Publication at the Journal of NeuroEngineering and Rehabilitation

Benefits of virtual reality based cognitive rehabilitation through simulated activities of daily living: a randomized controlled trial with stroke patients
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 conventional therapy.
Our results suggest that cognitive rehabilitation through the Reh@City, an ecologically valid VR system for the training of ADL’s, has more impact than conventional methods.

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Café Memória Madeira

Sábado, 22 de Outubro de 2016, ficará na história da Delegação da Madeira da Alzheimer Portugal por ter sido o dia da estreia do Café Memória da Madeira, no Restaurante Yuan Sushi Wok no MadeiraShopping. Havia muitas expectativas e no fim da sessão toda a equipa teve um sentimento de missão cumprida! Os participantes foram muito interventivos, principalmente durante a palestra do Dr. Armando Morganho sobre os sinais de alerta da demência. Bom acolhimento, uma excelente palestra, o conforto de ser escutado, o sabor do café, a boa disposição e disponibilidade da nossa equipa foram os ingredientes para o sucesso desta estreia.

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3º Congresso OPP



O 3º Congresso OPP teve lugar no Porto de 28 de Setembro a 1 de Outubro. Estive presente com a comunicação “Desenvolvimento e validação clínica de tecnologias interativas para a reabilitação cognitiva do acidente vascular cerebral”. O congresso contou com a presença de cerca de 1800 profissionais.

11th International Conference on Disability, Virtual Reality & Associated Technologies (Los Angeles, California, USA)

Impact of combined cognitive and motor rehabilitation in a virtual reality task: an on-going longitudinal study in the chronic phase of stroke

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 towards the integration of cognitive training for providing more effective solutions. In this work we present a VR cognitive and motor training task – the Reh@Task – and the preliminary results from an ongoing one-month longitudinal intervention. We show the results from twelve patients divided in two groups: experimental and control. Both groups were enrolled in conventional occupational therapy, which mostly involves motor training. Additionally, the experimental group performed a specific attention and memory training with the Reh@Task and the control group performed time-matched conventional occupational therapy. This VR-based task consists in performing adapted arm reaching movements and has difficulty progression levels implemented with guidelines from a participatory design study. We assessed the impact of both interventions post-treatment (4-5 weeks) and at 4 weeks follow-up through the Montreal Cognitive Assessment, Single Letter Cancellation, Digit Cancellation, Bells Test, Fugl- Meyer, Chedoke Arm and Hand Activity Inventory, Modified Ashworth Scale and Barthel Index. A within groups analysis revealed significant improvements with respect to baseline in the global cognitive functioning in both groups, but only the patients who used the Reh@Task improved significantly in attention and memory. With respect to the motor domain, the control group showed greater improvements. Nevertheless, both groups improved significantly in the functional recovery of the hand and arm scores, revealing that both interventions had an impact in the use of the hand and arm in the activities of daily living. Overall, results are supportive of the viability of tools that combine motor and cognitive training, such as the Reh@Task.

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International Neuropsychological Society 2016 Mid-Year Meeting


Recently, I had my work accepted as a Poster presentation at the International Neuropsychological Society 2016 Mid-Year Meeting happening in London from 6th to 8th of July.

This conference will have as keynotes: Edward De Haan (Netherlands), Kathleen Haaland (USA), Cathy Price (UK), Eleanor Maguire (UK), Giacomo Rizzolatti (Italy), Angela Sirigu (France) and Barbara A Wilson (UK).

I will be presenting the work “Personalizing cognitive rehabilitation through a web-based Task Generator: an evaluation study with stroke patients”.

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