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.
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.
More information at: http://centaur.reading.ac.uk/66645/
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”.
More information: http://www.ins-meeting.com
In the 28th of January I presented the following paper at the 11th Congresso Nacional de Psicologia da Saúde in Lisbon: Faria, A. L., Pinho, M., & Bermudez i Badia, S. (2016). Do papel-e-lápis à realidade virtual: uma nova abordagem para reabilitação cognitiva personalizada.
The congress proceedings can be found following this link: http://11cnps.iscte-iul.pt/sites/default/files/docs/livro_atas.pdf
Cognitive rehabilitation through interactive technologies: a randomized controlled trial with stroke patients (Best Communication Prize)
Stroke is one of the main causes of acquired adult disability worldwide, leaving more than 40% of survivors with cognitive impairments associated with higher mortality and greater rates of institutionalization. Rehabilitation of post-stroke cognitive impairment is generally limited by the use of paper-and-pencil methodologies, insufficient training personalization, and suboptimal intensity because of human resources. Virtual Reality (VR) tools have shown potential for improving cognitive rehabilitation by supporting carefully personalized, ecologically valid tasks through accessible technologies. Despite important progress in VR-based cognitive rehabilitation, there is still a need for the validation of key principles in clinical trials. In this work we present a one-month randomized controlled trial with 18 stroke patients: 9 performing a VR-based intervention and 9 performing a traditional intervention.
The VR-based intervention involved a virtual simulation of a city (RehabCity) where memory, attention, executive functions and language tasks are integrated in the performance of several activities of daily living. All participants were assessed pre and post-interventions with Addenbrooke Cognitive Examination, Trail Making Test A and B, Picture Completion from WAIS-III and Stroke Impact Scale. Additionally, the VR group answered the System Usability to evaluate the usability of the RehabCity.
A within groups analysis revealed significant improvements (Wilcoxon, p<.05) in global cognitive functioning, attention, memory (assessed and self-reported), visuo-spatial abilities, executive functions, emotion and overall recovery in the VR group. The control group improved in self-reported memory and social participation. A between groups analysis, showed significantly greater improvements (Mann-Whitney, p<.05) in global cognitive functioning, attention and executive functions when comparing VR to traditional therapy, which improvements were only in global cognitive functioning and attention. Finally, RehabCity obtained good levels of usability (Mdn=80/100). The results of this study suggest that cognitive rehabilitation, through an ecologically valid VR system, has more impact than standard methods.