A comparison of two personalization and adaptive cognitive rehabilitation approaches: a randomized controlled trial with chronic stroke patients
Abstract Background Paper-and-pencil tasks are still widely used for cognitive rehabilitation despite the proliferation of new computer-based methods, like VR-based simulations of ADL’s. Studies have established construct validity of VR assessment tools with their paper-and-pencil version by demonst...
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| Format: | Article |
| Language: | English |
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BMC
2020-06-01
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| Series: | Journal of NeuroEngineering and Rehabilitation |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12984-020-00691-5 |
| _version_ | 1828400720078962688 |
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| author | Ana Lúcia Faria Maria Salomé Pinho Sergi Bermúdez i Badia |
| author_facet | Ana Lúcia Faria Maria Salomé Pinho Sergi Bermúdez i Badia |
| author_sort | Ana Lúcia Faria |
| collection | DOAJ |
| description | Abstract Background Paper-and-pencil tasks are still widely used for cognitive rehabilitation despite the proliferation of new computer-based methods, like VR-based simulations of ADL’s. Studies have established construct validity of VR assessment tools with their paper-and-pencil version by demonstrating significant associations with their traditional construct-driven measures. However, VR rehabilitation intervention tools are mostly developed to include mechanisms such as personalization and adaptation, elements that are disregarded in their paper-and-pencil counterparts, which is a strong limitation of comparison studies. Here we compare the clinical impact of a personalized and adapted paper-and-pencil training and a content equivalent and more ecologically valid VR-based ADL’s simulation. Methods We have performed a trial with 36 stroke patients comparing Reh@City v2.0 (adaptive cognitive training through everyday tasks VR simulations) with Task Generator (TG: content equivalent and adaptive paper-and-pencil training). The intervention comprised 12 sessions, with a neuropsychological assessment pre, post-intervention and follow-up, having as primary outcomes: general cognitive functioning (assessed by the Montreal Cognitive Assessment - MoCA), attention, memory, executive functions and language specific domains. Results A within-group analysis revealed that the Reh@City v2.0 improved general cognitive functioning, attention, visuospatial ability and executive functions. These improvements generalized to verbal memory, processing speed and self-perceived cognitive deficits specific assessments. TG only improved in orientation domain on the MoCA, and specific processing speed and verbal memory outcomes. However, at follow-up, processing speed and verbal memory improvements were maintained, and a new one was revealed in language. A between-groups analysis revealed Reh@City v2.0 superiority in general cognitive functioning, visuospatial ability, and executive functions on the MoCA. Conclusions The Reh@City v2.0 intervention with higher ecological validity revealed higher effectiveness with improvements in different cognitive domains and self-perceived cognitive deficits in everyday life, and the TG intervention retained fewer cognitive gains for longer. Trial registration The trial is registered at ClinicalTrials.gov, number NCT02857803 . Registered 5 August 2016, . |
| first_indexed | 2024-12-10T09:36:08Z |
| format | Article |
| id | doaj.art-f2a6ae657d09467eb512adabad77a385 |
| institution | Directory Open Access Journal |
| issn | 1743-0003 |
| language | English |
| last_indexed | 2024-12-10T09:36:08Z |
| publishDate | 2020-06-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of NeuroEngineering and Rehabilitation |
| spelling | doaj.art-f2a6ae657d09467eb512adabad77a3852022-12-22T01:54:10ZengBMCJournal of NeuroEngineering and Rehabilitation1743-00032020-06-0117111510.1186/s12984-020-00691-5A comparison of two personalization and adaptive cognitive rehabilitation approaches: a randomized controlled trial with chronic stroke patientsAna Lúcia Faria0Maria Salomé Pinho1Sergi Bermúdez i Badia2Madeira Interactive Technologies Institute, Universidade da MadeiraFaculdade de Psicologia e de Ciências da Educação, Universidade de CoimbraMadeira Interactive Technologies Institute, Universidade da MadeiraAbstract Background Paper-and-pencil tasks are still widely used for cognitive rehabilitation despite the proliferation of new computer-based methods, like VR-based simulations of ADL’s. Studies have established construct validity of VR assessment tools with their paper-and-pencil version by demonstrating significant associations with their traditional construct-driven measures. However, VR rehabilitation intervention tools are mostly developed to include mechanisms such as personalization and adaptation, elements that are disregarded in their paper-and-pencil counterparts, which is a strong limitation of comparison studies. Here we compare the clinical impact of a personalized and adapted paper-and-pencil training and a content equivalent and more ecologically valid VR-based ADL’s simulation. Methods We have performed a trial with 36 stroke patients comparing Reh@City v2.0 (adaptive cognitive training through everyday tasks VR simulations) with Task Generator (TG: content equivalent and adaptive paper-and-pencil training). The intervention comprised 12 sessions, with a neuropsychological assessment pre, post-intervention and follow-up, having as primary outcomes: general cognitive functioning (assessed by the Montreal Cognitive Assessment - MoCA), attention, memory, executive functions and language specific domains. Results A within-group analysis revealed that the Reh@City v2.0 improved general cognitive functioning, attention, visuospatial ability and executive functions. These improvements generalized to verbal memory, processing speed and self-perceived cognitive deficits specific assessments. TG only improved in orientation domain on the MoCA, and specific processing speed and verbal memory outcomes. However, at follow-up, processing speed and verbal memory improvements were maintained, and a new one was revealed in language. A between-groups analysis revealed Reh@City v2.0 superiority in general cognitive functioning, visuospatial ability, and executive functions on the MoCA. Conclusions The Reh@City v2.0 intervention with higher ecological validity revealed higher effectiveness with improvements in different cognitive domains and self-perceived cognitive deficits in everyday life, and the TG intervention retained fewer cognitive gains for longer. Trial registration The trial is registered at ClinicalTrials.gov, number NCT02857803 . Registered 5 August 2016, .http://link.springer.com/article/10.1186/s12984-020-00691-5Cognitive rehabilitationVirtual realityStrokeEcological validity |
| spellingShingle | Ana Lúcia Faria Maria Salomé Pinho Sergi Bermúdez i Badia A comparison of two personalization and adaptive cognitive rehabilitation approaches: a randomized controlled trial with chronic stroke patients Journal of NeuroEngineering and Rehabilitation Cognitive rehabilitation Virtual reality Stroke Ecological validity |
| title | A comparison of two personalization and adaptive cognitive rehabilitation approaches: a randomized controlled trial with chronic stroke patients |
| title_full | A comparison of two personalization and adaptive cognitive rehabilitation approaches: a randomized controlled trial with chronic stroke patients |
| title_fullStr | A comparison of two personalization and adaptive cognitive rehabilitation approaches: a randomized controlled trial with chronic stroke patients |
| title_full_unstemmed | A comparison of two personalization and adaptive cognitive rehabilitation approaches: a randomized controlled trial with chronic stroke patients |
| title_short | A comparison of two personalization and adaptive cognitive rehabilitation approaches: a randomized controlled trial with chronic stroke patients |
| title_sort | comparison of two personalization and adaptive cognitive rehabilitation approaches a randomized controlled trial with chronic stroke patients |
| topic | Cognitive rehabilitation Virtual reality Stroke Ecological validity |
| url | http://link.springer.com/article/10.1186/s12984-020-00691-5 |
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