately, the addiction (with or without substances) is based on the alteration of brain decision-making processes. The neurosciences, particularly those responsible for behavior modification, must take into account the neurobiological processes underlying the observable behavior. Treatments of addiction usually do not take into account these findings, which may be at the base of the low retention rates and high dropout rates of addicted patients. Considered as an alteration of brain functioning, addiction could be addressed successfully through cognitive rehabilitation treatments used in other clinical pathologies such as brain damage or schizophrenia. Although there are few studies, it is suggest that intervention to improve patients' cognitive functioning can improve the efficiency of well-established cognitive-behavioral therapies, such as relapse prevention. This paper reviews the available evidence on cognitive rehabilitation in treating addiction as well as in other pathologies, in order to formulate interventions that may be included in comprehensive rehabilitation programs for people with addictive disorders.

Psychotropic Medication Use during Inpatient Rehabilitation for Traumatic Brain Injury

Science.gov (United States)

Hammond, Flora M.; Barrett, Ryan S.; Shea, Timothy; Seel, Ronald T.; McAlister, Thomas W.; Kaelin, Darryl; Ryser, David; Corrigan, John D.; Cullen, Nora; Horn, Susan D.

2015-01-01

by cognitive Functional Independence Measure (FIM) scores), except for those with higher admission cognitive FIM scores. Conclusion(s) Many psychotropic medications are used during inpatient rehabilitation. In general, lower admission FIM Cognitive groups were administered more of the medications under investigation, compared to those with higher cognitive function at admission. Considerable site variation existed regarding medications administered. The current investigation provides baseline data for future studies of effectiveness. PMID:26212402

Reasons for holding a Consensus Conference on neuropsychological rehabilitation in adult patients.

Science.gov (United States)

Làdavass, E; Paolucci, S; Umiltà, C

2011-03-01

Neuropsychological deficits are common in various cerebrovascular, neurodegenerative and traumatic pathologies. Neuropsychological rehabilitation refers to a set of interventions that aim to improve a person's ability to perform cognitive tasks by retraining previously learned skills and teaching compensatory strategies. However, today there are some relevant points that need of further investigations. In 2007, a Task Force was set up under the auspices of several scientific societies that operate in the field of psychology, neuropsychology, rehabilitation and neurology (AIP, GIRN, SIMFER, SIN, SINP, and SPAN) with the aim to clarify the theoretical background of neuropsychological rehabilitation and to assess the diagnostic instruments and the treatments available to date. This consensus conference (CC), using methods derived from those of Evidence-Based-Medicine (EMB), evaluated several points, including: a) legal aspects; b) epidemiological aspects; c) neuropsychological rehabilitation of attentional and executive disorders; d) neuropsychological rehabilitation of speech/language disorders; e) neuropsychological rehabilitation of visual field defects; f) neuropsychological rehabilitation of neglect; g) neuropsychological rehabilitation of memory disorders; h) cognitive rehabilitation of arm apraxia; i) neuropsychological rehabilitation of Alzheimer disease; j) rehabilitation of multiple sclerosis; k) rehabilitation of severe brain injuries; l) rehabilitation of mild to moderate brain injuries; m) rehabilitation of behavioral disorders in severe brain injuries. Then, CC submitted to a specific Jury a final report with summary tables and questions. The final meeting of the Jury was held in Siena in February 2010.

The effects of rehabilitation on intellectually-disabled people – a systematic review

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Ernest J. Sechoaro

2014-08-01

Objective: To synthesise critically and summarise the best available evidence of the effects of rehabilitation on intellectually-disabled people. Method: Literature searches of different electronic databases and manual searches were conducted using selected keywords. Studies on the effects of rehabilitation on intellectually-disabled people were selected systematically, appraised critically for methodological quality and summarised. Results: Rehabilitation interventions indicated good outcomes with regard to intellectually-disabled people. Findings showed that people with mild to moderate intellectual disabilities improved in terms of activities of daily living (ADL after rehabilitation. Improvement was noted in ADL, self-care skills, communication skills and cognitive achievements. Conclusion: Findings demonstrated positive rehabilitation effects on intellectually-disabled people. This study contributes to the comprehensive nursing care of intellectually-disabled people by endorsement of the effectiveness of rehabilitation in terms of ADL, self-care skills, communication skills and cognitive achievements. The collected evidence of this study may contribute to the education of more effective nurse practitioners involved in the daily care and rehabilitation of intellectually-disabled people.

Benefits of extending and adjusting the level of difficulty on computerized cognitive training for children with intellectual disabilities.

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Ottersen, Jon; Grill, Katja M

2015-01-01

Training on working memory (WM) improves attention and WM in children with attention-deficit hyperactivity disorder and memory impairments. However, for children with intellectual disabilities (ID), the results have been less encouraging. In this preliminary study it was hypothesized that children with ID would benefit from an extended amount of training and that the level of difficulty during training would affect the outcome. We included 21 children with mild or moderate ID aged 8-13 years. They went through between 37 and 50 training sessions with an adaptive computerized program on WM and non-verbal reasoning (NVR). The children were divided into two subgroups with different difficulty levels during training. The transfer to untrained cognitive tests was compared to the results of 22 children with ID training only 25 sessions, and to a control group. We found that the training group with the extended training program improved significantly on a block design task measuring NVR and on a WM task compared to the control group. There was also a significantly larger improvement on block design relative to the training group with the shorter training time. The children that received easier training tasks also improved significantly more on a verbal WM task compared to children with more demanding tasks. In conclusion, these preliminary data suggest that children with ID might benefit from cognitive training with longer training periods and less demanding tasks, compared to children without disabilities.

Benefits of extending and adjusting the level of difficulty on computerized cognitive training for children with intellectual disabilities

Directory of Open Access Journals (Sweden)

Jon eOttersen

2015-08-01

Full Text Available Training on working memory (WM improves attention and working memory in children with attention-deficit hyperactivity disorder and memory impairments. However, for children with intellectual disabilities (ID, the results have been less encouraging. In this preliminary study it was hypothesized that children with ID would benefit from an extended amount of training and that the level of difficulty during training would affect the outcome. We included 21 children with mild or moderate intellectual disabilities aged 8–13 years. They went through between 37 and 50 training sessions with an adaptive computerized program on WM and non-verbal reasoning (NVR. The children were divided into two subgroups with different difficulty levels during training. The transfer to untrained cognitive tests was compared to the results of 22 children with intellectual disabilities training only 25 sessions, and to a control group. We found that the training group with the extended training program improved significantly on a block design task measuring NVR and on a WM task compared to the control group. There was also a significantly larger improvement on block design relative to the training group with the shorter training time. The children that received easier training tasks also improved significantly more on a verbal WM task compared to children with more demanding tasks.In conclusion, these preliminary data suggest that children with ID might benefit from cognitive training with longer training periods and less demanding tasks, compared to children without disabilities.

Reliability of a Computerized Neurocognitive Test in Baseline Concussion Testing of High School Athletes.

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MacDonald, James; Duerson, Drew

2015-07-01

Baseline assessments using computerized neurocognitive tests are frequently used in the management of sport-related concussions. Such testing is often done on an annual basis in a community setting. Reliability is a fundamental test characteristic that should be established for such tests. Our study examined the test-retest reliability of a computerized neurocognitive test in high school athletes over 1 year. Repeated measures design. Two American high schools. High school athletes (N = 117) participating in American football or soccer during the 2011-2012 and 2012-2013 academic years. All study participants completed 2 baseline computerized neurocognitive tests taken 1 year apart at their respective schools. The test measures performance on 4 cognitive tasks: identification speed (Attention), detection speed (Processing Speed), one card learning accuracy (Learning), and one back speed (Working Memory). Reliability was assessed by measuring the intraclass correlation coefficient (ICC) between the repeated measures of the 4 cognitive tasks. Pearson and Spearman correlation coefficients were calculated as a secondary outcome measure. The measure for identification speed performed best (ICC = 0.672; 95% confidence interval, 0.559-0.760) and the measure for one card learning accuracy performed worst (ICC = 0.401; 95% confidence interval, 0.237-0.542). All tests had marginal or low reliability. In a population of high school athletes, computerized neurocognitive testing performed in a community setting demonstrated low to marginal test-retest reliability on baseline assessments 1 year apart. Further investigation should focus on (1) improving the reliability of individual tasks tested, (2) controlling for external factors that might affect test performance, and (3) identifying the ideal time interval to repeat baseline testing in high school athletes. Computerized neurocognitive tests are used frequently in high school athletes, often within a model of baseline testing

Communication skills and thalamic lesion: Strategies of rehabilitation.

Science.gov (United States)

Amaddii, Luisa; Centorrino, Santi; Cambi, Jacopo; Passali, Desiderio

2014-01-01

To describe the speech rehabilitation history of patients with thalamic lesions. Thalamic lesions can affect speech and language according to diverse thalamic nuclei involved. Because of the strategic functional position of the thalamus within the cognitive networks, its lesion can also interfere with other cognitive processes, such as attention, memory and executive functions. Alterations of these cognitive domains contribute significantly to language deficits, leading to communicative inefficacy. This fact must be considered in the rehabilitation efforts. Whereas evaluation of cognitive functions and communicative efficiency is different from that of aphasic disorder, treatment should also be different. The treatment must be focused on specific cognitive deficits with belief in the regaining of communicative ability, as well as it occurs in therapy of pragmatic disorder in traumatic brain injury: attention process training, mnemotechnics and prospective memory training. According to our experience: (a) there is a close correlation between cognitive processes and communication skills; (b) alterations of attention, memory and executive functions cause a loss of efficiency in the language use; and (c) appropriate cognitive treatment improves pragmatic competence and therefore the linguistic disorder. For planning a speech-therapy it is important to consider the relationship between cognitive functions and communication. The cognitive/behavioral treatment confirms its therapeutic efficiency for thalamic lesions. Copyright © 2014 Polish Otorhinolaryngology - Head and Neck Surgery Society. Published by Elsevier Urban & Partner Sp. z.o.o. All rights reserved.

A computerized Stroop task to assess cancer-related cognitive biases.

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DiBonaventura, Marco DaCosta; Erblich, Joel; Sloan, Richard P; Bovbjerg, Dana H

2010-01-01

Biases in processing information related to sources of stress have widely been demonstrated with the use of Stroop emotional color word tasks. One study reported such biases among women with histories of breast cancer in a first-degree relative (FH+) who were given a Stroop cancer word task. This study aimed to replicate and extend these findings with a computerized version of the task. Response latencies and errors were recorded during administration of the task to FH+ and FH- women. A cancer list and 5 comparison lists were administered. Results indicated that FH+ women exhibited longer response latencies for cancer words than did FH- women (p Stroop cancer word task.

Computerized Working-Memory Training for Children Following Arterial Ischemic Stroke: A Pilot Study With Long-Term Follow-Up.

Science.gov (United States)

Eve, Megan; O'Keeffe, Fiadhnait; Jhuty, Simren; Ganesan, Vijeya; Brown, Gary; Murphy, Tara

2016-01-01

Cognitive deficits in the domains of working memory (WM) and executive function are well documented following childhood arterial ischemic stroke (AIS). However, there are currently no evidence-based cognitive interventions for this population. Computerized, implicit WM training has been demonstrated to generate generalized cognitive gains for children with WM and attention deficits and for adults following brain injury. This study used a pilot design to investigate the efficacy and feasibility of such an intervention program (Cogmed WM Training) for a childhood AIS population. Outcomes were measured via psychometric assessment at preintervention and postintervention and again at 1-year follow-up. At longitudinal follow-up, participants were found to have significant and persistent cognitive difficulties, particularly with attention and response inhibition. Following the computerized, implicit WM intervention, a significant improvement in phonological-loop WM was seen; however, this improvement was not maintained after 12 months. No additional significant improvements on standardized psychometric outcome measures were seen either immediately or at 12-month follow-up. Findings of this pilot study therefore do not currently support Cogmed as an effective intervention for children with AIS but highlight the need for further research, including randomized, controlled trials, to investigate cognitive interventions for the childhood AIS population.

Effects of music production on cortical plasticity within cognitive rehabilitation of patients with mild traumatic brain injury.

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Vik, Berit Marie Dykesteen; Skeie, Geir Olve; Vikane, Eirik; Specht, Karsten

2018-01-01

We explored the effects of playing the piano on patients with cognitive impairment after mild traumatic brain injury (mTBI) and, addressed the question if this approach would stimulate neural networks in re-routing neural connections and link up cortical circuits that had been functional inhibited due to disruption of brain tissue. Functional neuroimaging scans (fMRI) and neuropsychological tests were performed pre-post intervention. Three groups participated, one mTBI group (n = 7), two groups of healthy participants, one with music training (n = 11), one baseline group without music (n = 12). The music groups participated in 8 weeks music-supported intervention. The patient group revealed training-related neuroplasticity in the orbitofrontal cortex. fMRI results fit well with outcome from neuropsychological tests with significant enhancement of cognitive performance in the music groups. Ninety per cent of mTBI group returned to work post intervention. Here, for the first time, we demonstrated behavioural improvements and functional brain changes after 8 weeks of playing piano on patients with mTBI having attention, memory and social interaction problems. We present evidence for a causal relationship between musical training and reorganisation of neural networks promoting enhanced cognitive performance. These results add a novel music-supported intervention within rehabilitation of patients with cognitive deficits following mTBI.

Advances in outcomes measurement in rehabilitation medicine: current initiatives from the National Institutes of Health and the National Institute on Disability and Rehabilitation Research.

Science.gov (United States)

Tulsky, David S; Carlozzi, Noelle E; Cella, David

2011-10-01

The articles in this supplement present recent advances in the measurement of patient-reported health-related quality-of-life (HRQOL) outcomes. Specifically, these articles highlight the combined efforts of the National Institutes of Health, National Institute for Neurological Disorders and Stroke, National Center on Medical Rehabilitation Research, National Institute on Disability and Rehabilitation Research, and Department of Veterans Affairs Rehabilitation Research and Development Service to improve HRQOL measurement. In addition, this supplement is intended to provide rehabilitation professionals with information about these efforts and the implications that these advances in outcomes measurement have for rehabilitation medicine and clinical practice. These new measurement scales use state-of-the-art method techniques, including item response theory and computerized adaptive testing. In addition, scale development involves both qualitative and quantitative methods, as well as the administration of items to hundreds or even thousands of research participants. The scales deliberately have been built with overlap of items between scales so that linkages and equivalency scores can be computed. Ultimately, these scales should facilitate direct comparison of outcomes instruments across studies and will serve as standard data elements across research trials without compromising the specificity of disease- or condition-targeted measures. This supplement includes the initial publications for many of these new measurement initiatives, each of which provides researchers and clinicians with better tools for evaluation of the efficacy of their interventions. Copyright © 2011 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Self-Reported Decline in Everyday Function, Cognitive Symptoms, and Cognitive Function in People With HIV

DEFF Research Database (Denmark)

Laverick, Rosanna; Haddow, Lewis; Daskalopoulou, Marina

2017-01-01

BACKGROUND: We determined factors associated with self-reported decline in activities of daily living (ADLs) and symptoms of cognitive impairment in HIV positive adults in 5 European clinics. METHODS: HIV+ adults underwent computerized and pen-and-paper neuropsychological tests and questionnaires...

Personalized cognitive training in unipolar and bipolar disorder: a study of cognitive functioning

Directory of Open Access Journals (Sweden)

Marek ePreiss

2013-05-01

Full Text Available Patients with unipolar depressive disorder and in the depressive phase of bipolar disorder often manifest psychological distress and cognitive deficits, notably in Executive Control. We used computerized cognitive training in anattempt to reduce psychological affliction, improve everyday coping and cognitive function. We asked one group of patients (intervention group to engage in cognitive training three times a week, for 20 minutes each time, for eight consecutive weeks. A second group of patients (control group received standard care only. Before the onset of training we administered to all patients self-report questionnaires of mood, mental and psychological health, and everyday coping. We also assessed Executive Control using a broad computerized neurocognitive battery of tests which yielded, among others, scores in Working Memory, Shifting, Inhibition, Visuomotor Vigilance, Divided Attention, Memory Span and a Global Executive Function score. All questionnaires and tests were re-administered to the patients who adhered to the study at the end of training. When we compared the groups (between-group comparisons on the amount of change that had taken place from baseline to post-training, we found improvements in Executive Control. Further exploration of the data showed that the cognitive improvements did not predict the improvements in everyday coping, and mood. Single-group data (within-group comparisons show that patients in the intervention group were reporting fewer cognitive failures, fewer dysexecutive incidents and less difficulty in everyday coping. This group had also improved significantly on the six Executive Control tests and on the Global Executive Control score. By contrast, the control group improved only on the reports of cognitive failure and on working memory.

Combined social cognitive and neurocognitive rehabilitation strategies in schizophrenia: neuropsychological and psychopathological influences on Theory of Mind improvement.

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Bechi, M; Bosia, M; Spangaro, M; Buonocore, M; Cocchi, F; Pigoni, A; Piantanida, M; Guglielmino, C; Bianchi, L; Smeraldi, E; Cavallaro, R

2015-11-01

Neurocognitive and social cognitive impairments represent important treatment targets in schizophrenia, as they are significant predictors of functional outcome. Different rehabilitative interventions have recently been developed, addressing both cognitive and psychosocial domains. Although promising, results are still heterogeneous and predictors of treatment outcome are not yet identified. In this study we evaluated the efficacy of two newly developed social cognitive interventions, respectively based on the use of videotaped material and comic strips, combined with domain-specific Cognitive Remediation Therapy (CRT). We also analysed possible predictors of training outcome, including basal neurocognitive performance, the degree of cognitive improvement after CRT and psychopathological variables. Seventy-five patients with schizophrenia treated with CRT, were randomly assigned to: social cognitive training (SCT) group, Theory of Mind Intervention (ToMI) group, and active control group (ACG). ANOVAs showed that SCT and ToMI groups improved significantly in ToM measures, whereas the ACG did not. We reported no influences of neuropsychological measures and improvement after CRT on changes in ToM. Both paranoid and non-paranoid subjects improved significantly after ToMI and SCT, without differences between groups, despite the better performance in basal ToM found among paranoid patients. In the ACG only non-paranoid patients showed an improvement in non-verbal ToM. Results showed that both ToMI and SCT are effective in improving ToM in schizophrenia with no influence of neuropsychological domains. Our data also suggest that paranoid symptoms may discriminate between different types of ToM difficulties in schizophrenia.

Therapeutic effects of intensive inpatient rehabilitation in advanced Parkinson's disease

OpenAIRE

Kaseda, Yumiko; Ikeda, Junko; Sugihara, Katsunobu; Yamawaki, Takemori; Kohriyama, Tatsuo; Matsumoto, Masayasu

2016-01-01

Abstract Background The importance of rehabilitation therapy in Parkinson's disease is well recognized. However, the effects of an inpatient rehabilitation program for advanced Parkinson's disease have not been fully investigated. Aim To assess the effects of intensive inpatient rehabilitation. Methods We enrolled 31 patients (mean age 69.5 ? 9.4 years; mean disease duration 8.8 ? 6.4 years) with advanced Parkinson's disease, without severe cognitive impairment. The median Hoehn?Yahr stage wa...

The Role of Client Motivation in Workplace Rehabilitation

OpenAIRE

Amanda Mabin; Christine Randall

2014-01-01

Motivation has been recognised as an essential component in managing medical issues, adjusting to physical disability, cognitive impairment, returning to work, and improving psychosocial functioning (Wagner & McMahon, 2004).  This research explores the role of client motivation in workplace rehabilitation and demonstrates the implications for rehabilitation counselling practice. The research focuses on understanding the concept of motivation, reasons for its presence or absence, and why motiv...

Toward an evidence-based patient-provider communication in rehabilitation: linking communication elements to better rehabilitation outcomes.

Science.gov (United States)

Jesus, Tiago Silva; Silva, Isabel Lopes

2016-04-01

There is a growing interest in linking aspects of patient-provider communication to rehabilitation outcomes. However, the field lacks a conceptual understanding on: (a) 'how' rehabilitation outcomes can be improved by communication; and (b) through 'which' elements in particular. This article elaborates on the conceptual developments toward informing further practice and research. Existing models of communication in healthcare were adapted to rehabilitation, and its outcomes through a comprehensive literature review. After depicting mediating mechanisms and variables (e.g. therapeutic engagement, adjustment toward disability), this article presents the '4 Rehab Communication Elements' deemed likely to underpin rehabilitation outcomes. The four elements are: (a) knowing the person and building a supportive relationship; (b) effective information exchange and education; (c) shared goal-setting and action planning; and (d) fostering a more positive, yet realistic, cognitive and self-reframing. This article describes an unprecedented, outcomes-oriented approach toward the design of rehabilitation communication, which has resulted in the development of a new intervention model: the '4 Rehab Communication Elements'. Further trials are needed to evaluate the impact of this whole intervention model on rehabilitation outcomes. © The Author(s) 2015.

Focused and Sustained Attention Is Modified by a Goal-Based Rehabilitation in Parkinsonian Patients.

Science.gov (United States)

Ferrazzoli, Davide; Ortelli, Paola; Maestri, Roberto; Bera, Rossana; Gargantini, Roberto; Palamara, Grazia; Zarucchi, Marianna; Giladi, Nir; Frazzitta, Giuseppe

2017-01-01

Rehabilitation for patients with Parkinson's disease (PD) is based on cognitive strategies that exploit attention. Parkinsonians exhibit impairments in divided attention and interference control. Nevertheless, the effectiveness of specific rehabilitation treatments based on attention suggests that other attentional functions are preserved. Data about attention are conflicting in PD, and it is not clear whether rehabilitative treatments that entail attentional strategies affect attention itself. Reaction times (RTs) represent an instrument to explore attention and investigate whether changes in attentional performances parallel rehabilitation induced-gains. RTs of 103 parkinsonian patients in "on" state, without cognitive deficits, were compared with those of a population of 34 healthy controls. We studied those attentional networks that subtend the use of cognitive strategies in motor rehabilitation: alertness and focused and sustained attention, which is a component of the executive system. We used visual and auditory RTs to evaluate alertness and multiple choices RTs (MC RTs) to explore focused and sustained attention. Parkinsonian patients underwent these tasks before and after a 4-week multidisciplinary, intensive and goal-based rehabilitation treatment (MIRT). Unified Parkinson's Disease Rating Scale (UPDRS) III and Timed Up and Go test (TUG) were assessed at the enrollment and at the end of MIRT to evaluate the motor-functional effectiveness of treatment. We did not find differences in RTs between parkinsonian patients and controls. Further, we found that improvements in motor-functional outcome measures after MIRT ( p attention, are preserved in "on" state. This explains why Parkinsonians benefit from a goal-based rehabilitation that entails the use of attention. The reduction in MC RTs suggests a positive effect of MIRT on the executive component of attention and indicates that this type of rehabilitation provides benefits by exploiting executive functions

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

Improving the utility of the fine motor skills subscale of the comprehensive developmental inventory for infants and toddlers: a computerized adaptive test.

Science.gov (United States)

Huang, Chien-Yu; Tung, Li-Chen; Chou, Yeh-Tai; Chou, Willy; Chen, Kuan-Lin; Hsieh, Ching-Lin

2017-07-27

This study aimed at improving the utility of the fine motor subscale of the comprehensive developmental inventory for infants and toddlers (CDIIT) by developing a computerized adaptive test of fine motor skills. We built an item bank for the computerized adaptive test of fine motor skills using the fine motor subscale of the CDIIT items fitting the Rasch model. We also examined the psychometric properties and efficiency of the computerized adaptive test of fine motor skills with simulated computerized adaptive tests. Data from 1742 children with suspected developmental delays were retrieved. The mean scores of the fine motor subscale of the CDIIT increased along with age groups (mean scores = 1.36-36.97). The computerized adaptive test of fine motor skills contains 31 items meeting the Rasch model's assumptions (infit mean square = 0.57-1.21, outfit mean square = 0.11-1.17). For children of 6-71 months, the computerized adaptive test of fine motor skills had high Rasch person reliability (average reliability >0.90), high concurrent validity (rs = 0.67-0.99), adequate to excellent diagnostic accuracy (area under receiver operating characteristic = 0.71-1.00), and large responsiveness (effect size = 1.05-3.93). The computerized adaptive test of fine motor skills used 48-84% fewer items than the fine motor subscale of the CDIIT. The computerized adaptive test of fine motor skills used fewer items for assessment but was as reliable and valid as the fine motor subscale of the CDIIT. Implications for Rehabilitation We developed a computerized adaptive test based on the comprehensive developmental inventory for infants and toddlers (CDIIT) for assessing fine motor skills. The computerized adaptive test has been shown to be efficient because it uses fewer items than the original measure and automatically presents the results right after the test is completed. The computerized adaptive test is as reliable and valid as the CDIIT.

Cognitive training on stroke patients via virtual reality-based serious games.

Science.gov (United States)

Gamito, Pedro; Oliveira, Jorge; Coelho, Carla; Morais, Diogo; Lopes, Paulo; Pacheco, José; Brito, Rodrigo; Soares, Fabio; Santos, Nuno; Barata, Ana Filipa

2017-02-01

Use of virtual reality environments in cognitive rehabilitation offers cost benefits and other advantages. In order to test the effectiveness of a virtual reality application for neuropsychological rehabilitation, a cognitive training program using virtual reality was applied to stroke patients. A virtual reality-based serious games application for cognitive training was developed, with attention and memory tasks consisting of daily life activities. Twenty stroke patients were randomly assigned to two conditions: exposure to the intervention, and waiting list control. The results showed significant improvements in attention and memory functions in the intervention group, but not in the controls. Overall findings provide further support for the use of VR cognitive training applications in neuropsychological rehabilitation. Implications for Rehabilitation Improvements in memory and attention functions following a virtual reality-based serious games intervention. Training of daily-life activities using a virtual reality application. Accessibility to training contents.

'Hot' cognition in major depressive disorder

DEFF Research Database (Denmark)

Miskowiak, Kamilla W; Carvalho, Andre F

2014-01-01

Major depressive disorder (MDD) is associated with significant cognitive dysfunction in both 'hot' (i.e. emotion-laden) and 'cold' (non-emotional) domains. Here we review evidence pertaining to 'hot' cognitive changes in MDD. This systematic review searched the PubMed and PsycInfo computerized......-limbic network with hyper-activity in limbic and ventral prefrontal regions paired with hypo-activity of dorsal prefrontal regions subserve these abnormalities. A cross-talk of 'hot' and 'cold' cognition disturbances in MDD occurs. Disturbances in 'hot cognition' may also contribute to the perpetuation......' cognition deficits in healthy relatives of patients with MDD. Taken together, these findings suggest that abnormalities in 'hot' cognition may constitute a candidate neurocognitive endophenotype for depression....

Cognitive Symptom Management and Rehabilitation Therapy (CogSMART) for veterans with traumatic brain injury: pilot randomized controlled trial.

Science.gov (United States)

Twamley, Elizabeth W; Jak, Amy J; Delis, Dean C; Bondi, Mark W; Lohr, James B

2014-01-01

Traumatic brain injury (TBI) can result in cognitive impairments and persistent postconcussive symptoms that limit functional recovery, including return to work. We evaluated a 12 wk compensatory cognitive training intervention (Cognitive Symptom Management and Rehabilitation Therapy [CogSMART]) in the context of supported employment for Veterans with mild to moderate TBI. Participants were randomly assigned to receive 12 wk of supported employment plus CogSMART or enhanced supported employment that controlled for therapist attention (control). CogSMART sessions were delivered by the employment specialist and included psychoeducation regarding TBI; strategies to improve sleep, fatigue, headaches, and tension; and compensatory cognitive strategies in the domains of prospective memory, attention, learning and memory, and executive functioning. Compared with controls, those assigned to supported employment plus CogSMART demonstrated significant reductions in postconcussive symptoms (Cohen d = 0.97) and improvements in prospective memory functioning (Cohen d = 0.72). Effect sizes favoring CogSMART for posttraumatic stress disorder symptom severity, depressive symptom severity, and attainment of competitive work within 14 wk were in the small to medium range (Cohen d = 0.35-0.49). Those who received CogSMART rated the intervention highly. Results suggest that adding CogSMART to supported employment may improve postconcussive symptoms and prospective memory. These effects, as well as smaller effects on psychiatric symptoms and ability to return to work, warrant replication in a larger trial.

Predictors for living at home after geriatric inpatient rehabilitation: A prospective cohort study.

OpenAIRE

Kool, Jan; Oesch, Peter; Bachmann, Stefan

2017-01-01

OBJECTIVE To evaluate patient characteristics predicting living at home after geriatric rehabilitation. DESIGN Prospective cohort study. PATIENTS A total of 210 patients aged 65 years or older receiving inpatient rehabilitation. METHODS Candidate predictors evaluated during rehabilitation were: age, vulnerability (Vulnerable Elders Survey), multimorbidity (Cumulative Illness Rating Scale), cognition (Mini-Mental State Examination), depression (Hospital Anxiety and ...

Feasibility of the evidence-based cognitive telerehabilitation program ReMind for patients with primary brain tumors

NARCIS (Netherlands)

van der Linden, S.D.; Sitskoorn, M.M.; Rutten, G.J.M.; Gehring, K.

2018-01-01

Many patients with primary brain tumors experience cognitive deficits. Cognitive rehabilitation programs focus on alleviating these deficits, but availability of such programs is limited. Our large randomized controlled trial (RCT) demonstrated positive effects of the cognitive rehabilitation

Personalized cognitive training in unipolar and bipolar disorder: a study of cognitive functioning.

Science.gov (United States)

Preiss, Marek; Shatil, Evelyn; Cermáková, Radka; Cimermanová, Dominika; Ram, Ilana

2013-01-01

Patients with unipolar depressive disorder and in the depressive phase of bipolar disorder often manifest psychological distress and cognitive deficits, notably in executive control. We used computerized cognitive training in an attempt to reduce psychological affliction, improve everyday coping, and cognitive function. We asked one group of patients (intervention group) to engage in cognitive training three times a week, for 20 min each time, for eight consecutive weeks. A second group of patients (control group) received standard care only. Before the onset of training we administered to all patients self-report questionnaires of mood, mental and psychological health, and everyday coping. We also assessed executive control using a broad computerized neurocognitive battery of tests which yielded, among others, scores in Working Memory, Shifting, Inhibition, Visuomotor Vigilance, Divided Attention, Memory Span, and a Global Executive Function score. All questionnaires and tests were re-administered to the patients who adhered to the study at the end of training. When we compared the groups (between-group comparisons) on the amount of change that had taken place from baseline to post-training, we found significantly reduced depression level for the intervention group. This group also displayed significant improvements in Shifting, Divided Attention, and in the Global executive control score. Further exploration of the data showed that the cognitive improvement did not predict the improvements in mood. Single-group data (within-group comparisons) show that patients in the intervention group were reporting fewer cognitive failures, fewer dysexecutive incidents, and less difficulty in everyday coping. This group had also improved significantly on the six executive control tests and on the Global executive control score. By contrast, the control group improved only on the reports of cognitive failure and on working memory.

Cognitive remediation therapy for older adults

Directory of Open Access Journals (Sweden)

Indira Sharma

2016-01-01

Full Text Available There is a large body of research on cognitive interventions for older adults the review which suggests the following: (1 Cognition remediation therapy is indicated for healthy elderly, and in mild cognitive impairment (MCI, early dementia, brain disease and injury, and severe mental illness (SMI. (2 Studies on healthy elderly demonstrate that with cognitive training (CT, cognitive stimulation (CS, and/or cognitive rehabilitation (CR age-related cognitive decline can be reversed, at least partially if not fully, even in advanced age, with improved social functioning and quality of life. Better results are obtained if cognitive remediation therapy (CRT is combined with vocational/psychosocial rehabilitation. Generalization of training to activities of daily living (ADL and to secondary outcome measures such as quality of life and self-esteem are issues that need to be addressed in older adults. (3 Research in MCI has indicated that CRT, especially memory training, has some role. Future studies should place focus on the assessment of dose-response relationship, training generalization, and ecologically relevant approaches. (4 Findings of earlier work in early-stage dementia were frustrating, more recent work, especially randomized controlled trials of high quality, has provided a ray of rope with respect to effectiveness of CT and CR. Further well-designed studies are required to provide more definitive evidence. (5 Significant therapeutic effects of CR have been observed on cognitive function and ADL in the elderly patients with stroke. Routine screening for stroke patients and those with brain injury for cognitive impairment is recommended. (6 Available research provides evidence that cognitive remediation benefits people with SMI, and when combined with psychiatric rehabilitation this benefit generalizes to functioning. Elderly with SMI need special focus. Further needs to be carried out on older people with SMI.

A practical application of text mining to literature on cognitive rehabilitation and enhancement through neurostimulation.

Science.gov (United States)

Balan, Puiu F; Gerits, Annelies; Vanduffel, Wim

2014-01-01

The exponential growth in publications represents a major challenge for researchers. Many scientific domains, including neuroscience, are not yet fully engaged in exploiting large bodies of publications. In this paper, we promote the idea to partially automate the processing of scientific documents, specifically using text mining (TM), to efficiently review big corpora of publications. The "cognitive advantage" given by TM is mainly related to the automatic extraction of relevant trends from corpora of literature, otherwise impossible to analyze in short periods of time. Specifically, the benefits of TM are increased speed, quality and reproducibility of text processing, boosted by rapid updates of the results. First, we selected a set of TM-tools that allow user-friendly approaches of the scientific literature, and which could serve as a guide for researchers willing to incorporate TM in their work. Second, we used these TM-tools to obtain basic insights into the relevant literature on cognitive rehabilitation (CR) and cognitive enhancement (CE) using transcranial magnetic stimulation (TMS). TM readily extracted the diversity of TMS applications in CR and CE from vast corpora of publications, automatically retrieving trends already described in published reviews. TMS emerged as one of the important non-invasive tools that can both improve cognitive and motor functions in numerous neurological diseases and induce modulations/enhancements of many fundamental brain functions. TM also revealed trends in big corpora of publications by extracting occurrence frequency and relationships of particular subtopics. Moreover, we showed that CR and CE share research topics, both aiming to increase the brain's capacity to process information, thus supporting their integration in a larger perspective. Methodologically, despite limitations of a simple user-friendly approach, TM served well the reviewing process.

A practical application of text mining to literature on cognitive rehabilitation and enhancement through neurostimulation

Directory of Open Access Journals (Sweden)

Puiu F Balan

2014-09-01

Full Text Available The exponential growth in publications represents a major challenge for researchers. Many scientific domains, including neuroscience, are not yet fully engaged in exploiting large bodies of publications. In this paper, we promote the idea to partially automate the processing of scientific documents, specifically using text mining (TM, to efficiently review big corpora of publications. The cognitive advantage given by TM is mainly related to the automatic extraction of relevant trends from corpora of literature, otherwise impossible to analyze in short periods of time. Specifically, the benefits of TM are increased speed, quality and reproducibility of text processing, boosted by rapid updates of the results. First, we selected a set of TM-tools that allow user-friendly approaches of the scientific literature, and which could serve as a guide for researchers willing to incorporate TM in their work. Second, we used these TM-tools to obtain basic insights into the relevant literature on cognitive rehabilitation (CR and cognitive enhancement (CE using transcranial magnetic stimulation (TMS. TM readily extracted the diversity of TMS applications in CR and CE from vast corpora of publications, automatically retrieving trends already described in published reviews. TMS emerged as one of the important non-invasive tools that can both improve cognitive and motor functions in numerous neurological diseases and induce modulations/enhancements of many fundamental brain functions. TM also revealed trends in big corpora of publications by extracting occurrence frequency and relationships of particular subtopics. Moreover, we showed that CR and CE share research topics, both aiming to increase the brain’s capacity to process information, thus supporting their integration in a larger perspective. Methodologically, despite limitations of a simple user-friendly approach, TM served well the reviewing process.

The impact of positive, negative and neutral stimuli in a virtual reality cognitive-motor rehabilitation task: a pilot study with stroke patients.

Science.gov (United States)

Cameirão, Mónica S; Faria, Ana Lúcia; Paulino, Teresa; Alves, Júlio; Bermúdez I Badia, Sergi

2016-08-09

Virtual Reality (VR) based methods for stroke rehabilitation have mainly focused on motor rehabilitation, but there is increasing interest in integrating motor and cognitive training to increase similarity to real-world settings. Unfortunately, more research is needed for the definition of which type of content should be used in the design of these tools. One possibility is the use of emotional stimuli, which are known to enhance attentional processes. According to the Socioemotional Selectivity Theory, as people age, the emotional salience arises for positive and neutral, but not for negative stimuli. For this study we developed a cognitive-motor VR task involving attention and short-term memory, and we investigated the impact of using emotional images of varying valence. The task consisted of finding a target image, shown for only two seconds, among fourteen neutral distractors, and selecting it through arm movements. After performing the VR task, a recall task took place and the patients had to identify the target images among a valence-matched number of distractors. Ten stroke patients participated in a within-subjects experiment with three conditions based on the valence of the images: positive, negative and neutral. Eye movements were recorded during VR task performance with an eye tracking system. Our results show decreased attention for negative stimuli in the VR task performance when compared to neutral stimuli. The recall task shows significantly more wrongly identified images (false memories) for negative stimuli than for neutral. Regression and correlation analyses with the Montreal Cognitive Assessment and the Geriatric Depression Scale revealed differential effects of cognitive function and depressive symptomatology in the encoding and recall of positive, negative and neutral images. Further, eye movement data shows reduced search patterns for wrongly selected stimuli containing emotional content. The results of this study suggest that it is feasible

Individualized evaluation of cholinesterase inhibitors effects in dementia with adaptive cognitive testing

NARCIS (Netherlands)

Wouters, Hans; van Campen, Jos P. C. M.; Appels, Bregje A.; Beijnen, Jos H.; Zwinderman, Aeilko H.; van Gool, Willem A.; Schmand, Ben

2016-01-01

Computerized Adaptive Testing (CAT) of cognitive function, selects for every individual patient, only items of appropriate difficulty to estimate his or her level of cognitive impairment. Therefore, CAT has the potential to combine brevity with precision. We retrospectively examined the evaluation

Individualized evaluation of cholinesterase inhibitors effects in dementia with adaptive cognitive testing

NARCIS (Netherlands)

Wouters, Hans; Van Campen, Jos P C M; Appels, Bregje A; Beijnen, Jos H; Zwinderman, Aeilko H; Van Gool, Willem A; Schmand, Ben

2015-01-01

Computerized Adaptive Testing (CAT) of cognitive function, selects for every individual patient, only items of appropriate difficulty to estimate his or her level of cognitive impairment. Therefore, CAT has the potential to combine brevity with precision. We retrospectively examined the evaluation

Individualized evaluation of cholinesterase inhibitors effects in dementia with adaptive cognitive testing

NARCIS (Netherlands)

Wouters, H.; van Campen, J.P.C.M.; Appels, B.A.; Beijnen, J.H.; Zwinderman, A.H.; van Gool, W.A.; Schmand, B.

Computerized Adaptive Testing (CAT) of cognitive function, selects for every individual patient, only items of appropriate difficulty to estimate his or her level of cognitive impairment. Therefore, CAT has the potential to combine brevity with precision. We retrospectively examined the evaluation

THE CHANGES OF BEHAVIORS AND COGNITIVE FUNCTIONS BY COGNITIVE BEHAVIOURAL THERAPY IN THE DRUG ABUSERS

Directory of Open Access Journals (Sweden)

Herni Susanti

2017-04-01

Full Text Available Introduction: This study was aimed to find out the effect of CBT on the behaviors i.e. depressive, agressive and antisocial behaviors as well as cognitive functions of patients who were treated in rehabilitation unit at a drug addiction hospital (Rumah Sakit Ketergantungan Obat in Jakarta. Method: The research design was Quasi experimental pre-post test without control group by providing intervention: CBT for 6 sessions (10–12 times intervention. The population was all patients in the rehabilitation unit with a nursing diagnosis: low self esteem and/or inffective coping strategies. There were 23 participants who involved in this investigation. The data was analized by using dependent and independent sample t, and anova tests. Result: The results showed that p value for depressive behaviours, agressive behaviurs, antisocial behaviors, and cognitive functions were 0.914; 0.001; 0.039; 0.003 respectively. The outcomes indicated that there was significant impact of CBT on agressive behaviors, antisocial behaviors, and cognitive functions (α = 0.05, p value 0.05. Discussion: It is argued that depressive symptoms might not be apparent for the users in rehabilitative phase. The findings also showed that there was significant relation between antisocial behaviors and the length of drug usage. This affirms exsiting concepts in that long drug usage brings about serious damage in the users' behaviors and cognitive functions. It is recommended, therefore, to include CBT as an important intervention for clients with drug abuse problems who are cared in rehabilitation center.

Rehabilitation exoskeletal robotics. The promise of an emerging field.

Science.gov (United States)

Pons, José L

2010-01-01

Exoskeletons are wearable robots exhibiting a close cognitive and physical interaction with the human user. These are rigid robotic exoskeletal structures that typically operate alongside human limbs. Scientific and technological work on exoskeletons began in the early 1960s but have only recently been applied to rehabilitation and functional substitution in patients suffering from motor disorders. Key topics for further development of exoskeletons in rehabilitation scenarios include the need for robust human-robot multimodal cognitive interaction, safe and dependable physical interaction, true wearability and portability, and user aspects such as acceptance and usability. This discussion provides an overview of these aspects and draws conclusions regarding potential future research directions in robotic exoskeletons.

Rehabilitation of deaf persons with cochlear implants

International Nuclear Information System (INIS)

Gstoettner, W.; Hamzavi, J.; Czerny, C.

1997-01-01

In the last decade, the rehabilitation of postlingually deaf adults and prelingually deaf children with cochlear implants has been established as a treatment of deafness. The technological development of the implant devices and improvement of the surgical technique have led to a considerable increase of hearing performance during the last years. The postlingually deaf adults are able to use the telephone and may be integrated in their original job. Prelingually deaf children can even visit normal schools after cochlear implantation and hearing rehabilitation training. In order to preoperatively establish the state of the cochlear, radiological diagnosis of the temporal bone is necessary. High resolution computerized tomography imaging of the temporal bone with coronar and axial 1 mm slices and MRI with thin slice technique (three dimensional, T2 weighted turbo-spinecho sequence with 0.7 mm slices) have proved to be valuable according to our experience. Furthermore a postoperative synoptical X-ray, in a modified Chausse III projection, offers good information about the position of the implant and insertion of the stimulating electrode into the cochlea. (orig.) [de

Self-Perceived Benefits of Cognitive Training in Healthy Older Adults

Directory of Open Access Journals (Sweden)

Vina M. Goghari

2018-04-01

Full Text Available The idea that individualized, computer-based cognitive training improves cognitive functioning in non-trained domains is highly contested. An understudied area is whether cognitive training improves one’s own perception of cognitive and day-to-day functioning. Furthermore, no studies have compared working memory training to programs that train higher-level processes themselves, namely logic and planning, in improving perception of cognitive abilities. We investigated self-reported changes in: (a cognitive errors relevant to daily life; (b expectations regarding training; and (c impact of training on daily life, in healthy older adults who completed working memory training or logic and planning training. Ninety-seven healthy older adults completed 8-weeks of computerized cognitive training that targeted either working memory or logic and planning. Findings were compared to a no-training control group. Participants reported fewer cognitive failures relevant to daily life after training compared to the no-training control group, with a greater reduction in errors reported by the logic and planning training group compared to the working memory training group. Trainees’ perception of training efficacy decreased over time. Nonetheless, approximately half of the participants in both training groups endorsed “some improvement” or more in self-perceived day-to-day functioning at post-testing. These results support the conclusion that individualized computerized cognitive training may enhance subjective perceptions of change and that higher level cognitive training may confer additional benefits. Findings suggest that cognitive training can enhance cognitive self-efficacy in healthy seniors.

Computerized test versus personal interview as admission methods for graduate nursing studies: A retrospective cohort study.

Science.gov (United States)

Hazut, Koren; Romem, Pnina; Malkin, Smadar; Livshiz-Riven, Ilana

2016-12-01

The purpose of this study was to compare the predictive validity, economic efficiency, and faculty staff satisfaction of a computerized test versus a personal interview as admission methods for graduate nursing studies. A mixed method study was designed, including cross-sectional and retrospective cohorts, interviews, and cost analysis. One hundred and thirty-four students in the Master of Nursing program participated. The success of students in required core courses was similar in both admission method groups. The personal interview method was found to be a significant predictor of success, with cognitive variables the only significant contributors to the model. Higher satisfaction levels were reported with the computerized test compared with the personal interview method. The cost of the personal interview method, in annual hourly work, was 2.28 times higher than the computerized test. These findings may promote discussion regarding the cost benefit of the personal interview as an admission method for advanced academic studies in healthcare professions. © 2016 John Wiley & Sons Australia, Ltd.

Development of early comprehensive stroke inpatient rehabilitation in Poland - current status and future requirements.

Science.gov (United States)

Sarzyńska-Długosz, Iwona; Krawczyk, Maciej; Członkowska, Anna

2011-01-01

Every stroke patient should undergo early rehabilitation. We aimed to evaluate accessibility, development and needs in early stroke inpatient rehabilitation in Poland. A questionnaire evaluating rehabilitation departments was prepared and sent (in 2004 and 2008) to rehabilitation wards in Poland, where stroke patients are treated and undergo early rehabilitation. We divided departments into classes: class A - having comprehensive rehabilitation (physiotherapy minimum 60 minutes/day, speech therapy minimum 30 minutes/5 days/week, rehabilitation of other cognitive impairments minimum 30 minutes/5 days/week, group physiotherapy); B - having the possibility of all types of therapy, but done less frequently; C - physiotherapy and speech therapy; D - physiotherapy and cognitive rehabilitation; E - only physiotherapy. In 2004, we obtained responses from 115 of 172 (66.9%) rehabilitation departments. According to prespecified criteria there were 11 class A, 31 class B, 28 class C, 4 class D, and 41 class E wards. In 2008, we received response from 89 of 149 (59.7%) rehabilitation departments. According to prespecified criteria there were 17 class A, 40 class B, 22 class C, 0 class D, and 10 class E wards. In 2004, 159 beds and in 2008, 294 beds in class A departments were available for stroke patients. The minimal number of needed but lacking beds was 604 in 2004 and 469 in 2008. Development of departments providing early comprehensive stroke rehabilitation from 2004 to 2008 is marked, but still insufficient. In 2008, 19% of rehabilitation departments could provide comprehensive stroke rehabilitation and this was 38.5% of beds actually needed.

Designing Intuitive Web Solutions for Monitoring Patients’ Rehabilitation at Home

Directory of Open Access Journals (Sweden)

Raihana Ferdous

2015-12-01

Full Text Available This paper describes the design of web-based remote monitoring interfaces aimed at supporting therapists and caregivers in supervising motor-cognitive rehabilitation plans of care to be performed by patients at home. This work was part of a three years’ research project where game-based environments for upper body motor rehabilitation of post-stroke patients were developed in collaboration with two main rehabilitation centers in Italy and Austria, for a subsequent deployment at patients’ homes. The paper will specifically focus on describing the iterative design of the home rehabilitation features for clinicians over the first two years of the project to enable the delivery and monitoring of more personalized, engaging plans of care for home therapy by rehabilitation centers and services.

Music-based interventions in neurological rehabilitation.

Science.gov (United States)

Sihvonen, Aleksi J; Särkämö, Teppo; Leo, Vera; Tervaniemi, Mari; Altenmüller, Eckart; Soinila, Seppo

2017-08-01

During the past ten years, an increasing number of controlled studies have assessed the potential rehabilitative effects of music-based interventions, such as music listening, singing, or playing an instrument, in several neurological diseases. Although the number of studies and extent of available evidence is greatest in stroke and dementia, there is also evidence for the effects of music-based interventions on supporting cognition, motor function, or emotional wellbeing in people with Parkinson's disease, epilepsy, or multiple sclerosis. Music-based interventions can affect divergent functions such as motor performance, speech, or cognition in these patient groups. However, the psychological effects and neurobiological mechanisms underlying the effects of music interventions are likely to share common neural systems for reward, arousal, affect regulation, learning, and activity-driven plasticity. Although further controlled studies are needed to establish the efficacy of music in neurological recovery, music-based interventions are emerging as promising rehabilitation strategies. Copyright © 2017 Elsevier Ltd. All rights reserved.

Steady State Visual Evoked Potential Based Brain-Computer Interface for Cognitive Assessment

DEFF Research Database (Denmark)

Westergren, Nicolai; Bendtsen, Rasmus L.; Kjær, Troels W.

2016-01-01

decline is important. Cognitive decline may be detected using fullyautomated computerized assessment. Such systems will provide inexpensive and widely available screenings of cognitive ability. The aim of this pilot study is to develop a real time steady state visual evoked potential (SSVEP) based brain-computer...... interface (BCI) for neurological cognitive assessment. It is intended for use by patients who suffer from diseases impairing their motor skills, but are still able to control their gaze. Results are based on 11 healthy test subjects. The system performance have an average accuracy of 100% ± 0%. The test...... subjects achieved an information transfer rate (ITR) of 14:64 bits/min ± 7:63 bits=min and a subject test performance of 47:22% ± 34:10%. This study suggests that BCI may be applicable in practice as a computerized cognitive assessment tool. However, many improvements are required for the system...

[Investigation and analysis of the cognition degree of parents of 150 pediatric burn patients on scar rehabilitation].

Science.gov (United States)

Han, Da-wei; Fu, Jin-feng; Yan, Gang; Jiang, He; Liu, Wen-jun

2013-02-01

To analyze the cognition degree of parents of pediatric burn patients on hyperplasia of scar and its prevention and rehabilitation, so as to provide a guidance for preventing deformity and dysfunction caused by scar hyperplasia. Questionnaire survey was carried out among parents of 150 pediatric burn patients hospitalized from October 2010 to November 2011 to analyze the cognition degree of patients on the formation of scar after burns, the demand degree for scar treatment between parents of different genders of patients and among parents of patients with burn injury occurred in different body sites, the relationship between the literacy level of parents and their degree of willingness of undergoing scar treatment, and the degree of comprehension and acceptance on the part of parents regarding the methods of prevention and treatment of scar. Data were processed with chi-square test or Fisher's exact test. (1) Only the parents of 19 pediatric burn patients (accounting for 12.7%) realized the possibility of scar formation before admission. After admission, more than half of the parents were told that their children would bear scar and need regular follow-up, while only parents of 52 patients (34.7%) were instructed the methods of preventing and treating scar. (2) One hundred and forty parents (93.3%) considered their children need prevention and treatment of scar after burns. There was no statistically significant difference between parents of male patients and female patients in the demand for scar treatment (χ(2) = 0.825, P > 0.05). The demand degree of parents for rehabilitation treatment for the upper limbs after burns surpassed those of the other sites of body, and altogether there were 85 parents accounting for 97.7% of all. (3) The difference among parents with different levels of literacy was not obvious in the willingness of receiving treatment for scar hyperplasia (P > 0.05). (4) Eight methods were chosen by parents to prevent and treat scars of patients

Computerizing primary schools in rural kenya

DEFF Research Database (Denmark)

Ogembo, J.G.; Ngugi, B.; Pelowski, Matthew John

2012-01-01

questions surrounding this endeavour. Specifically: 1.) what problems do rural schools actually want to solve with computerization; 2.) is computerization the most important priority for rural schools; 3.) are schools ready, in terms of infrastructure, for a computer in the classroom; or 4.) might...... and protective roofing -posing severe challenges to the outstanding conception of computerization. We consider these results and make recommendations for better adapting programs for computer introduction, and also suggest the use of new innovative devices, such as cell phones, which might already have overcome......This paper investigates the outstanding challenges facing primary schools' computerization in rural Kenya. Computerization of schools is often envisaged as a 'magic', or at least a particularly efficient, solution to many of the problems that developing countries face in improving primary school...

Assessment of Minimal HE (with emphasis on computerized psychometric tests)

Science.gov (United States)

Kappus, Matthew R; Bajaj, Jasmohan S

2012-01-01

Synopsis Minimal hepatic encephalopathy (MHE) is associated with a high risk of development of overt hepatic encephalopathy, impaired quality of life and driving accidents. The detection of MHE requires specialized testing since it cannot by definition, be diagnosed on standard clinical examination. Psychometric (paper-pencil or computerized or a combination) and neuro-physiological techniques are often used to test for MHE. Paper-pencil psychometric batteries like the Psychometric Hepatic Encephalopathy Score (PHES) have been validated in several countries but do not have US normative values. Computerized tests such as the inhibitory control test (ICT), cognitive drug research system and Scan test have proven useful to diagnose MHE and predict outcomes. The specificity and sensitivity of these tests are similar to the recommended gold standards. Neuro-physiological tests such as the EEG and its interpretations, evoked potentials and Critical Flicker Frequency (CFF) also provide useful information. The diagnosis of MHE is an important issue for clinicians and patients alike and the testing strategies depend on the normative data available, patient comfort and local expertise. PMID:22321464

Acute cognitive dysfunction after hip fracture

DEFF Research Database (Denmark)

Bitsch, M S; Foss, N B; Kristensen, B B

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...

Music based cognitive remediation therapy for patients with traumatic brain injury

Directory of Open Access Journals (Sweden)

Shantala eHegde

2014-03-01

Full Text Available Traumatic brain injury (TBI is one of the common causes of disability in physical, psychological and social domains of functioning leading to poor quality of life. TBI leads to impairment in sensory, motor, language and emotional processing, and also in cognitive functions such as attention, information processing, executive functions and memory. Cognitive impairment plays a central role in functional recovery in TBI. Innovative methods such as music therapy to alleviate cognitive impairments have been investigated recently. The role of music in cognitive rehabilitation is evolving, based on newer findings emerging from the fields of neuromusicology and music cognition. Research findings from these fields have contributed significantly to our understanding of music perception and cognition, and its neural underpinnings. From a neuroscientific perspective, indulging in music is considered as one of the best cognitive exercises. With ‘plasticity’ as its veritable nature, brain engages in producing music indulging an array of cognitive functions and the product, the music, in turn permits restoration and alter brain functions. With scientific findings as its basis, ‘Neurologic Music Therapy’ (NMT has been developed as a systematic treatment method to improve sensorimotor, language and cognitive domains of functioning via music. A preliminary study examining the effect of NMT in cognitive rehabilitation has reported promising results in improving executive functions along with improvement in emotional adjustment and decreasing depression and anxiety following TBI. The potential usage of music-based cognitive rehabilitation therapy in various clinical conditions including TBI is yet to be fully explored. There is a need for systematic research studies to bridge the gap between increasing theoretical understanding of usage of music in cognitive rehabilitation and application of the same in a heterogeneous condition such as TBI.

Music-based cognitive remediation therapy for patients with traumatic brain injury.

Science.gov (United States)

Hegde, Shantala

2014-01-01

Traumatic brain injury (TBI) is one of the common causes of disability in physical, psychological, and social domains of functioning leading to poor quality of life. TBI leads to impairment in sensory, motor, language, and emotional processing, and also in cognitive functions such as attention, information processing, executive functions, and memory. Cognitive impairment plays a central role in functional recovery in TBI. Innovative methods such as music therapy to alleviate cognitive impairments have been investigated recently. The role of music in cognitive rehabilitation is evolving, based on newer findings emerging from the fields of neuromusicology and music cognition. Research findings from these fields have contributed significantly to our understanding of music perception and cognition, and its neural underpinnings. From a neuroscientific perspective, indulging in music is considered as one of the best cognitive exercises. With "plasticity" as its veritable nature, brain engages in producing music indulging an array of cognitive functions and the product, the music, in turn permits restoration and alters brain functions. With scientific findings as its basis, "neurologic music therapy" (NMT) has been developed as a systematic treatment method to improve sensorimotor, language, and cognitive domains of functioning via music. A preliminary study examining the effect of NMT in cognitive rehabilitation has reported promising results in improving executive functions along with improvement in emotional adjustment and decreasing depression and anxiety following TBI. The potential usage of music-based cognitive rehabilitation therapy in various clinical conditions including TBI is yet to be fully explored. There is a need for systematic research studies to bridge the gap between increasing theoretical understanding of usage of music in cognitive rehabilitation and application of the same in a heterogeneous condition such as TBI.

A Robot-Based Tool for Physical and Cognitive Rehabilitation of Elderly People Using Biofeedback

Science.gov (United States)

Lopez-Samaniego, Leire; Garcia-Zapirain, Begonya

2016-01-01

This publication presents a complete description of a technological solution system for the physical and cognitive rehabilitation of elderly people through a biofeedback system, which is combined with a Lego robot. The technology used was the iOS’s (iPhone Operating System) Objective-C programming language and its XCode programming environment; and SQLite in order to create the database. The biofeedback system is implemented by the use of two biosensors which are, in fact, a Microsoft band 2 in order to register the user’s heart rate and a MYO sensor to detect the user’s arm movement. Finally, the system was tested with seven elderly people from La Santa y Real Casa de la Misericordia nursing home in Bilbao. The statistical assessment has shown that the users are satisfied with the usability of the system, with a mean score of 79.29 on the System Usability Scale (SUS) questionnaire. PMID:27886146

Demographic Variables and Selective, Sustained Attention and Planning through Cognitive Tasks among Healthy Adults

Directory of Open Access Journals (Sweden)

Afsaneh Zarghi

2011-04-01

Full Text Available Introduction: Cognitive tasks are considered to be applicable and appropriate in assessing cognitive domains. The purpose of our study is to determine the relationship existence between variables of age, sex and education with selective, sustained attention and planning abilities by means of computerized cognitive tasks among healthy adults. Methods: A cross-sectional study was implemented during 6 months from June to November, 2010 on 84 healthy adults (42 male and 42 female. The whole participants performed computerized CPT, STROOP and TOL tests after being content and trained. Results: The obtained data indicate that there is a significant correlation coefficient between age, sex and education variables (p<0.05. Discussion: The above-mentioned tests can be used to assess selective, sustained attention and planning.

Design and Implementation of an Assistive Controller for Rehabilitation Robotic Systems

Directory of Open Access Journals (Sweden)

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.

Virtual Rehabilitation with Children: Challenges for Clinical Adoption [From the Field].

Science.gov (United States)

Glegg, Stephanie

2017-01-01

Virtual, augmented, and mixed reality environments are increasingly being developed and used to address functional rehabilitation goals related to physical, cognitive, social, and psychological impairments. For example, a child with an acquired brain injury may participate in virtual rehabilitation to address impairments in balance, attention, turn taking, and engagement in therapy. The trend toward virtual rehabilitation first gained momentum with the adoption of commercial off-the-shelf active video gaming consoles (e.g., Nintendo Wii and XBox). Now, we are seeing the rapid emergence of customized rehabilitation-specific systems that integrate technological advances in virtual reality, visual effects, motion tracking, physiological monitoring, and robotics.

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

Education attenuates the negative impact of traumatic brain injury on cognitive status.

Science.gov (United States)

Sumowski, James F; Chiaravalloti, Nancy; Krch, Denise; Paxton, Jessica; Deluca, John

2013-12-01

To investigate whether the cognitive reserve hypothesis helps to explain differential cognitive impairment among survivors of traumatic brain injury (TBI), whereby survivors with greater intellectual enrichment (estimated with education) are less vulnerable to cognitive impairment. Cross-sectional study. Medical rehabilitation research center. Survivors of moderate or severe TBI (n=44) and healthy controls (n=36). Not applicable. Intellectual enrichment was estimated with educational attainment. Group was defined as TBI or healthy control. Current cognitive status (processing speed, working memory, episodic memory) was evaluated with neuropsychological tasks. TBI survivors exhibited worse cognitive status than healthy persons (Peducation was positively correlated with cognitive status in TBI survivors (r=.54, Peducation (R(2) change=.036, P=.004), whereas higher education attenuated the negative impact of TBI on cognitive status. TBI survivors with lower education performed much worse than matched healthy persons, but this TBI-related performance discrepancy was attenuated at higher levels of education. Higher intellectual enrichment (estimated with education) reduces the negative effect of TBI on cognitive outcomes, thereby supporting the cognitive reserve hypothesis in persons with TBI. Future work is necessary to investigate whether intellectual enrichment can build cognitive reserve as a rehabilitative intervention in survivors of TBI. Copyright © 2013 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Outcomes and weight-bearing status during rehabilitation after arthroplasty for hip fractures.

Science.gov (United States)

Siebens, Hilary C; Sharkey, Phoebe; Aronow, Harriet U; Horn, Susan D; Munin, Michael C; DeJong, Gerben; Smout, Randall J; Radnay, Craig S

2012-08-01

To examine the association of weight-bearing status with patient-related variables and outcomes of inpatient rehabilitation after hip arthroplasty for acute hip fracture. A multi-site prospective observational cohort study. Eighteen skilled nursing and inpatient rehabilitation facilities. Patients with hip fractures (N = 224) treated with hip arthroplasty and admitted to either skilled nursing or inpatient rehabilitation facilities; a subset (N = 84) with telephone follow-up outcomes 8 months after rehabilitation discharge. Measurements included demographic variables, medical severity using the Comprehensive Severity Index, and functional levels using the Functional Independence Measure. MAIN OUTCOMES MEASUREMENT: Cognitive, motor, and total Functional Independence Measure scores at rehabilitation discharge and at 8-month follow-up; living location at discharge and follow-up. Patients on average (standard deviation) were 76.8 ± 11.4 years old, mainly women (78%), and mainly white (87%). In unadjusted analysis, weight bearing as tolerated (WBAT) was associated with less osteoarthritis (P = .025) and lower admission medical severity (ACSI) (P = .014). One participating facility had a significant preponderance of restricted weight-bearing cases. WBAT had no bivariate association with cognitive or motor function at discharge. Therapists cited restricted weight bearing as a barrier to therapy in 11% of cases. In logistic regressions, lower medical admission severity, older age, and one specified site significantly predicted WBAT (c statistic = 0.714). Significant predictors for home discharge included lower maximum severity (P < .001), younger age (P < .001), higher cognition (P = .037), and WBAT (P = .051) (c statistic = 0.863). WBAT is associated with a greater likelihood of home discharge and had similar functional outcomes compared with restricted weight bearing. These findings add support for allowing WBAT after arthroplasty for hip fracture. Copyright © 2012

The implementation of computerized cognitive behavioural therapies in a service user-led, third sector self help clinic.

Science.gov (United States)

Cavanagh, Kate; Seccombe, Nick; Lidbetter, Nicky

2011-07-01

The efficacy and effectiveness of a computerized cognitive behavioural therapy (CCBT) package, Beating the Blues, has been demonstrated in a large randomized controlled trial and several pragmatic studies in the National Health Service (NHS). The current study tests the generalizability of this finding to the implementation of CCBT in a service user-led, third sector Self Help Clinic. 510 referrals for the Beating the Blues program were received over a 16 month period in routine care. The Patient Health Questionnaire Depression (PHQ-9) and Anxiety (GAD-7) Scales were administered pre-treatment and during each treatment session. The 10-item Clinical Outcomes in Routine Evaluation-Outcome Measure (CORE-OM), Work and Social Adjustment Scale and Patient Experience Questionnaire were also administered pre-treatment and immediately on completing treatment. More than two-thirds of referrals were suitable for treatment and completed a baseline assessment; 84% of these started the Beating the Blues program. Two-hundred and twenty-six people meeting caseness criteria at baseline completed at least two sessions of CCBT. Of these, 50% met recovery criteria at their final point of measurement. Completer and intention-to-treat analysis also demonstrated statistically and clinically significant improvements on key outcome measures. CCBT can be effectively implemented in a service user-led, third sector Self Help Clinic, increasing access to psychological therapies to meet local needs for tier two interventions for depression and anxiety.

Computerized adaptive testing in computer assisted learning?

NARCIS (Netherlands)

Veldkamp, Bernard P.; Matteucci, Mariagiulia; Eggen, Theodorus Johannes Hendrikus Maria; De Wannemacker, Stefan; Clarebout, Geraldine; De Causmaecker, Patrick

2011-01-01

A major goal in computerized learning systems is to optimize learning, while in computerized adaptive tests (CAT) efficient measurement of the proficiency of students is the main focus. There seems to be a common interest to integrate computerized adaptive item selection in learning systems and

A multi-faceted knowledge translation approach to support persons with stroke and cognitive impairment: evaluation protocol.

Science.gov (United States)

McEwen, Sara E; Donald, Michelle; Dawson, Deirdre; Egan, Mary Y; Hunt, Anne; Quant, Sylvia; Runions, Sharron; Linkewich, Elizabeth

2015-11-05

Patients with cognitive impairments following a stroke are often denied access to inpatient rehabilitation. The few patients with cognitive impairment admitted to rehabilitation generally receive services based on outdated impairment-reduction models, rather than recommended function-based approaches. Both reduced access to rehabilitation and the knowledge-to-practice gap stem from a reported lack of skills and knowledge regarding cognitive rehabilitation on the part of inpatient rehabilitation team members. To address these issues, a multi-faceted knowledge translation (KT) initiative will be implemented and evaluated. It will be targeted specifically at the inter-professional application of the cognitive orientation to daily occupational performance (CO-OP). CO-OP training combined with KT support is called CO-OP KT. The long-term objective of CO-OP KT is to optimize functional outcomes for individuals with stroke and cognitive impairments. Three research questions are posed: 1. Is the implementation of CO-OP KT associated with a change in the proportion of patients with cognitive impairment following a stroke accepted to inpatient rehabilitation? 2. Is the implementation of CO-OP KT associated with a change in rehabilitation clinicians' practice, knowledge, and self-efficacy related to implementing the CO-OP approach, immediately following and 1 year later? 3. Is CO-OP KT associated with changes in activity, participation, and self-efficacy to perform daily activities in patients with cognitive impairment following stroke at discharge from inpatient rehabilitation and at 1-, 3-, and 6-month follow-ups? Three interrelated studies will be conducted. Study 1 will be a quasi-experimental, interrupted time series design measuring monthly summaries of stroke unit level data. Study 2, which relates to changes in health care professional practice and self-efficacy, will be a single group pre-post evaluation design incorporating chart audits and a self-report survey

Force and touch make video games 'serious' for dexterity rehabilitation.

Science.gov (United States)

Confalonieri, Michele; Guandalini, Giovanni; Da Lio, Mauro; De Cecco, Mariolino

2012-01-01

Computerized interfaces are able to represent 3D immersive simulations. Most of them make use of joystick, mouse, gloves, or grasp pressure transducers. Those have the drawback of 'filtering' the user interaction and/or de-locate the touch with respect to the visual stimulus. To overcome this we developed dexterity rehabilitation games on a novel touch interface that measures also force. The system allows dexterity training through 'direct' manipulation of virtual objects in 3D. Two dimensions via the touch screen, the third by the force channel. Tactile feedback is provided with a vibration device mounted on the screen back.

Behavior change, acceptance, and coping flexibility in highly distressed patients with rheumatic diseases: feasibility of a cognitive-behavioral therapy in multimodal rehabilitation.

Science.gov (United States)

Vriezekolk, Johanna E; Geenen, Rinie; van den Ende, Cornelia H M; Slot, Helma; van Lankveld, Wim G J M; van Helmond, Toon

2012-05-01

To describe the development and feasibility of the integration of a cognitive-behavioral therapy (CBT) within a multimodal rehabilitation program for highly distressed patients with rheumatic diseases. Development included the detailed specification of the theoretical and empirical-based underpinnings of the CBT and the comprehensive description of its design and content. Feasibility was assessed by percentage of eligible patients, attrition and attendance rates, and patient satisfaction. The developed CBT component seeks to decrease psychological distress and improve activities and participation across multiple life domains by accomplishing behavior change, acceptance, and coping flexibility. Motivational interviewing was applied to endorse patients' own reasons to change. Forty percent (35/87) of the eligible patients were admitted to the program. Attendance rate (>95%) was high. Patient satisfaction ranged from 6.8 to 8.0 (10-point scale). Integrating CBT within a multimodal rehabilitation program is feasible. An acceptable proportion of the intended patient sample is eligible and patient's attendance and satisfaction is high. Patients with impaired physical and psychosocial functioning despite adequate medical treatment pose a great challenge. Their treatment outcome may be improved by screening and selecting highly distressed patients and offering them a CBT embedded in multimodal rehabilitation program. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Community reintegration in rehabilitated South Indian persons with spinal cord injury.

Science.gov (United States)

Samuelkamaleshkumar, Selvaraj; Radhika, Somasundaram; Cherian, Binu; Elango, Aarumugam; Winrose, Windsor; Suhany, Baby T; Prakash, M Henry

2010-07-01

To explore community reintegration in rehabilitated South Indian persons with spinal cord injury (SCI) and to compare the level of community reintegration based on demographic variables. Survey. Rehabilitation center of a tertiary care university teaching hospital. Community-dwelling persons with SCI (N=104). Not applicable. Craig Handicap Assessment and Reporting Technique (CHART). The mean scores for each CHART domain were physical independence 98+/-5, social Integration 96+/-11, cognitive independence 92+/-17, occupation 70+/-34, mobility 65+/-18, and economic self sufficiency 53+/-40. Demographic variables showed no statistically significant difference with any of the CHART domains except for age and mobility, level of education, and social integration. Persons with SCI in rural South India who have completed comprehensive, mostly self-financed, rehabilitation with an emphasis on achieving functional ambulation, family support, and self-employment and who attend a regular annual follow-up show a high level of community reintegration in physical independence, social integration, and cognitive independence. CHART scores in the domains of occupation, mobility, and economic self-sufficiency showed lower levels of community reintegration. Copyright 2010 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Individual Differences in Working Memory Capacity Predicts Responsiveness to Memory Rehabilitation After Traumatic Brain Injury.

Science.gov (United States)

Sandry, Joshua; Chiou, Kathy S; DeLuca, John; Chiaravalloti, Nancy D

2016-06-01

To explore how individual differences affect rehabilitation outcomes by specifically investigating whether working memory capacity (WMC) can be used as a cognitive marker to identify who will and will not improve from memory rehabilitation. Post hoc analysis of a randomized controlled clinical trial designed to treat learning and memory impairment after traumatic brain injury (TBI): 2 × 2 between-subjects quasiexperimental design (2 [group: treatment vs control] × 2 [WMC: high vs low]). Nonprofit medical rehabilitation research center. Participants (N=65) with moderate to severe TBI with pre- and posttreatment data. The treatment group completed 10 cognitive rehabilitation sessions in which subjects were taught a memory strategy focusing on learning to use context and imagery to remember information. The placebo control group engaged in active therapy sessions that did not involve learning the memory strategy. Long-term memory percent retention change scores for an unorganized list of words from the California Verbal Learning Test-II. Group and WMC interacted (P=.008, ηp(2)=.12). High WMC participants showed a benefit from treatment compared with low WMC participants. Individual differences in WMC accounted for 45% of the variance in whether participants with TBI in the treatment group benefited from applying the compensatory treatment strategy to learn unorganized information. Individuals with higher WMC showed a significantly greater rehabilitation benefit when applying the compensatory strategy to learn unorganized information. WMC is a useful cognitive marker for identifying participants with TBI who respond to memory rehabilitation with the modified Story Memory Technique. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

COGNITIVE RESERVE IN DEMENTIA: IMPLICATIONS FOR COGNITIVE TRAINING

Directory of Open Access Journals (Sweden)

Sara eMondini

2016-04-01

Full Text Available Cognitive reserve (CR is a potential mechanism to cope with brain damage. The aim of this study was to evaluate the effect of cognitive reserve on a cognitive training (CT in a group of patients with dementia. 86 participants with mild to moderate dementia were identified by their level of CR quantified by the Cognitive Reserve Index questionnaire (CRIq and underwent a cycle of CT. A global measure of cognition (MMSE was obtained before (T0 and after (T1 the training. Multiple linear regression analyses highlighted CR as a significant factor able to predict changes in cognitive performance after the CT. In particular, patients with lower CR benefited from a CT program more than those with high CR. These data show that CR can modulate the outcome of a CT program and that it should be considered as a predictive factor of neuropsychological rehabilitation training efficacy in people with dementia.

Human Reliability Analysis For Computerized Procedures

International Nuclear Information System (INIS)

Boring, Ronald L.; Gertman, David I.; Le Blanc, Katya

2011-01-01

This paper provides a characterization of human reliability analysis (HRA) issues for computerized procedures in nuclear power plant control rooms. It is beyond the scope of this paper to propose a new HRA approach or to recommend specific methods or refinements to those methods. Rather, this paper provides a review of HRA as applied to traditional paper-based procedures, followed by a discussion of what specific factors should additionally be considered in HRAs for computerized procedures. Performance shaping factors and failure modes unique to computerized procedures are highlighted. Since there is no definitive guide to HRA for paper-based procedures, this paper also serves to clarify the existing guidance on paper-based procedures before delving into the unique aspects of computerized procedures.

Computerized Adaptive Personality Testing: A Review and Illustration With the MMPI-2 Computerized Adaptive Version.

Science.gov (United States)

Forbey, Johnathan D.; Ben-Porath, Yossef S.

2007-01-01

Computerized adaptive testing in personality assessment can improve efficiency by significantly reducing the number of items administered to answer an assessment question. Two approaches have been explored for adaptive testing in computerized personality assessment: item response theory and the countdown method. In this article, the authors…

Feasibility of incorporating functionally relevant virtual rehabilitation in sub-acute stroke care: perception of patients and clinicians.

Science.gov (United States)

Demers, Marika; Chan Chun Kong, Daniel; Levin, Mindy F

2018-03-11

To determine user satisfaction and safety of incorporating a low-cost virtual rehabilitation intervention as an adjunctive therapeutic option for cognitive-motor upper limb rehabilitation in individuals with sub-acute stroke. A low-cost upper limb virtual rehabilitation application incorporating realistic functionally-relevant unimanual and bimanual tasks, specifically designed for cognitive-motor rehabilitation was developed for patients with sub-acute stroke. Clinicians and individuals with stroke interacted with the intervention for 15-20 or 20-45 minutes, respectively. The study had a mixed-methods convergent parallel design that included a focus group interview with clinicians working in a stroke program and semi-structured interviews and standardized assessments (Borg Perceived Exertion Scale, Short Feedback Questionnaire) for participants with sub-acute stroke undergoing rehabilitation. The occurrence of adverse events was also noted. Three main themes emerged from the clinician focus group and patient interviews: Perceived usefulness in rehabilitation, satisfaction with the virtual reality intervention and aspects to improve. All clinicians and the majority of participants with stroke were highly satisfied with the intervention and perceived its usefulness to decrease arm motor impairment during functional tasks. No participants experienced major adverse events. Incorporation of this type of functional activity game-based virtual reality intervention in the sub-acute phase of rehabilitation represents a way to transfer skills learned early in the clinical setting to real world situations. This type of intervention may lead to better integration of the upper limb into everyday activities. Implications for Rehabilitation • Use of a cognitive-motor low-cost virtual reality intervention designed to remediate arm motor impairments in sub-acute stroke is feasible, safe and perceived as useful by therapists and patients for stroke rehabilitation. �

Rehabilitation of deaf persons with cochlear implants; Rehabilitation Hoergeschaedigter mit Cochlearimplantaten

Energy Technology Data Exchange (ETDEWEB)

Gstoettner, W.; Hamzavi, J. [Universitaetsklinik fuer Hals-Nasen-Ohrenheilkunde, Wien (Austria); Czerny, C. [Universitaetsklinik fuer Radiologie, Wien (Austria)

1997-12-01

In the last decade, the rehabilitation of postlingually deaf adults and prelingually deaf children with cochlear implants has been established as a treatment of deafness. The technological development of the implant devices and improvement of the surgical technique have led to a considerable increase of hearing performance during the last years. The postlingually deaf adults are able to use the telephone and may be integrated in their original job. Prelingually deaf children can even visit normal schools after cochlear implantation and hearing rehabilitation training. In order to preoperatively establish the state of the cochlear, radiological diagnosis of the temporal bone is necessary. High resolution computerized tomography imaging of the temporal bone with coronar and axial 1 mm slices and MRI with thin slice technique (three dimensional, T2 weighted turbo-spinecho sequence with 0.7 mm slices) have proved to be valuable according to our experience. Furthermore a postoperative synoptical X-ray, in a modified Chausse III projection, offers good information about the position of the implant and insertion of the stimulating electrode into the cochlea. (orig.) [Deutsch] In der letzten Dekade hat sich der operative Einsatz von Cochlearimplantaten fuer die Rehabilitation taubgeborener Kinder und ertaubter Erwachsenen als erfolgreiche Therapie etabliert. Durch technische Weiterentwicklung der Implantatsysteme und Verbesserung der Operationstechnik konnten in den letzten Jahren die Hoerleistungen der Patienten deutlich verbessert werden. Postlingual ertaubte Erwachsene koennen nun oftmals wieder ins Berufsleben eingegliedert werden und praelingual ertaubte Kinder koennen regulaere Schulen besuchen. Im Rahmen der Voruntersuchung fuer die Cochlearimplantation ist die radiologische Felsenbeindiagnostik von besonderer Bedeutung. Hochaufloesendes CT des Felsenbeins in koronaren und axialen Ebenen mit 1 mm Schichtdicke und MRT in Duennschichttechnik (dreidimensionale, T2

Gait, dual task and history of falls in elderly with preserved cognition, mild cognitive impairment, and mild Alzheimer's disease

OpenAIRE

Ansai, Juliana H.; Andrade, Larissa P.; Rossi, Paulo G.; Takahashi, Anielle C.M.; Vale, Francisco A.C.; Rebelatto, Jos? R.

2017-01-01

Background Studies with functional and applicable methods and new cognitive demands involving executive function are needed to improve screening, prevention and rehabilitation of cognitive impairment and falls. Objective to identify differences in gait, dual task performances, and history of falls between elderly people with preserved cognition, mild cognitive impairment and mild Alzheimer's disease. Method A cross-sectional study was conducted. The sample consisted of 40 community-dwelling o...

An augmented reality system for upper-limb post-stroke motor rehabilitation: a feasibility study.

Science.gov (United States)

Assis, Gilda Aparecida de; Corrêa, Ana Grasielle Dionísio; Martins, Maria Bernardete Rodrigues; Pedrozo, Wendel Goes; Lopes, Roseli de Deus

2016-08-01

To determine the clinical feasibility of a system based on augmented reality for upper-limb (UL) motor rehabilitation of stroke participants. A physiotherapist instructed the participants to accomplish tasks in augmented reality environment, where they could see themselves and their surroundings, as in a mirror. Two case studies were conducted. Participants were evaluated pre- and post-intervention. The first study evaluated the UL motor function using Fugl-Meyer scale. Data were compared using non-parametric sign tests and effect size. The second study used the gain of motion range of shoulder flexion and abduction assessed by computerized biophotogrammetry. At a significance level of 5%, Fugl-Meyer scores suggested a trend for greater UL motor improvement in the augmented reality group than in the other. Moreover, effect size value 0.86 suggested high practical significance for UL motor rehabilitation using the augmented reality system. System provided promising results for UL motor rehabilitation, since enhancements have been observed in the shoulder range of motion and speed. Implications for Rehabilitation Gain of range of motion of flexion and abduction of the shoulder of post-stroke patients can be achieved through an augmented reality system containing exercises to promote the mental practice. NeuroR system provides a mental practice method combined with visual feedback for motor rehabilitation of chronic stroke patients, giving the illusion of injured upper-limb (UL) movements while the affected UL is resting. Its application is feasible and safe. This system can be used to improve UL rehabilitation, an additional treatment past the traditional period of the stroke patient hospitalization and rehabilitation.

The association between patient participation and functional gain following inpatient rehabilitation.

Science.gov (United States)

Morghen, Sara; Morandi, Alessandro; Guccione, Andrew A; Bozzini, Michela; Guerini, Fabio; Gatti, Roberto; Del Santo, Francesco; Gentile, Simona; Trabucchi, Marco; Bellelli, Giuseppe

2017-08-01

To evaluate patients' participation during physical therapy sessions as assessed with the Pittsburgh rehabilitation participation scale (PRPS) as a possible predictor of functional gain after rehabilitation training. All patients aged 65 years or older consecutively admitted to a Department of Rehabilitation and Aged Care (DRAC) were evaluated on admission regarding their health, nutritional, functional and cognitive status. Functional status was assessed with the functional independence measure (FIM) on admission and at discharge. Participation during rehabilitation sessions was measured with the PRPS. Functional gain was evaluated using the Montebello rehabilitation factor score (MRFS efficacy), and patients stratified in two groups according to their level of functional gain and their sociodemographic, clinical and functional characteristics were compared. Predictors of poor functional gain were evaluated using a multivariable logistic regression model adjusted for confounding factors. A total of 556 subjects were included in this study. Patients with poor functional gain at discharge demonstrated lower participation during physical therapy sessions were significantly older, more cognitively and functionally impaired on admission, more depressed, more comorbid, and more frequently admitted for cardiac disease or immobility syndrome than their counterparts. There was a significant linear association between PRPS scores and MRFS efficacy. In a multivariable logistic regression model, participation was independently associated with functional gain at discharge (odds ratio 1.51, 95 % confidence interval 1.19-1.91). This study showed that participation during physical therapy affects the extent of functional gain at discharge in a large population of older patients with multiple diseases receiving in-hospital rehabilitation.

Poor oral status is associated with rehabilitation outcome in older people.

Science.gov (United States)

Shiraishi, Ai; Yoshimura, Yoshihiro; Wakabayashi, Hidetaka; Tsuji, Yuri

2017-04-01

Poor oral status is associated with increased physical dependency and cognitive decline. Malnutrition, a potential result of poor oral status, is associated with poorer rehabilitation outcome and physical function. However, the association between oral status and rehabilitation outcome is not fully understood. The present study investigated the association of poor oral status with rehabilitation outcome in older patients. A retrospective cohort study was carried out of 108 consecutive patients (mean age 80.5 ± 6.8 years; 50.9% men) who were admitted to convalescent rehabilitation wards. The Revised Oral Assessment Guide was used to evaluate oral status. Rehabilitation outcome was evaluated by the Functional Independence Measure (FIM) on discharge. Multivariate analyses were applied to examine the associations between poor oral status and motor-FIM on discharge. According to the Revised Oral Assessment Guide score, 14.8% of participants had normal oral status, 52.8% had slight to moderate oral problems and 32.4% had severe oral problems. The median scores of motor-FIM on admission and on discharge were 52 (interquartile range 25-70) and 75 (interquartile range 51-89), respectively. Multivariate analysis showed that the Revised Oral Assessment Guide score and the motor-/cognitive-FIM scores on admission were significant independent factors for motor-FIM on discharge, after adjusted for sex, age, length of stay, nutritional status, handgrip and causative diseases (P < 0.001). Poor oral status is associated with rehabilitation outcome in older people. Geriatr Gerontol Int 2017; 17: 598-604. © 2016 Japan Geriatrics Society.

Prospective memory functioning: a new area of investigation in the clinical neuropsychology and rehabilitation of Parkinson's disease and mild cognitive impairment. Review of evidence.

Science.gov (United States)

Costa, Alberto; Carlesimo, Giovanni Augusto; Caltagirone, Carlo

2012-10-01

The integrity of prospective memory (PM) is likely crucial for independent human behavior. PM refers to the ability to execute an intention after a certain delay. Its impaired functioning may significantly affect the correct execution of common daily activities, such as taking a pill at a certain time or complying with future plans. The results of recent studies indicate that PM is impaired pervasively and early in individuals with mild cognitive impairment (MCI) and Parkinson's disease (PD). In this study, we reviewed studies investigating the characteristics of PM disorders in these individuals and the potential for cognitive rehabilitation. The PM profiles of individuals with MCI and PD indicate that interventions aimed at enhancing the different cognitive processes underlying their PM disorders could be useful. At the current state of the art, however, no evidence-based protocols are available. Therefore, the discussion proposed here should be considered an attempt to identify some valuable perspectives for future research and interventions.

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.

Integrative rehabilitation of elderly stroke survivors: The design and evaluation of the BrightArm™

Science.gov (United States)

Rabin, Bryan A.; Burdea, Grigore C.; Roll, Doru T.; Hundal, Jasdeep S.; Damiani, Frank; Pollack, Simcha

2011-01-01

Purpose To describe the development of the BrightArm upper extremity rehabilitation system, and to determine its clinical feasibility with older hemiplegic patients. Method The BrightArm adjusted arm gravity loading through table tilting. Patients wore an arm support that sensed grasp strength and communicated wirelessly with a personal computer. Games were written to improve cognitive, psychosocial and the upper extremity motor function and adapted automatically to each patient. The system underwent feasibility trials spanning 6 weeks. Participants were evaluated pre-therapy, post-therapy, and at 6 weeks follow-up using standardized clinical measures. Computerized measures of supported arm reach and game performance were stored on a remote server. Results Five participants had clinically significant improvements in their active range of shoulder movement, shoulder strength, grasp strength, and their ability to focus. Several participants demonstrated substantially higher arm function (measured with the Fugl-Meyer test) and two were less-depressed (measured with the Becks Depression Inventory, Second Edition). The BrightArm technology was well-accepted by the participants, who gave it an overall subjective rating of 4.1 on a 5 point Likert scale. Conclusions Given these preliminary findings, it will be beneficial to evaluate the BrightArm through controlled clinical trials and to investigate its application to other clinical populations. PMID:22107353

The advantages and disadvantages of using high technology in hand rehabilitation.

Science.gov (United States)

Levanon, Yafi

2013-01-01

A brief review of the history of occupational therapy shows that the relationship between health and activity was of great concern to the founders of the Occupational Therapy (OT) field, and continues to be of concern to today's occupational therapists. Today, computers and Virtual Reality (VR) take the place of clay and the weaving loom. The goal of this article is to describe both known and innovative computerized equipment being used in interventions for hand rehabilitation and evaluations, as well as answer the question: 'what are the advantages and disadvantages of using technology in hand rehabilitation?' Our conclusion, based on clinical experience and supported by the literature, appears to emphasize that advanced technology can enrich treatment and help patients who are unable to visit the clinic regularly, to get appropriate treatment. However, advanced technology has not been found to be superior to traditional treatment and cannot replace the occupational therapist. Copyright © 2013 Hanley & Belfus. Published by Elsevier Inc. All rights reserved.

Innovation in Rehabilitation Services and Clinical Programs for Health Care

Directory of Open Access Journals (Sweden)

Asghar Dadkhah

2014-06-01

Full Text Available Rehabilitation program is a critical piece of clinical care strategy in order to accelerate healing and improve quality of life to the fullest extent possible. An innovated program should have 3 inspiring concepts: Seek inspire and Advance. Seeking and evaluating is a breakthrough technology, innovative methodology and emerging trend in the healthcare industry. The program should inspire clinicians to critically evaluate and implement the highest standards of care. Also an innovated program should advance clinical program development to maximize opportunities for first to market positioning and community partnerships. The scope of program can be from psycho-rehabilitation to predictor in addiction (1-3, Cognitive and motor rehabilitation researchers are quite concerned about system wide biases that may impair development of innovative rehabilitation techniques. In this issue ....

Development of Cognitive Bias Modification (CBM) Tools to Promote Adjustment During Reintegration Following Deployment

Science.gov (United States)

2016-11-01

14. ABSTRACT The overarching goal of the grant is to develop valid and reliable computerized tools to measure and modify anger-related cognitive...plasticity in threat processing may confer risk for military performance and psychological adjustment both in theatre and upon reintegration back to...civilian environments. The overarching goal of the current grant is to develop valid and reliable computerized tools to measure and modify anger

Cognitive rehabilitation of attention deficits in traumatic brain injury using action video games: A controlled trial

Directory of Open Access Journals (Sweden)

Alexandra Vakili

2016-12-01

Full Text Available This paper investigates the utility and efficacy of a novel eight-week cognitive rehabilitation programme developed to remediate attention deficits in adults who have sustained a traumatic brain injury (TBI, incorporating the use of both action video game playing and a compensatory skills programme. Thirty-one male TBI patients, aged 18–65 years, were recruited from 2 Australian brain injury units and allocated to either a treatment or waitlist (treatment as usual control group. Results showed improvements in the treatment group, but not the waitlist control group, for performance on the immediate trained task (i.e. the video game and in non-trained measures of attention and quality of life. Neither group showed changes to executive behaviours or self-efficacy. The strengths and limitations of the study are discussed, as are the potential applications and future implications of the research.

Formal Verification of Computerized Procedure with Colored Petri Nets

International Nuclear Information System (INIS)

Kim, Yun Goo; Shin, Yeong Cheol

2008-01-01

Computerized Procedure System (CPS) supports nuclear power plant operators in performing operating procedures which are instructions to guide in monitoring, decision making and controlling nuclear power plants. Computerized Procedure (CP) should be loaded to CPS. Due to its execution characteristic, computerized procedure acts like a software in CPS. For example, procedure flows are determined by operator evaluation and computerized procedure logic which are pre-defined. So the verification of Computerized Procedure logic and execution flow is needed before computerized procedures are installed in the system. Formal verification methods are proposed and the modeling of operating procedures with Coloured Petri Nets(CP-nets) is presented

Strength-balance supplemented with computerized cognitive training to improve dual task gait and divided attention in older adults: a multicenter randomized-controlled trial.

Science.gov (United States)

van het Reve, Eva; de Bruin, Eling D

2014-12-15

Exercise interventions often do not combine physical and cognitive training. However, this combination is assumed to be more beneficial in improving walking and cognitive functioning compared to isolated cognitive or physical training. A multicenter parallel randomized controlled trial was conducted to compare a motor to a cognitive-motor exercise program. A total of 182 eligible residents of homes-for-the-aged (n = 159) or elderly living in the vicinity of the homes (n = 23) were randomly assigned to either strength-balance (SB) or strength-balance-cognitive (SBC) training. Both groups conducted similar strength-balance training during 12 weeks. SBC additionally absolved computerized cognitive training. Outcomes were dual task costs of walking, physical performance, simple reaction time, executive functions, divided attention, fear of falling and fall rate. Participants were analysed with an intention to treat approach. The 182 participants (mean age ± SD: 81.5 ± 7.3 years) were allocated to either SB (n = 98) or SBC (n = 84). The attrition rate was 14.3%. Interaction effects were observed for dual task costs of step length (preferred walking speed: F(1,174) = 4.94, p = 0.028, η2 = 0.027, fast walking speed: F(1,166) = 6.14, p = 0.009, η2 = 0.040) and dual task costs of the standard deviation of step length (F(1,166) = 6.14, p = 0.014, η2 = 0.036), in favor of SBC. Significant interactions in favor of SBC revealed for in gait initiation (F(1,166) = 9.16, p = 0.003, η2 = 0.052), 'reaction time' (F(1,180) = 5.243, p = 0.023, η² = 0.028) & 'missed answers' (F(1,180) = 11.839, p = 0.001, η² = 0.062) as part of the test for divided attention. Within-group comparison revealed significant improvements in dual task costs of walking (preferred speed; velocity (p = 0.002), step time (p = 0.018), step length (p = 0.028), fast speed; velocity (p�

Technologies in computerized lexicography | Kruyt | Lexikos

African Journals Online (AJOL)

Although the topic of this paper is technology, focus is on functional rather than technical aspects of computerized lexicography. Keywords: computerized lexicography, electronic dictionary, electronic text corpus, lexicographer's workbench, integrated language database, automatic linguistic analysis, information retrieval, ...

[Computerized medical record: deontology and legislation].

Science.gov (United States)

Allaert, F A; Dusserre, L

1996-02-01

Computerization of medical records is making headway for patients' follow-up, scientific research, and health expenses control, but it must not alter the guarantees provided to the patients by the medical code of ethics and the law of January 6, 1978. This law, modified on July 1, 1994, requires to register all computerized records of personal data and establishes rights to protect privacy against computer misdemeanor. All medical practitioners using computerized medical records must be aware that the infringement of this law may provoke suing in professional, civil or criminal court.

39 CFR 501.15 - Computerized Meter Resetting System.

Science.gov (United States)

2010-07-01

... 39 Postal Service 1 2010-07-01 2010-07-01 false Computerized Meter Resetting System. 501.15... AND DISTRIBUTE POSTAGE EVIDENCING SYSTEMS § 501.15 Computerized Meter Resetting System. (a) Description. The Computerized Meter Resetting System (CMRS) permits customers to reset their postage meters at...

[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

[Comparison of efficacy of different neurometabolic and vasoactive medicines in ischemic stroke patients's rehabilitation].

Science.gov (United States)

Galkin, A S; Koval'chuk, V V; Gusev, A O

2011-01-01

The aim of present investigation is research of influence of vasoactive and neurometabolic medicines in stroke patients's rehabilitation. We had analysed 280 stroke patients. The degree of rehabilitation had been defined with the help of Barthel and Lindmark scales. The degree of cognitive functions's rehabilitation had been defined with the help of MMSE scale. For every medicine coefficients of efficiency were calculated. As the result of the present investigation the medicine's efficiency was found out. The most efficient medicines in ischaemic stroke patients's rehabilitation among the investigated ones are the medicines which activate the neuronal metabolism, first of all,--ceraxon (citicoline).

Rehabilitation interventions in multiple sclerosis: an overview.

Science.gov (United States)

Beer, Serafin; Khan, Fary; Kesselring, Jürg

2012-09-01

Multiple sclerosis is a complex, heterogeneous disease associated with long-term disability. Despite the availability of advanced disease-modifying and symptomatic therapies that may decrease activity and progression of disease and alleviate complaints to a certain extent, there is still a need for comprehensive rehabilitation interventions in order to reduce sequels and symptoms of the disease on personal activities and social participation to achieve the highest possible independence and the best quality of life. Timing and setting of rehabilitation interventions should be selected individually depending on disease phase, functional deficits, personal requirements, as well as specific goals. In addition, limitations and disease-specific characteristics that may influence rehabilitation outcome should be noted. Rehabilitation interventions should be considered early for maintaining functional capacity and reducing risk for losing important abilities or independence. Due to gradual failure of adaptive compensatory mechanisms along the course of disease, benefits of rehabilitation interventions are generally higher in earlier phases of MS. Inpatient and outpatient multidisciplinary rehabilitation has been shown to be beneficial in improving disability, participation and quality of life despite progression of the disease. Good evidence exists for different specific interventions improving physical and cognitive performance. Other important issues responsible for beneficial effects of comprehensive rehabilitation in MS include education, instruction, and information of patients and caregivers. Comprehensive assessment of health domains in MS patients using standardized framework and common language for describing the impact of disease at different levels, using International Classification of Functioning, Disability and Health (ICF) core sets may increase the knowledge of needs of these patients for more efficient and adapted rehabilitation interventions meeting these

COMPUTERIZATION OF EDUCATION AS A TOOL OF UNIVERSITY TEACHER’S BASIC FUNCTIONS SUPPORT

Directory of Open Access Journals (Sweden)

V. V. Denysenko

2014-04-01

Full Text Available The intensive process of education computerization confronts modern educators a number of economic, technical, social, psychological and educational problems that need to be solved. The use of computer technology in educational process opens enormous opportunities for the development of cognitive abilities – from sensory and perceptual to speech and mental forms. In broad dissemination and use of technical aids, optical and acoustic techniques, programmed education, cinema, television, computer, the modern scientists and researchers see one of the main factors to enhance education and upbringing level both at regular and higher education institutions. Unfortunately, the process of the organic combination of technical and pedagogical sciences in terms of theory and practice introducing computer (multimedia teaching aids is not as powerful as expected; and as it has been dictated by the needs of the modern society. The slow pace of computerization’s implementation of the learning process at high school has been caused by the reasons of different nature and scale. The main objective of the article is to highlight the problems of computer teaching aids using in teaching process at higher education institutions. The conducted analysis of studying computerization allowed us determining the impact and role in providing the university teacher’s basic functions. It has been established that the teacher is one of the management leading objects of educational and cognitive students’ activity and all its functions practically may have computer support.

Technology-Based Rehabilitation to Improve Communication after Acquired Brain Injury

Directory of Open Access Journals (Sweden)

Carrie A. Des Roches

2017-07-01

Full Text Available The utilization of technology has allowed for several advances in aphasia rehabilitation for individuals with acquired brain injury. Thirty-one previous studies that provide technology-based language or language and cognitive rehabilitation are examined in terms of the domains addressed, the types of treatments that were provided, details about the methods and the results, including which types of outcomes are reported. From this, we address questions about how different aspects of the delivery of treatment can influence rehabilitation outcomes, such as whether the treatment was standardized or tailored, whether the participants were prescribed homework or not, and whether intensity was varied. Results differed by these aspects of treatment delivery but ultimately the studies demonstrated consistent improvement on various outcome measures. With these aspects of technology-based treatment in mind, the ultimate goal of personalized rehabilitation is discussed.

Technology-Based Rehabilitation to Improve Communication after Acquired Brain Injury.

Science.gov (United States)

Des Roches, Carrie A; Kiran, Swathi

2017-01-01

The utilization of technology has allowed for several advances in aphasia rehabilitation for individuals with acquired brain injury. Thirty-one previous studies that provide technology-based language or language and cognitive rehabilitation are examined in terms of the domains addressed, the types of treatments that were provided, details about the methods and the results, including which types of outcomes are reported. From this, we address questions about how different aspects of the delivery of treatment can influence rehabilitation outcomes, such as whether the treatment was standardized or tailored, whether the participants were prescribed homework or not, and whether intensity was varied. Results differed by these aspects of treatment delivery but ultimately the studies demonstrated consistent improvement on various outcome measures. With these aspects of technology-based treatment in mind, the ultimate goal of personalized rehabilitation is discussed.

Neuro-cognition and social-cognition: application to exercise rehabilitation

OpenAIRE

Kim, Sooyeon

2013-01-01

The discovery of mirror neurons has been recognized as one of the major developments in neuroscience, with possible implications for the explanation of many important cognitive functions, including action and perception understanding, imitation, and empathy. In the mirror neuron system, action observation, imitation, and empathy are represented in the same basic motor circuit as action execution. The present paper presents basic neurophysiological findings about mirror neuron system and discu...

The rehabilitation of attention in patients with mild cognitive impairment and brain subcortical vascular changes using the Attention Process Training-II. The RehAtt Study: rationale, design and methodology.

Science.gov (United States)

Salvadori, Emilia; Poggesi, Anna; Valenti, Raffaella; Della Rocca, Eleonora; Diciotti, Stefano; Mascalchi, Mario; Inzitari, Domenico; Pantoni, Leonardo

2016-10-01

Cerebral small vessel disease (SVD) may cause attentional and executive cognitive deficits. No drug is currently available to improve cognitive performance or to prevent dementia in SVD patients, and cognitive rehabilitation could be a promising approach. We aimed to investigate: (1) the effectiveness of the Attention Process Training-II program in the rehabilitation of patients with mild cognitive impairment (MCI) and SVD; (2) the impact of the induced cognitive improvement on functionality and quality of life; (3) the effect of training on brain activity at rest and the possibility of a training-induced plasticity effect. The RehAtt study is designed as a 3-year prospective, single-blinded, randomized clinical trial. Inclusion criteria were: (1) MCI defined according to Winblad et al. criteria; (2) evidence of impairment across attention neuropsychological tests; (3) evidence on MRI of moderate/severe white matter hyperintensities. All enrolled patients are evaluated at baseline, and after 6 and 12 months, according to an extensive clinical, functional, MRI and neuropsychological protocol. The baseline RehAtt cohort includes 44 patients (66 % males, mean ± SD age and years of education 75.3 ± 6.8 and 8.3 ± 4.3, respectively). After baseline assessment, patients have been randomly assigned to 'attention training' or 'standard care'. Treatments and follow-up visits at 6 months are completed, while follow-up visits at 12 months are ongoing. This study is the first attempt to reduce attention deficits in patients affected by MCI with SVD. The results of this pilot experience will represent an essential background for designing larger multicenter, prospective, double-blinded, randomized and controlled clinical trials. NCT02033850 (ClinicalTrials.gov Identifier).

Microcomputer Network for Computerized Adaptive Testing (CAT)

Science.gov (United States)

1984-03-01

PRDC TR 84-33 \\Q.�d-33- \\ MICROCOMPUTER NETWOJlt FOR COMPUTERIZED ADAPTIVE TESTING ( CAT ) Baldwin Quan Thomas A . Park Gary Sandahl John H...ACCEIIION NO NPRDC TR 84-33 4. TITLE (-d Sul>tlllo) MICROCOMP UTER NETWORK FOR COMPUTERIZED ADA PTIVE TESTING ( CAT ) 1. Q B. uan T. A . Park...adaptive testing ( CAT ) Bayesian sequential testing 20. ABSTitACT (Continuo on ro•••• aide II noco .. _, _., ld-tlly ,.,. t.loclt _._.) DO Computerized

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.

Association of self-reported cognitive concerns with mobility in people with lower limb loss.

Science.gov (United States)

Kelly, Valerie E; Morgan, Sara J; Amtmann, Dagmar; Salem, Rana; Hafner, Brian J

2018-01-01

This study tested the hypothesis that greater perceived cognitive concerns are associated with worse mobility in a cohort of prosthesis users with lower limb loss (LLL). We performed a secondary analysis of cross-sectional self-report data from a volunteer sample of people with LLL due to dysvascular and non-dysvacular causes. Perceived cognitive difficulties were assessed using the Quality of Life in Neurological Disorders Applied Cognition - General Concerns (Neuro-QoL ACGC). Mobility was measured with the Activities-Specific Balance Confidence Scale (ABC) and the Prosthetic Limb Users Survey of Mobility (PLUS-M). Simple linear regressions examined univariate relationships between cognitive concerns and mobility. Multiple linear regression analyses included demographic and amputation-related variables that could influence this relationship. Analysis of data from 1291 people with LLL demonstrated that greater cognitive concerns, measured by the Neuro-QoL ACGC, were associated with poorer perceived mobility, measured by both ABC and PLUS-M instruments. This relationship remained statistically significant after adjusting for demographic and amputation-related factors. These results suggest that greater cognitive concerns are associated with worse mobility among a broad range of people with LLL. An improved understanding of this relationship is critical for optimizing rehabilitation outcomes for this population. Implications for rehabilitation Rehabilitation for people with lower limb loss (LLL) typically focuses on physical impairments and mobility limitations, but cognition is increasingly recognized to have an impact on functional outcomes. Greater perceived cognitive concerns are associated with poorer mobility among a broad range of people with LLL, even when adjusting for demographic and amputation-related factors. Cognitive status can impact relevant rehabilitative outcomes, including mobility, and should be considered when planning prosthetic and therapeutic

Using Mouse and Keyboard Dynamics to Detect Cognitive Stress During Mental Arithmetic

OpenAIRE

Ayesh, Aladdin, 1972-; Stacey, Martin; Lim, Yee Mei

2015-01-01

To build a personalized e-learning system that can deliver adaptive learning content based on student’s cognitive effort and efficiency, it is important to develop a construct that can help measuring perceived mental state, such as stress and cognitive load. The construct must be able to be quantified, computerized and automated. Our research investigates how mouse and keyboard dynamics analyses could be used to detect cognitive stress, which is induced by high mental arithmetic demand with t...

Computerized system for measuring cerebral metabolism

International Nuclear Information System (INIS)

McGlone, J.S.; Hibbard, L.S.; Hawkins, R.A.; Kasturi, R.

1987-01-01

A computerized stereotactic measurement system for evaluating rat brain metabolism was developed to utilize the large amount of data generated by quantitative autoradiography. Conventional methods of measurement only analyze a small percent of these data because these methods are limited by instrument design and the subjectiveness of the investigator. However, a computerized system allows digital images to be analyzed by placing data at their appropriate three-dimensional stereotactic coordinates. The system automatically registers experimental data to a standard three-dimensional image using alignment, scaling, and matching operations. Metabolic activity in different neuronal structures is then measured by generating digital masks and superimposing them on to experimental data. Several experimental data sets were evaluated and it was noticed that the structures measured by the computerized system, had in general, lower metabolic activity than manual measurements had indicated. This was expected because the computerized system measured the structure over its volume while the manual readings were taken from the most active metabolic area of a particular structure

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

Communicative-pragmatic impairment in schizophrenia: Cognitive rehabilitative training

OpenAIRE

Francesca Marina Bosco; Francesca Marina Bosco; Ilaria eGabbatore; Luigi eGastaldo; Katiuscia eSacco; Katiuscia eSacco

2016-01-01

This paper aims to verify in patients with schizophrenia, the efficacy of Cognitive Pragmatic Treatment (CPT), a new remediation program for improving communicative-pragmatic abilities. The CPT program consists of 20 group sessions, focused on several communication modalities, i.e. linguistic, extralinguistic and paralinguistic, Theory of Mind (ToM) and other cognitive functions that can affect communicative performance, such as awareness and planning. A group of 17 patients with schizophreni...

Ameliorating intrusive memories of distressing experiences using computerized reappraisal training.

Science.gov (United States)

Woud, Marcella L; Holmes, Emily A; Postma, Peggy; Dalgleish, Tim; Mackintosh, Bundy

2012-08-01

The types of appraisals that follow traumatic experiences have been linked to the emergence of posttraumatic stress disorder (PTSD). Could changing reappraisals following a stressful event reduce the emergence of PTSD symptoms? The present proof-of-principle study examined whether a nonexplicit, systematic computerized training in reappraisal style following a stressful event (a highly distressing film) could reduce intrusive memories of the film, and symptoms associated with posttraumatic distress over the subsequent week. Participants were trained to adopt a generally positive or negative poststressor appraisal style using a series of scripted vignettes after having been exposed to highly distressing film clips. The training targeted self-efficacy beliefs and reappraisals of secondary emotions (emotions in response to the emotional reactions elicited by the film). Successful appraisal induction was verified using novel vignettes and via change scores on the post traumatic cognitions inventory. Compared with those trained negatively, those trained positively reported in a diary fewer intrusive memories of the film during the subsequent week, and lower scores on the Impact of Event Scale (a widely used measure of posttraumatic stress symptoms). Results support the use of computerized, nonexplicit, reappraisal training after a stressful event has occurred and provide a platform for future translational studies with clinical populations that have experienced significant real-world stress or trauma.

Self-efficacy and quality of life after low-intensity neuropsychological rehabilitation: A pre-post intervention study.

Science.gov (United States)

Brands, Ingrid; Custers, Maud; van Heugten, Caroline

2017-01-01

Being highly self-efficacious is a key factor in successful chronic disease self-management. It is unknown whether neuropsychological rehabilitation improves self-efficacy in managing the consequences of brain injury. To investigate whether levels of general and brain injury specific self-efficacy and quality of life (QoL) increased after neuropsychological rehabilitation and whether cognitive performance was associated with self-efficacy. We conducted a retrospective clinical cohort study of 62 patients with acquired brain injury and cognitive complaints with measurements before start and after completion of treatment. QoL was measured with the visual analogue scale (EQ VAS) of the EuroQol (EQ-5D); self-efficacy with the TBI Self-efficacy Questionnaire (SEsx) and the General Self-efficacy Scale (GSES). Cognitive performance was measured as a compound score of tests for memory, attention and information processing speed. Self-efficacy for managing brain injury-specific symptoms and QoL increased significantly after neuropsychological rehabilitation. Both general and brain injury-specific self-efficacy were positively associated with QoL after completion of the programme. Cognitive performance was not associated with self-efficacy for managing brain injury-specific symptoms nor with general self-efficacy. Self-efficacy and QoL improve after treatment. Further research is needed to identify the specific ingredients responsible for improvement of self-efficacy in patients with cognitive complaints.

Evaluation of brain scintigraphy and computerized tomography

International Nuclear Information System (INIS)

Cavailloles, F.; Dairou, R.; Desbleds, M.T.; Benoit, C.; Larmande, P.; Bok, B.; Alperovitch, A.

1983-01-01

In order to assess the clinical usefulness of brain computerized tomography and radionuclide scan, a prospective study was performed on a series of 554 patients. The detection rate was assessed as well as the identification rate of lesions. In addition, the usefulness of both tests was appreciated subjectively by two neurologists reviewing the patients' files. Both give reasonably similar results: computerized tomography is superior to radionuclide scan in the diagnosis of tumors and intracerebral hematomas, the radionuclide scan being slightly superior in the diagnosis of purely ischemic CVA and subdural hematomas. The superiority which was subjectively conceded to computerized tomography was greater than that objectively demonstrated. However, clinical usefulness of computerized tomography was judged important in only 50% of the cases. Moreover, to request both computerized tomography and radionuclide scan appeared as having no interest in 83% of the cases. In that series, the diagnostic hypotheses were in agreement with the final diagnosis in 88% of the cases. Bias encountered in this type of studies are discussed [fr

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

Computerized tomography in myotonic dystrophy

International Nuclear Information System (INIS)

Gellerich, I.; Mueller, D.; Koch, R.D.

1986-01-01

Besides clinical symptoms, progress and electromyography computerized tomography improves the diagnostics of myotonic dystrophy. Even small changes in muscular structure are detectable and especially the musculus soleus exhibits early and pronounced alterations. By means of density distribution pattern an improved characterization of the disease is possible. Additional information is obtained by cerebral computerized tomography. Atrophy of brain tissue is to be expected in all patients with myotonic dystrophy. (author)

Computerized reactor monitor and control for research reactors

International Nuclear Information System (INIS)

Buerger, L.; Vegh, E.

1981-09-01

The computerized process control system developed in the Central Research Institute for Physics, Budapest, Hungary, is described together with its special applications at research reactors. The nuclear power of the Hungarian research reactor is controlled by this computerized system, too, while in Lybia many interesting reactor-hpysical calculations are built into the computerized monitor system. (author)

Rehabilitation of discourse impairments after acquired brain injury

Directory of Open Access Journals (Sweden)

Gigiane Gindri

Full Text Available ABSTRACT Language impairments in patients with acquired brain injury can have a negative impact on social life as well as on other cognitive domains. Discourse impairments are among the most commonly reported communication deficits among patients with acquired brain damage. Despite advances in the development of diagnostic tools for detecting such impairments, few studies have investigated interventions to rehabilitate patients presenting with these conditions. Objective: The aim of this study was to present a systematic review of the methods used in the rehabilitation of discourse following acquired brain injury. Methods: The PubMed database was searched for articles using the following keywords: "rehabilitation", "neurological injury", "communication" and "discursive abilities". Results: A total of 162 abstracts were found, but only seven of these met criteria for inclusion in the review. Four studies involved samples of individuals with aphasia whereas three studies recruited samples of individuals with traumatic brain injury. Conclusion: All but one article found that patient performance improved following participation in a discourse rehabilitation program.

The impact of subjective cognitive fatigue and depression on cognitive function in patients with multiple sclerosis.

Science.gov (United States)

Golan, Daniel; Doniger, Glen M; Wissemann, Karl; Zarif, Myassar; Bumstead, Barbara; Buhse, Marijean; Fafard, Lori; Lavi, Idit; Wilken, Jeffrey; Gudesblatt, Mark

2018-02-01

The association between subjective cognitive fatigue and objective cognitive dysfunction in patients with multiple sclerosis (PwMS) has been studied, with conflicting results. To explore the impact of fatigue on cognitive function, while controlling for the influence of depression, disability, comorbidities, and psychotropic medications. PwMS completed a computerized cognitive testing battery with age- and education-adjusted cognitive domain scores. Disability (Expanded Disability Status Scale (EDSS)), cognitive fatigue, and depression were concurrently evaluated. In all, 699 PwMS were included. Both cognitive fatigue and depression were significantly and negatively correlated with the same cognitive domains: information processing speed, executive function, attention, motor function, and memory (-0.15 ⩽ r ⩽ -0.14 for cognitive fatigue; -0.24 ⩽ r ⩽ -0.19 for depression). Multivariate analysis revealed significant but small independent correlations only between depression and neuropsychological test results, while cognitive fatigue had no independent correlation with objective cognitive function except for a trend toward impaired motor function in highly fatigued PwMS. Depression and cognitive fatigue accounted for no more than 6% of the variance in objective cognitive domain scores. Cognitive fatigue is not independently related to objective cognitive impairment. Depression may influence cognitive function of PwMS primarily when it is severe. Cognitive impairment in PwMS should not be ascribed to fatigue or mild depression.

Symptoms versus neurocognition as predictors of change in life skills in schizophrenia after outpatient rehabilitation.

Science.gov (United States)

Kurtz, Matthew M; Wexler, Bruce E; Fujimoto, Marco; Shagan, Dana S; Seltzer, James C

2008-07-01

A growing body of literature has shown that neurocognitive deficits in schizophrenia account for 20-60% of the variance in measures of outcome, and in many studies are more closely related to outcome than symptoms [Green, M.F., Kern, R.S., Braff, D.L., Mintz, J., 2000. Neurocognitive deficits and functional outcome in schizophrenia: are we measuring the "right stuff"? Schizophr. Bull. 26(1), 119-136; Green, M.F., Kern, R.S., Heaton, R.K., 2004. Longitudinal studies of cognition and functional outcome in schizophrenia: implications for MATRICS. Schizophr. Res. 72(1), 41-51]. Most of these studies have been cross-sectional, few longitudinal studies have investigated the degree to which neurocognition and symptoms predict ability to benefit from outpatient rehabilitation, and no longitudinal studies use measures of everyday life skills that are performance-based. In the current study we investigated the relationship between five measures of neurocognitive function, crystallized verbal ability, visual sustained vigilance, verbal learning, problem-solving, and processing speed, and two measures of symptoms, total positive and negative symptoms, and change on a performance-based measure of everyday life skills after a year of outpatient rehabilitation. Rehabilitation consisted of both psychosocial and cognitive interventions. Forty-six patients with schizophrenia or schizoaffective disorder were studied. Results of a linear regression model revealed that verbal learning predicted a significant amount of the variance in change in performance-based measures of everyday life skills after outpatient rehabilitation, even when variance for all other variables in the model was accounted for. Measures of crystallized verbal ability, sustained visual vigilance, problem-solving, processing speed and symptoms were not linked to functional status change. These findings emphasize the importance of verbal learning for benefiting from psychosocial and cognitive rehabilitation

4: Rehabilitation after traumatic brain injury.

Science.gov (United States)

Khan, Fary; Baguley, Ian J; Cameron, Ian D

2003-03-17

Traumatic brain injury (TBI) commonly affects younger people and causes life-long impairments in physical, cognitive, behavioural and social function. The cognitive, behavioural and personality deficits are usually more disabling than the residual physical deficits. Recovery from TBI can continue for at least 5 years after injury. Rehabilitation is effective using an interdisciplinary approach, and close liaison with the patient, family and carers. The focus is on issues such as retraining in activities of daily living, pain management, cognitive and behavioural therapies, and pharmacological management. The social burden of TBI is significant, and therefore family education and counselling, and support of patient and carers, is important. General practitioners play an important role in providing ongoing support in the community, monitoring for medical complications, behavioural and personality issues, social reintegration, carer coping skills and return-to-work issues.

Effect of eslicarbazepine acetate and oxcarbazepine on cognition and psychomotor function in healthy volunteers.

Science.gov (United States)

Milovan, Denise; Almeida, Luis; Romach, Myroslava K; Nunes, Teresa; Rocha, José Francisco; Sokowloska, Marta; Sellers, Edward M; Soares-da-Silva, Patrício

2010-08-01

The results of two single-blind studies conducted to evaluate the cognitive and psychomotor effects of eslicarbazepine acetate and oxcarbazepine following single and repeated administration in healthy volunteers are reported. The cognitive and psychomotor evaluation consisted of several computerized and paper-and-pencil measures. Eslicarbazepine acetate and oxcarbazepine had similar overall cognitive profiles and did not cause clinically relevant cognitive impairment. The incidence of adverse events was lower with eslicarbazepine acetate than with oxcarbazepine. Copyright 2010. Published by Elsevier Inc.

Study on Language Rehabilitation for Aphasia.

Science.gov (United States)

Yu, Zeng-Zhi; Jiang, Shu-Jun; Jia, Zi-Shan; Xiao, Hong-Yu; Zhou, Mei-Qi

2017-06-20

The aim is to update our clinical recommendations for evidence-based language rehabilitation of people with aphasia, based on a systematic review of the literature from 1999 to 2015. Articles referred to in this systematic review of the Medline and PubMed published in English language literatures were from 1998 to 2015. The terms used in the literature searches were aphasia and evidenced-based. The task force initially identified citations for 51 published articles. Of the 51 articles, 44 studies were selected after further detailed review. Six articles, which were not written in English, and one study related to laryngectomy rehabilitation interventions, were excluded from the study. This study referred to all the important and English literature in full. Aphasia is the linguistic disability, which usually results from injuries to the dominant hemisphere of the brain. The rehabilitation of aphasia is until in the process of being debated and researched. Evidence-based medicine (EBM), EBM based on the clinical evidence, promotes the practice of combining the clinicians' first-hand experience and the existing objective and scientific evidence encouraging making decisions based on both empirical evidence and the scientific evidence. Currently, EBM is being gradually implemented in the clinical practice as the aim of the development of modern medicine. At present, the research for the aphasia rehabilitation mainly focuses on the cognitive language rehabilitation and the intensive treatment and the precise treatment, etc. There is now sufficient information to support evidence-based protocols and implement empirically-supported treatments for linguistic disability after traumatic brain injury and stroke, which can be used to develop linguistic rehabilitation guidelines for patients with aphasia.

The Flower Workshop in psychosocial rehabilitation: a pilot study.

Science.gov (United States)

Pereira, Alfredo; Pereira, Maria Alice Ornellas

2009-01-01

We report a pilot study with the Flower Workshop, a new modality of psychosocial rehabilitation group activity. Cognitive performance in schizophrenia and other mental conditions can be impaired depending on the tasks to be executed and their respective social context. The vulnerability of these individuals can be reduced by means of cognitive and socio-affective facilitation. We conducted a pilot study to introduce the Flower Workshop in a public Mental Health Service in the city of Ribeirão Preto (São Paulo-Brasil) with 12 participants during 18 months (2002-2003). With cognitive and socio-affective facilitation, participants were able to construct vases and make flower arrangements successfully.

Analysis of internal and external validity criteria for a computerized visual search task: A pilot study.

Science.gov (United States)

Richard's, María M; Introzzi, Isabel; Zamora, Eliana; Vernucci, Santiago

2017-01-01

Inhibition is one of the main executive functions, because of its fundamental role in cognitive and social development. Given the importance of reliable and computerized measurements to assessment inhibitory performance, this research intends to analyze the internal and external criteria of validity of a computerized conjunction search task, to evaluate the role of perceptual inhibition. A sample of 41 children (21 females and 20 males), aged between 6 and 11 years old (M = 8.49, SD = 1.47), intentionally selected from a private management school of Mar del Plata (Argentina), middle socio-economic level were assessed. The Conjunction Search Task from the TAC Battery, Coding and Symbol Search tasks from Wechsler Intelligence Scale for Children were used. Overall, results allow us to confirm that the perceptual inhibition task form TAC presents solid rates of internal and external validity that make a valid measurement instrument of this process.

Demographic Variables and Selective, Sustained Attention and Planning through Cognitive Tasks among Healthy Adults

OpenAIRE

Afsaneh Zarghi; Zali; A; Tehranidost; M; Mohammad Reza Zarindast; Ashrafi; F; Doroodgar; Khodadadi

2011-01-01

Introduction: Cognitive tasks are considered to be applicable and appropriate in assessing cognitive domains. The purpose of our study is to determine the relationship existence between variables of age, sex and education with selective, sustained attention and planning abilities by means of computerized cognitive tasks among healthy adults. Methods: A cross-sectional study was implemented during 6 months from June to November, 2010 on 84 healthy adults (42 male and 42 female). The whole part...

Anti-3-[(18)F]FACBC positron emission tomography-computerized tomography and (111)In-capromab pendetide single photon emission computerized tomography-computerized tomography for recurrent prostate carcinoma: results of a prospective clinical trial.

Science.gov (United States)

Schuster, David M; Nieh, Peter T; Jani, Ashesh B; Amzat, Rianot; Bowman, F Dubois; Halkar, Raghuveer K; Master, Viraj A; Nye, Jonathon A; Odewole, Oluwaseun A; Osunkoya, Adeboye O; Savir-Baruch, Bital; Alaei-Taleghani, Pooneh; Goodman, Mark M

2014-05-01

We prospectively evaluated the amino acid analogue positron emission tomography radiotracer anti-3-[(18)F]FACBC compared to ProstaScint® ((111)In-capromab pendetide) single photon emission computerized tomography-computerized tomography to detect recurrent prostate carcinoma. A total of 93 patients met study inclusion criteria who underwent anti-3-[(18)F]FACBC positron emission tomography-computerized tomography plus (111)In-capromab pendetide single photon emission computerized tomography-computerized tomography for suspected recurrent prostate carcinoma within 90 days. Reference standards were applied by a multidisciplinary board. We calculated diagnostic performance for detecting disease. In the 91 of 93 patients with sufficient data for a consensus on the presence or absence of prostate/bed disease anti-3-[(18)F]FACBC had 90.2% sensitivity, 40.0% specificity, 73.6% accuracy, 75.3% positive predictive value and 66.7% negative predictive value compared to (111)In-capromab pendetide with 67.2%, 56.7%, 63.7%, 75.9% and 45.9%, respectively. In the 70 of 93 patients with a consensus on the presence or absence of extraprostatic disease anti-3-[(18)F]FACBC had 55.0% sensitivity, 96.7% specificity, 72.9% accuracy, 95.7% positive predictive value and 61.7% negative predictive value compared to (111)In-capromab pendetide with 10.0%, 86.7%, 42.9%, 50.0% and 41.9%, respectively. Of 77 index lesions used to prove positivity histological proof was obtained in 74 (96.1%). Anti-3-[(18)F]FACBC identified 14 more positive prostate bed recurrences (55 vs 41) and 18 more patients with extraprostatic involvement (22 vs 4). Anti-3-[(18)F]FACBC positron emission tomography-computerized tomography correctly up-staged 18 of 70 cases (25.7%) in which there was a consensus on the presence or absence of extraprostatic involvement. Better diagnostic performance was noted for anti-3-[(18)F]FACBC positron emission tomography-computerized tomography than for (111)In-capromab pendetide single

The effects of repeated rehabilitation “Tune-Ups” on functional recovery after stroke

DEFF Research Database (Denmark)

Clarke, Jared; Mala, Hana; Windle, Victoria

2008-01-01

and rehabilitative reaching (i.e. “enriched/rehab”). Following 9 weeks of treatment, all animals were placed in standard housing for 5 weeks, after which they received 2 weeks of intensive therapy consisting of enhanced enriched environments and structured sensorimotor/cognitive rehabilitative activities (i.e. “Tune......Objectives: For the vast majority of stroke survivors, rehabilitation (i.e. physiotherapy and occupational therapy) is the only treatment option available. Following an initial phase of rehabilitation, many patients are sent home and return periodically for brief periods of therapy … often lasting...... just days. It is unclear what, if any, benefit this periodic return to therapy has for functional recovery, and if the type and intensity of therapy is optimal for maintaining or further enhancing functional gains. While the beneficial effects of early rehabilitation on neuroplasticity and functional...

Affective and cognitive empathy in adolescents with autism spectrum disorder

Directory of Open Access Journals (Sweden)

Monica eMazza

2014-10-01

Full Text Available The broad construct of empathy incorporates both cognitive and affective dimensions. Recent evidence suggests that the subjects with Autistic Spectrum disorder (ASD show a significant impairment in empathic ability. The aim of this study was to evaluate the cognitive and affective components of empathy in adolescents with ASD compared to controls. Fifteen adolescents with ASD and fifteen controls underwent paper and pencil measures and a computerized Multifaceted Empathy Test. All measures were divided into Mentalizing and Experience sharing abilities. Adolescents with ASD compared to controls showed deficits in all mentalizing measures: they were incapable of interpreting and understanding the mental and emotional states of other people. Instead, in the sharing experience measures, the adolescents with ASD were able to empathize with the emotional experience of other people when they express emotions with positive valence, but were not able to do so when the emotional valence is negative. These results were confirmed by the computerized task. In conclusion, our results suggest that adolescents with ASD show a difficulty in cognitive empathy, whereas the deficit in affective empathy is specific for the negative emotional valence.

Effects of multicomponent training of cognitive control on cognitive function and brain activation in older adults.

Science.gov (United States)

Kim, Hoyoung; Chey, Jeanyung; Lee, Sanghun