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Oh S, Hodson T, Kendall M, Shirota C, Kendall E. A technology-focused service within a rehabilitation setting: exploring the experiences and current technology demands of people with disabilities. Disabil Rehabil Assist Technol 2024; 19:2000-2009. [PMID: 37615165 DOI: 10.1080/17483107.2023.2244001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 07/21/2023] [Indexed: 08/25/2023]
Abstract
PURPOSE To understand and combat the challenges in taking up and implementing technology in rehabilitation settings, the HabITec Lab, a clinical service focused on technology, was piloted for 12-months within a tertiary hospital. This article reports on its preliminary impacts as a clinical service and on clients, including the types of assistive technology (AT) in demand. MATERIALS AND METHODS Referral and administrative data from 25 individuals who attended the HabITec Lab were collated and analysed using descriptive statistics. For those who attended more than once (n = 12), goal attainment was assessed using the Modified Goal Attainment Measure (MGAM). Post-intervention semi-structured interviews were completed with participants to understand their experience at the HabITec Lab. Interviews were analysed using thematic analysis. RESULTS Most attendees (92%) were undergoing inpatient rehabilitation following a spinal cord injury (SCI). The majority (73%) of goals related to improving entertainment and connection. All participants who completed the MGAM showed improved goal attainment following their HabITec Lab attendance. Qualitative data highlighted appreciation for the service and suggestions for its future. CONCLUSIONS This study revealed a high level of demand for support to use AT amongst individuals with SCI, particularly consumer-grade smart devices that could assist communication. This finding may have been influenced by the impacts of the COVID-19 pandemic and frequent lockdowns during this period. This study indicated that the HabITec Lab was able to address important goals for attendees, but also illuminate a new future and trigger enthusiasm about future goals. Attendance was liberating, but resourcing barriers were frustrating.
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Affiliation(s)
- Soo Oh
- The Hopkins Centre, Menzies Health Institute Queensland, Griffith University, Nathan, Queensland, Australia
- Occupational Therapy Department, Princess Alexandra Hospital, Brisbane, Queensland, Australia
| | - Tenelle Hodson
- The Hopkins Centre, Menzies Health Institute Queensland, Griffith University, Nathan, Queensland, Australia
- School of Health Sciences and Social Work, Griffith University, Nathan, Queensland, Australia
| | - Melissa Kendall
- The Hopkins Centre, Menzies Health Institute Queensland, Griffith University, Nathan, Queensland, Australia
- School of Health Sciences and Social Work, Griffith University, Nathan, Queensland, Australia
- Transitional Rehabilitation Program, Princess Alexandra Hospital, Brisbane, Queensland, Australia
- Acquired Brain Injury Outreach Service, Princess Alexandra Hospital, Brisbane, Queensland, Australia
| | - Camila Shirota
- The Hopkins Centre, Menzies Health Institute Queensland, Griffith University, Nathan, Queensland, Australia
| | - Elizabeth Kendall
- The Hopkins Centre, Menzies Health Institute Queensland, Griffith University, Nathan, Queensland, Australia
- School of Health Sciences and Social Work, Griffith University, Nathan, Queensland, Australia
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Beaulieu-Bonneau S, Dubois L, Lafond-Desmarais SJ, Fortin S, Forest-Dionne G, Ouellet MC, Poulin V, Monetta L, Best KL, Bottari C, Bier N, Gullo HL. Use of smartphones and tablets after acquired brain injury to support cognition. Disabil Rehabil Assist Technol 2024; 19:1473-1481. [PMID: 37039326 DOI: 10.1080/17483107.2023.2199036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 03/30/2023] [Indexed: 04/12/2023]
Abstract
OBJECTIVES To describe the use of mobile devices after acquired brain injury (ABI), from the perspectives of injured individuals and significant others, and to examine factors associated with mobile device use for cognition. METHODS Cross-sectional study with 50 adults with moderate/severe traumatic brain injury or stroke (42% women; mean of 50.7 years old, 4.6 years post-ABI), and 24 significant others. Participants completed questionnaires on mobile technology, cognitive functioning and the impact of technology. RESULTS Of 45/50 adults with ABI who owned a smartphone/tablet, 31% reported difficulties in using their device post-injury, 44% had received support, and 46% were interested in further training. Significant others reported motor/visual impairments and the fear of becoming dependent on technology as barriers for mobile device use, and 65% mentioned that their injured relative needed additional support. Mobile device use for cognition was common (64%), predicted in a regression model by lower subjective memory and more positive perception of the psychosocial impacts of technology, and also associated in univariate analyses with younger age, lower executive functioning, and greater use of memory strategies. CONCLUSION Using mobile devices for cognition is common post-ABI but remains challenging for a significant proportion. Developing training approaches may help supporting technology use.
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Affiliation(s)
- Simon Beaulieu-Bonneau
- École de Psychologie, Faculté des Sciences Sociales, Université Laval, Québec, Canada
- Centre Interdisciplinaire de Recherche en Réadaptation et Intégration Sociale (CIRRIS), Québec, Canada
| | - Laurie Dubois
- École de Psychologie, Faculté des Sciences Sociales, Université Laval, Québec, Canada
| | | | - Seena Fortin
- École de Psychologie, Faculté des Sciences Sociales, Université Laval, Québec, Canada
| | | | - Marie-Christine Ouellet
- École de Psychologie, Faculté des Sciences Sociales, Université Laval, Québec, Canada
- Centre Interdisciplinaire de Recherche en Réadaptation et Intégration Sociale (CIRRIS), Québec, Canada
| | - Valérie Poulin
- Centre Interdisciplinaire de Recherche en Réadaptation et Intégration Sociale (CIRRIS), Québec, Canada
- Département d'Ergothérapie, Université du Québec à Trois-Rivières, Trois-Rivières, Canada
| | - Laura Monetta
- Centre Interdisciplinaire de Recherche en Réadaptation et Intégration Sociale (CIRRIS), Québec, Canada
- Département de Réadaptation, Faculté de médecine, Université Laval, Québec, Canada
| | - Krista L Best
- Centre Interdisciplinaire de Recherche en Réadaptation et Intégration Sociale (CIRRIS), Québec, Canada
- Département de Réadaptation, Faculté de médecine, Université Laval, Québec, Canada
| | - Carolina Bottari
- École de réadaptation, Faculté de médecine, Université de Montréal, Montreal, Canada
- Centre de Recherche Interdisciplinaire en Réadaptation du Montréal Métropolitain, Montréal, Canada
| | - Nathalie Bier
- École de réadaptation, Faculté de médecine, Université de Montréal, Montreal, Canada
- Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal, Montreal, Canada
| | - Hannah L Gullo
- School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, Australia
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Babbage DR, Drown JC, Van Solkema M, Armstrong J, Levack W, Kayes N. Inpatient trial of a tablet app for communicating brain injury rehabilitation goals. Disabil Rehabil Assist Technol 2024; 19:1287-1297. [PMID: 36634029 DOI: 10.1080/17483107.2023.2167009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Accepted: 01/06/2023] [Indexed: 01/13/2023]
Abstract
PURPOSE We examine the use of a custom iPad application, the Rehab Portal, to provide clients in an inpatient brain injury rehabilitation service with access to short videos where clinicians-or the clients themselves-discuss their current rehabilitation goals. MATERIALS AND METHODS We developed an initial version of the Rehab Portal app based on our previous co-design with service users, their families, and clinicians. This was examined in a field trial with a series of six clients over the course of their stays in inpatient rehabilitation, collecting quantitative data on clinician and client engagement with the Rehab Portal, alongside a thematic analysis of qualitative interviews with clients and clinicians at the point of discharge. RESULTS Engagement with the platform was high for two clients while it was limited with four more. In our thematic analysis we discuss how introduction of the Rehab Portal disrupted practice, changing how things are done, causing deviation from usual routines, adding burden, and threatening professional integrity. At the same time, where it worked well it led to a repositioning of goal planning away from being clinician directed and towards an ongoing, dynamic collaboration between clinicians, clients and their families. Finally, in some cases we identified a reverting to the status quo, with client demotivation having an unexpected impact on clinician behaviour leading to the process being abandoned. CONCLUSIONS The current findings do not provide wholesale support for this approach, yet we continue to feel that approaches that support clinician-client communication using asynchronous video may offer considerable future value and are worthy of further investigation.
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Affiliation(s)
- Duncan R Babbage
- Centre for eHealth, Auckland University of Technology, Auckland, New Zealand
- Centre for Person Centred Research, Auckland University of Technology, Auckland, New Zealand
| | - Juliet C Drown
- Centre for eHealth, Auckland University of Technology, Auckland, New Zealand
- Centre for Person Centred Research, Auckland University of Technology, Auckland, New Zealand
| | - Maegan Van Solkema
- Clinical Lead Speech Language Therapist, ABI Rehabilitation NZ Ltd, Auckland, New Zealand
| | - Jonathan Armstrong
- Director of Rehabilitation, ABI Rehabilitation NZ Ltd, Auckland, New Zealand
| | - William Levack
- Rehabilitation Teaching & Research Unit, University of Otago, Dunedin, New Zealand
| | - Nicola Kayes
- Centre for Person Centred Research, Auckland University of Technology, Auckland, New Zealand
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Vasquez BP, Cretu A, Max A, Moscovitch M. Early mobile app training proficiency predicts how well memory-impaired individuals learn to use digital memory aids in the real world. Neuropsychol Rehabil 2023; 33:1411-1429. [PMID: 35930245 DOI: 10.1080/09602011.2022.2107020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 07/22/2022] [Indexed: 10/16/2022]
Abstract
Functional memory impairment following acquired brain injury can lead to decreased independence. External memory aids such as smartphones can be highly effective compensation tools, but cognitive deficits may create barriers to implementation in daily life. The present study examined predictors of real-world use of mobile calendar applications for memory compensation in an acquired brain injury sample. A retrospective chart review was completed from an outpatient rehabilitation program, extending 15 years into the past, yielding data from 34 eligible participants. All participants demonstrated skill learning of the calendar function in their digital device and subsequently completed the generalization phase of training, which is focused on real-world implementation (measured through prospective memory tasks). The results showed that the length of time required for skill learning of mobile calendars (event entry or responding to alerts) was not predictive of the duration of generalization training. Initial training performance for responding to alerts, but not event entry, was a significant predictor of the duration of generalization training needed to complete the program. A secondary analysis with a subset of the data revealed that individuals with additional executive deficits took significantly longer to complete generalization training compared to those with a more focal memory impairment.
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Affiliation(s)
- Brandon P Vasquez
- Neuropsychology & Cognitive Health, Baycrest, Toronto, Canada
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Canada
| | - Andrada Cretu
- Neuropsychology & Cognitive Health, Baycrest, Toronto, Canada
| | - Adina Max
- Neuropsychology & Cognitive Health, Baycrest, Toronto, Canada
| | - Morris Moscovitch
- Neuropsychology & Cognitive Health, Baycrest, Toronto, Canada
- Rotman Research Institute, Baycrest, Toronto, Canada
- Department of Psychology, University of Toronto, Toronto, Canada
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5
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De Wit L, Levy SA, Kurasz AM, Amofa P, DeFeis B, O'Shea D, Chandler MJ, Smith GE. Procedural learning, declarative learning, and working memory as predictors of learning the use of a memory compensation tool in persons with amnestic mild cognitive impairment. Neuropsychol Rehabil 2023; 33:1278-1303. [PMID: 35749375 DOI: 10.1080/09602011.2022.2089697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Accepted: 06/09/2022] [Indexed: 09/30/2022]
Abstract
Persons with amnestic Mild Cognitive Impairment (aMCI) are at risk for experiencing changes in their daily functioning due to their memory impairment. The Memory Support System (MSS), a compensatory calendaring system, was developed to support functional independence in persons with aMCI (pwaMCI). This cross-sectional study examined procedural learning, declarative learning, and working memory as predictors of MSS learning efficiency in pwaMCI. Sixty pwaMCI participated in MSS training. The Serial Reaction Time Test and Mirror Tracing Test were used to assess procedural learning. The Rey Auditory Verbal Learning Test and CogState One Card Learning were used to assess declarative learning and the CogState One Back task was used to assess working memory. Multiple regression analyses were conducted to assess if procedural learning, declarative learning, and working memory predicted MSS learning efficiency. This study showed that declarative learning predicted MSS learning efficiency in pwaMCI, with less consistent results for procedural learning and non-significant results for working memory. Findings suggest that success in teaching compensatory tools is greater when training is offered in early aMCI before declarative learning skill is fully lost. Future studies should assess additional strategies to facilitate MSS learning in advanced aMCI.
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Affiliation(s)
- Liselotte De Wit
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
| | - Shellie-Anne Levy
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
| | - Andrea M Kurasz
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
| | - Priscilla Amofa
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
| | - Brittany DeFeis
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
| | - Deirdre O'Shea
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA
| | - Melanie J Chandler
- Department of Psychiatry and Psychology, Mayo Clinic Florida, Jacksonville, FL, USA
| | - Glenn E Smith
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
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Ramirez-Hernandez D, Wong D, Ownsworth T, Stolwyk RJ. Which training methods are effective for learning new smartphone memory apps after acquired brain injury? A pilot randomized controlled trial comparing trial and error, systematic instruction and error-based learning. Neuropsychol Rehabil 2023; 33:139-172. [PMID: 34724874 DOI: 10.1080/09602011.2021.1993273] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
This study aimed to compare the efficacy of three skills training methods (Trial and error TEL; systematic instruction SI; and error-based learning EBL) for training the use of a smartphone reminder app in individuals with an acquired brain injury. Participants (N = 38, Mage = 61.21 years, 71.1% stroke) were randomly allocated to one of three training conditions and trained over one two-hour session. Proficiency of performance with the trained app (primary outcome) was assessed immediately post-training, one- and six-weeks post-intervention. Secondary outcomes included generalization of skills, error commission, smartphone use frequency and confidence, and subjective memory complaints. Proficiency with the trained app after TEL was higher than SI immediately after the training (d = 0.87) and EBL at the one-week follow-up (d = 0.98). No differences were found six-weeks post-training. Smartphone use confidence increased at the six-week follow-up after TEL (d = 1.12) and EBL training (d = 0.91) but not after SI (d = 0.26). Self-reported memory complaints decreased across time for all groups (ηp2 = 0.30). There was no clearly superior training method for optimizing proficiency with the reminder app. The expected benefits of SI and EBL may not have emerged due to the single-session format of the training. However, smartphone training via TEL or EBL has the potential to address confidence-related barriers to smartphone use.
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Affiliation(s)
- Diana Ramirez-Hernandez
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Australia
| | - Dana Wong
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Australia.,Monash-Epworth Rehabilitation Research Centre, Melbourne, Australia.,School of Psychology and Public Health, La Trobe University, Melbourne, Australia
| | - Tamara Ownsworth
- School of Applied Psychology, Griffith University, Mt Gravatt, Australia
| | - Renerus J Stolwyk
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Australia.,Monash-Epworth Rehabilitation Research Centre, Melbourne, Australia
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Vasquez BP, Lloyd-Kuzik A, Santiago AT, Shahaf G, Lass JW. Attentional Engagement During Mobile Application Skill Learning Among Patients With Memory Impairment: A Case Series Exploration. Am J Occup Ther 2023; 77:24039. [PMID: 36764006 DOI: 10.5014/ajot.2023.050064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023] Open
Abstract
IMPORTANCE Attentional engagement is essential for successful cognitive rehabilitation, but little is known about longitudinal interactions with skill learning. OBJECTIVE To examine how attentional engagement is associated with mobile application skill learning for memory compensation. We hypothesized that patients with greater functional capacity would demonstrate faster learning and attentional engagement drop with skill acquisition, whereas patients with lesser functional capacity would have to maintain attentional engagement to progress throughout training. DESIGN A case series approach was used with longitudinal skill learning and electroencephalographic (EEG) data recorded across multiple trials and sessions of mobile calendar application training. SETTING The study was run in a hospital-based neuropsychology clinic. PARTICIPANTS Seven participants (5 with acquired brain injury, 1 with mild cognitive impairment, and 1 healthy older adult) were recruited. INTERVENTION Mobile application operation was trained for the purpose of memory compensation. Skill learning was facilitated through a structured rehabilitation protocol, including large amounts of guided practice with the integration of errorless learning. OUTCOMES AND MEASURES We quantified learning using the proportion of application steps completed independently at each session. We measured attentional engagement using an EEG marker: the Brain Engagement Index. RESULTS For fast learners, attentional engagement generally decreased as mobile application learning progressed. In contrast, slow learners exhibited stable engagement over time with consistent, yet much slower, progress in skill learning. CONCLUSIONS AND RELEVANCE The present data indicate that when cognitive impairment is more substantial, skill learning may involve greater attentional engagement. What This Article Adds: Patients undergoing memory rehabilitation may benefit from methods to enhance attentional engagement during skill learning when executive dysfunction is a considerable element of their cognitive profile. Monitoring attentional engagement during cognitive rehabilitation may be useful in identifying and addressing barriers to learning in real time.
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Affiliation(s)
- Brandon P Vasquez
- Brandon P. Vasquez, PhD, is Clinical Neuropsychologist, Neuropsychology and Cognitive Health, Baycrest, Toronto, Ontario, Canada, and Assistant Professor, Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Ontario, Canada;
| | - Andrew Lloyd-Kuzik
- Andrew Lloyd-Kuzik, MSc, is Research Assistant, Neuropsychology and Cognitive Health, Baycrest, Toronto, Ontario, Canada
| | - Anna Theresa Santiago
- Anna Theresa Santiago, MPH, MSc, is Biostatistician, Kunin-Lunenfeld Centre for Applied Research and Evaluation, Rotman Research Institute, Baycrest, Toronto, Ontario, Canada
| | - Goded Shahaf
- Goded Shahaf, MD, PhD, is Chief Scientist, BrainMARC LTD, Yokneam, Israel, and Head, The Applied Neurophysiology Laboratory, Rambam Healthcare Campus, Haifa, Israel
| | - Jordan W Lass
- Jordan W. Lass, PhD, is Project Manager, Kunin-Lunenfeld Centre for Applied Research and Evaluation, Rotman Research Institute, Baycrest, Toronto, Ontario, Canada
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Gopi Y, Wilding E, Madan CR. Memory rehabilitation: restorative, specific knowledge acquisition, compensatory, and holistic approaches. Cogn Process 2022; 23:537-557. [PMID: 35790619 PMCID: PMC9553770 DOI: 10.1007/s10339-022-01099-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 05/25/2022] [Indexed: 11/29/2022]
Abstract
Memory impairment following an acquired brain injury can negatively impact daily living and quality of life—but can be reduced by memory rehabilitation. Here, we review the literature on four approaches for memory rehabilitation and their associated strategies: (1) the restorative approach, aimed at a return to pre-morbid functioning, (2) the knowledge acquisition approach, involving training on specific information relevant to daily life, (3) the compensatory approach, targeted at improving daily functioning, and (4) the holistic approach, in which social, emotional, and behavioral deficits are addressed alongside cognitive consequences of acquired brain injury. Each memory rehabilitation approach includes specific strategies such as drill and practice (restorative), spaced retrieval (knowledge acquisition), memory aids (compensatory), or a combination of psychotherapy and cognitive strategies (holistic). Past research has demonstrated mixed support for the use of restorative strategies to improve memory function, whereas knowledge acquisition strategies show promising results on trained tasks but little generalization to untrained tasks and activities of daily living. Compensatory strategies remain widely used but require intensive training to be effectively employed. Finally, the holistic approach is becoming more widespread due to improvements in psychosocial wellbeing, yet there are considerable resource and cost requirements. Several factors can influence rehabilitation outcomes including metacognition and emotional disturbances. Considerations for future research to improve the applicability of strategies for memory rehabilitation include assessing memory impairment severity, examining memory needs in daily life, and exploring the long-term effects of memory rehabilitation.
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Affiliation(s)
- Yashoda Gopi
- School of Psychology, University of Nottingham, Nottingham, NG7 2RD, UK.
| | - Edward Wilding
- School of Psychology, University of Birmingham, Birmingham, UK
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Abstract
Human memory is prone to error and distortion. Schacter (1999, 2001) proposed that memory's misdeeds can be classified into seven categories or "sins". This article discusses the impact of media and technology on four memory sins, transience (forgetting over time), absent-mindedness (lapses in attention that produce forgetting), misattribution (attributing a memory to the wrong source), and suggestibility (implanted memories). Growing concerns have been expressed about the negative impact of media and technology on memory. With respect to transience, I review research regarding the impact of the Internet (ie, Google), GPS, and photographs. Studies have documented impaired memory following specific tasks on which people rely on media/technology (eg, poor memory for a route after using GPS), but have revealed little evidence for broader impairments (eg, generally impaired memory in GPS users), and have also documented some mnemonic benefits (eg, reviewing photos of past experiences). For absent-mindedness, there is strong evidence that media multitasking is associated with poor memory for a target task (eg, a lecture) because of attentional lapses, suggestive evidence that chronic media multitasking could be associated with broader memory problems, and emerging evidence that technology can help to reduce certain kinds of absent-minded errors. Regarding misattribution and suggestibility, there is clear evidence that manipulated or misleading photos are associated with false memories for personal events and fake news, but no evidence of broader effects on susceptibility to memory distortion. Further study of the impact of media and technology on the memory sins is a fruitful pursuit for interdisciplinary studies.
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Ramirez-Hernandez D, Stolwyk RJ, Chapman J, Wong D. The experience and acceptability of smartphone reminder app training for people with acquired brain injury: a mixed methods study. Neuropsychol Rehabil 2021; 32:1263-1290. [PMID: 33563100 DOI: 10.1080/09602011.2021.1879875] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Smartphones are useful compensatory memory aids, yet training on how to use them is seldom offered as part of rehabilitation for acquired brain injuries (ABIs). We aimed to explore the experience and acceptability of a smartphone training intervention in 26 people with ABI who participated in a pilot randomized controlled trial comparing three skills training approaches. Participants completed questionnaire ratings and a semi-structured interview, six weeks post-training. Most participants rated the training as enjoyable (80.8%) and reasonable in duration (88.5%). Others reported that more than one training session was needed to learn the app (34.6%). Five themes were identified from qualitative data through thematic analysis: (1) Attitudes and pre-existing factors, (2) Experiencing the intervention, (3) Tailoring the intervention to the individual, (4) Facilitators and barriers to implementation and (5) Enhancing smartphone use in everyday life. These themes were juxtaposed with a theoretical framework of acceptability, which indicated that some elements (e.g., having a structured session and a supportive trainer) contributed to the acceptability of the intervention by minimizing training burden and increasing self-efficacy. Tailoring the training to the individual's technological skills and lifestyle, providing post-training resources and involving family members were identified as factors that could improve intervention acceptability.
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Affiliation(s)
- Diana Ramirez-Hernandez
- School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, Melbourne, Australia.,Monash-Epworth Rehabilitation Research Centre, Melbourne, Australia
| | - Renerus J Stolwyk
- School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, Melbourne, Australia.,Monash-Epworth Rehabilitation Research Centre, Melbourne, Australia
| | - Jodie Chapman
- School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, Melbourne, Australia.,School of Behavioural and Health Sciences, Australian Catholic University, Melbourne, Australia
| | - Dana Wong
- School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, Melbourne, Australia.,Monash-Epworth Rehabilitation Research Centre, Melbourne, Australia.,School of Psychology and Public Health, La Trobe University, Melbourne, Australia
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11
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Vasquez BP, Lloyd-Kuzik A, Moscovitch M. Mobile app learning in memory intervention for acquired brain injury: Neuropsychological associations of training duration. Neuropsychol Rehabil 2021; 32:1048-1074. [PMID: 33400894 DOI: 10.1080/09602011.2020.1866620] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Memory impairment is a common consequence of acquired brain injury, often leading to functional difficulties day-to-day and decreased independence. Memory Link is a theory-driven training programme for individuals with moderate-to-severe memory dysfunction, which enables the acquisition of digital device skills for functional compensation. The present study examined how neuropsychological functioning and initial training performance contribute to training duration in our outpatient memory rehabilitation programme. A retrospective chart review was conducted, extending 12 years into the past, yielding data from 37 eligible participants. All participants demonstrated skill learning of the calendar function in their digital device to the criterion point. The results showed that performance on neuropsychological tests of explicit memory (e.g., CVLT-II, BVMT-R), processing speed (e.g., Digit Symbol Coding, Trail Making sequencing), executive functioning (e.g., Trail Making switching), and perceptual ability (i.e., Block Design) were significantly associated with training duration to learn the core steps of calendar use. Furthermore, linear regression revealed that initial training performance was a significant predictor of training duration. Lastly, profile of cognitive impairment, with regard to severity of memory functioning and the presence of additional deficits, was found to be a significant factor contributing to how many training trials were required to learn application skills.
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Affiliation(s)
- Brandon P Vasquez
- Neuropsychology & Cognitive Health, Baycrest, Toronto, Canada.,Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Canada
| | | | - Morris Moscovitch
- Neuropsychology & Cognitive Health, Baycrest, Toronto, Canada.,Rotman Research Institute, Baycrest, Toronto, Canada.,Department of Psychology, University of Toronto, Toronto, Canada
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12
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A comparison of systematic instruction, error-based learning and trial and error to train the use of smartphone memory apps after acquired brain injury: A three-armed phase II randomised controlled trial study protocol. BRAIN IMPAIR 2020. [DOI: 10.1017/brimp.2020.10] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
AbstractBackground:The uptake of smartphones as external compensatory memory aids following an acquired brain injury (ABI) in rehabilitation settings is low. Potential reasons for this include professionals not having evidence-based guidelines regarding the best methods to train smartphone use and prospective users not being familiar with technology and/or having memory and learning difficulties. This paper describes the protocol of a study that aims to compare the efficacy of three training methods (Systematic Instruction, Error-based Learning and Trial-and-Error) for training the use of a smartphone reminder app, in people with ABI presenting with memory complaints.Methods/Design:This is a three-armed, assessor-blinded, Phase II randomised controlled trial. The estimated sample size is 51 participants aged >18 years, who are equally randomised to one of the three training groups. They are seen across four sessions: one to conduct baseline measures; one for training the use of an app and two for follow-up assessments (1- and 6-weeks post-training). The main outcome measure is proficiency of performance in tasks with the trained app. Secondary outcomes include generalisation of skills to other apps, number of errors committed while attempting the tasks, frequency of smartphone usage in general and as a memory aid and confidence in smartphone use and memory self-efficacy. Outcome measures are collected by an independent blinded assessor. Proficiency of performance, generalisation of skills and error commission are measured immediately post-training and at the two follow-up sessions. The other secondary measures are taken pre-intervention and at the two follow-up sessions.Discussion:This study will provide initial evidence regarding the efficacy of three different methods to train ABI survivors with memory difficulties in how to use smartphone apps as compensatory memory aids. The results could inform a larger Phase III trial and advance knowledge concerning the advantages or disadvantages of using error-reducing and trial-and-error techniques. Further, the findings could determine the potential of error-based learning as an emerging training method for people with memory impairment within rehabilitation.
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Jamieson M, Cullen B, Lennon M, Brewster S, Evans J. Designing ApplTree: usable scheduling software for people with cognitive impairments. Disabil Rehabil Assist Technol 2020; 17:338-348. [PMID: 32633592 DOI: 10.1080/17483107.2020.1785560] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND Smartphone reminding applications can help overcome memory difficulties experienced by people with acquired brain injury (ABI). Cognitive difficulties with memory and attention make entering reminders into a device, and remembering to set reminders, challenging for this group. ApplTree is a reminding app with features that aim to address challenges. One app feature was push notifications (asking "Do you need to set any reminders?") to support people to initiate use of the app to set reminders. Another app feature was a customisable user interface design to support attention and short term memory during reminder setting. METHODS In a mixed-methods user study, five people with self or other reported memory impairment following ABI used ApplTree for at least 4 months. They received push notifications for at least 2 months and no push notifications for at least 2 months. Monthly participant interviews provided insight into user interface preference, app use, and push notification acceptability. RESULTS Receiving four Push notifications per day doubled number of daily reminders set and four of the five participants found receiving them to be acceptable. This long-term field study uncovered issues relevant for clinicians and designers, including insights into the potential benefits of different user interface designs, the impact of family members on app use, and the importance of perceived need influencing use and acceptance. CONCLUSIONS Feedback provided insight into future considerations when designing reminding apps and using them in neuropsychological rehabilitation. This work highlights the benefit of user-led research into accessible design and use of assistive technologies.IMPLICATIONS FOR REHABILITATION"Unsolicited" push prompts are an easy to implement feature of reminding technology that is useful and acceptable for people with ABI in community rehabilitation.Observations provide insights about how people with ABI make use of reminding apps over time. This can inform those designing apps or providing reminding technology as part of neuropsychological rehabilitation.Participants differed on their preference of the two user-interface designs available in ApplTree. This highlights an area for future research because currently available reminding apps have a broad-shallow design which may not always be appropriate for people with ABI.
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Affiliation(s)
- Matthew Jamieson
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, Scotland.,Human Computer Interaction, Department of Computing Science, University of Glasgow, Scotland
| | - Breda Cullen
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, Scotland
| | - Marilyn Lennon
- Computer and Information Science, University of Strathclyde, Glasgow, Scotland
| | - Stephen Brewster
- Human Computer Interaction, Department of Computing Science, University of Glasgow, Scotland
| | - Jonathan Evans
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, Scotland
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Gao AF, Keith JL, Gao FQ, Black SE, Moscovitch M, Rosenbaum RS. Neuropathology of a remarkable case of memory impairment informs human memory. Neuropsychologia 2020; 140:107342. [PMID: 31972232 DOI: 10.1016/j.neuropsychologia.2020.107342] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Revised: 01/03/2020] [Accepted: 01/13/2020] [Indexed: 12/28/2022]
Abstract
Kent Cochrane (K.C.) has been investigated by researchers for nearly three decades after intracranial trauma from a motorcycle accident at age 30 resulted in a striking profile of amnesia. K.C. suffered severe anterograde amnesia in both verbal and non-verbal domains which was accompanied by selective retrograde amnesia for personal events experienced prior to the time of his injury (episodic memory), with relative preservation of memory for personal and world facts (semantic memory), and of implicit memory. This pattern of spared and impaired memory extended to spatial memory for large-scale environments and beyond memory to future imagining and decision-making. Post-mortem brain findings at age 62 included moderate diffuse atrophy, left orbitofrontal contusion, left posterior cerebral artery infarct, and left anterior frontal watershed infarct. Notably, there was severe neuronal loss and gliosis of the hippocampi bilaterally. The left hippocampus was severely affected anteriorly and posteriorly, but CA2, CA4, and the dentate gyrus (DG) were focally spared. There was associated degeneration of the left fornix. The right hippocampus showed near complete destruction anteriorly, with relative preservation posteriorly, mainly of CA4 and DG. Bilateral parahippocampal gyri and left anterior thalamus also showed neuron loss and gliosis. There was no evidence of co-existing neurodegenerative phenomena on beta-amyloid, phosphorylated tau, or TDP-43 immunostaining. The extent of damage to medial temporal lobe structures is in keeping with K.C.'s profound anterograde and retrograde amnesia, with the exception of the unexpected finding of preserved CA2/CA4 and DG. K.C.'s case demonstrates that relatively clean functional dissociations are still possible following widespread brain damage, with structurally compromised brain regions unlikely to be critical to cognitive functions found to be intact. In this way, the findings presented here add to K.C.'s significant contributions to our understanding of clinical-anatomical relationships in memory.
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Affiliation(s)
- Andrew F Gao
- Department of Anatomic Pathology, Sunnybrook Health Sciences Centre, Toronto, ON, Canada; Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada
| | - Julia L Keith
- Department of Anatomic Pathology, Sunnybrook Health Sciences Centre, Toronto, ON, Canada; Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada
| | - Fu-Qiang Gao
- L.C. Campbell Cognitive Neurology Research Group, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Sandra E Black
- L.C. Campbell Cognitive Neurology Research Group, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Morris Moscovitch
- Rotman Research Institute, Baycrest Centre for Geriatric Care, Toronto, ON, Canada; Department of Psychology, University of Toronto, Toronto, ON, Canada
| | - R Shayna Rosenbaum
- Rotman Research Institute, Baycrest Centre for Geriatric Care, Toronto, ON, Canada; Department of Psychology and Vision: Science to Applications (VISTA) Program, York University, Toronto, ON, Canada.
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15
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Cicerone KD, Goldin Y, Ganci K, Rosenbaum A, Wethe JV, Langenbahn DM, Malec JF, Bergquist TF, Kingsley K, Nagele D, Trexler L, Fraas M, Bogdanova Y, Harley JP. Evidence-Based Cognitive Rehabilitation: Systematic Review of the Literature From 2009 Through 2014. Arch Phys Med Rehabil 2019; 100:1515-1533. [DOI: 10.1016/j.apmr.2019.02.011] [Citation(s) in RCA: 140] [Impact Index Per Article: 28.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Revised: 02/19/2019] [Accepted: 02/20/2019] [Indexed: 10/27/2022]
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16
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Mobile Health Interventions for Traumatic Brain Injuries. CURRENT PHYSICAL MEDICINE AND REHABILITATION REPORTS 2019. [DOI: 10.1007/s40141-019-00240-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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17
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Bos HR, Babbage DR, Leathem JM. Efficacy of memory aids after traumatic brain injury: A single case series. NeuroRehabilitation 2018; 41:463-481. [PMID: 29036840 DOI: 10.3233/nre-151528] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Individuals living with traumatic brain injury commonly have difficulties with prospective memory-the ability to remember a planned action at the intended time. Traditionally a memory notebook has been recommended as a compensatory memory aid. Electronic devices have the advantage of providing a cue at the appropriate time to remind participants to refer to the memory aid and complete tasks. Research suggests these have potential benefit in neurorehabilitation. OBJECTIVE This study aimed to investigate the efficacy of a memory notebook and specifically a smartphone as a compensatory memory aid. METHODS A single case series design was used to assess seven participants. A no-intervention baseline was followed by training and intervention with either the smartphone alone, or a memory notebook and later the smartphone. Memory was assessed with weekly assigned memory tasks. RESULTS Participants using a smartphone showed improvements in their ability to complete assigned memory tasks accurately and within the assigned time periods. Use of a smartphone provided additional benefits over and above those already seen for those who received a memory notebook first. CONCLUSIONS Smartphones have the potential to be a useful and cost effective tool in neurorehabilitation practice.
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Affiliation(s)
- Hannah R Bos
- School of Psychology, Massey University, Wellington, New Zealand
| | - Duncan R Babbage
- Centre for eHealth, Centre for Person Centred Research, Auckland University of Technology, Auckland, New Zealand
| | - Janet M Leathem
- School of Psychology, Massey University, Wellington, New Zealand
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18
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Harte R, Hall T, Glynn L, Rodríguez-Molinero A, Scharf T, Quinlan LR, ÓLaighin G. Enhancing Home Health Mobile Phone App Usability Through General Smartphone Training: Usability and Learnability Case Study. JMIR Hum Factors 2018; 5:e18. [PMID: 29699969 PMCID: PMC5945986 DOI: 10.2196/humanfactors.7718] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2017] [Revised: 07/21/2017] [Accepted: 09/18/2017] [Indexed: 12/02/2022] Open
Abstract
Background Each year, millions of older adults fall, with more than 1 out of 4 older people experiencing a fall annually, thereby causing a major social and economic impact. Falling once doubles one’s chances of falling again, making fall prediction an important aspect of preventative strategies. In this study, 22 older adults aged between 65 and 85 years were trained in the use of a smartphone-based fall prediction system. The system is designed to continuously assess fall risk by measuring various gait and balance parameters using a smart insole and smartphone, and is also designed to detect falls. The use case of the fall prediction system in question required the users to interact with the smartphone via an app for device syncing, data uploads, and checking system status. Objective The objective of this study was to observe the effect that basic smartphone training could have on the user experience of a group that is not technically proficient with smartphones when using a new connected health system. It was expected that even short rudimentary training could have a large effect on user experience and therefore increase the chances of the group accepting the new technology. Methods All participants received training on how to use the system smartphone app; half of the participants (training group) also received extra training on how to use basic functions of the smartphone, such as making calls and sending text messages, whereas the other half did not receive this extra training (no extra training group). Comparison of training group and no extra training group was carried out using metrics such as satisfaction rating, time taken to complete tasks, cues required to complete tasks, and errors made during tasks. Results The training group fared better in the first 3 days of using the system. There were significant recorded differences in number of cues required and errors committed between the two groups. By the fourth and fifth day of use, both groups were performing at the same level when using the system. Conclusions Supplementary basic smartphone training may be critical in trials where a smartphone app–based system for health intervention purposes is being introduced to a population that is not proficient with technology. This training could prevent early technology rejection and increase the engagement of older participants and their overall user experience with the system.
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Affiliation(s)
- Richard Harte
- Electrical & Electronic Engineering, School of Engineering & Informatics, NUI Galway, University Road, Galway, Ireland.,Human Movement Laboratory, NUI Galway, University Road, Galway, Ireland.,CÚRAM, Centre for Research in Medical Devices, NUI Galway, University Road, Galway, Ireland
| | - Tony Hall
- School of Education, NUI Galway, University Road, Galway, Ireland
| | - Liam Glynn
- General Practice, School of Medicine, NUI Galway, University Road, Galway, Ireland
| | - Alejandro Rodríguez-Molinero
- Electrical & Electronic Engineering, School of Engineering & Informatics, NUI Galway, University Road, Galway, Ireland.,Clinical Research Unit, Consorci Sanitari del Garraf, Sant Pere de Ribes, Barcelona, Spain
| | - Thomas Scharf
- Irish Centre for Social Gerontology, Institute for Lifecourse and Society, NUI Galway, University Road, Galway, Ireland
| | - Leo R Quinlan
- Human Movement Laboratory, NUI Galway, University Road, Galway, Ireland.,CÚRAM, Centre for Research in Medical Devices, NUI Galway, University Road, Galway, Ireland.,Physiology, School of Medicine, NUI Galway, Galway, Ireland
| | - Gearóid ÓLaighin
- Electrical & Electronic Engineering, School of Engineering & Informatics, NUI Galway, University Road, Galway, Ireland.,Human Movement Laboratory, NUI Galway, University Road, Galway, Ireland.,CÚRAM, Centre for Research in Medical Devices, NUI Galway, University Road, Galway, Ireland
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19
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Goodwin RA, Lincoln NB, das Nair R, Bateman A. Evaluation of NeuroPage as a memory aid for people with multiple sclerosis: A randomised controlled trial. Neuropsychol Rehabil 2018; 30:15-31. [PMID: 29557731 DOI: 10.1080/09602011.2018.1447973] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Memory problems are reported in 40%-60% of people with multiple sclerosis (MS). These problems affect independence and may limit the ability to benefit from rehabilitation. Our aim was to evaluate the effectiveness of NeuroPage for people with MS living in the community. A multicentre, single-blind, randomised controlled crossover trial was conducted. The intervention comprised the NeuroPage service, which sends reminder messages to mobile phones at pre-arranged times. In the control condition participants received "non-memory texts", that is, messages not aimed at providing a reminder; for example, supplying news headlines or sport updates. Outcome measures were completed using postal questionnaires after each condition. There were 38 participants aged 28 to 72 (mean 48, SD 11) and 10 (26%) were men. There were no significant differences between NeuroPage and control conditions on the Everyday Memory Questionnaire (p = 0.41, d = 0.02). The number of daily diary items forgotten in the NeuroPage condition was significantly less than in the control (9% vs. 31%, p = 0.01, d = -0.64). Psychological distress was less in the NeuroPage condition than control (p = 0.001, d = -0.84). Further evaluation of the effect on everyday memory is required.
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Affiliation(s)
- Rachel A Goodwin
- Division of Rehabilitation & Ageing, University of Nottingham, Nottingham, UK.,The Oliver Zangwill Centre for Neuropsychological Rehabilitation, Princess of Wales Hospital, Ely, UK
| | - Nadina B Lincoln
- Division of Rehabilitation & Ageing, University of Nottingham, Nottingham, UK
| | - Roshan das Nair
- Division of Rehabilitation & Ageing, University of Nottingham, Nottingham, UK.,Division of Psychiatry & Applied Psychology, Institute of Mental Health, School of Medicine, University of Nottingham, UK
| | - Andrew Bateman
- The Oliver Zangwill Centre for Neuropsychological Rehabilitation, Princess of Wales Hospital, Ely, UK
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20
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El Haj M, Gallouj K, Antoine P. Google Calendar Enhances Prospective Memory in Alzheimer's Disease: A Case Report. J Alzheimers Dis 2018; 57:285-291. [PMID: 28222535 DOI: 10.3233/jad-161283] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
We investigated whether an external memory aid (i.e., Google Calendar) would alleviate prospective memory compromise in a patient with mild Alzheimer's disease. The patient was asked in the baseline phase to perform three prospective targeted events (e.g., attending her weekly bridge game at the community club) and three prospective control events (e.g., buying her weekly magazine). The same six prospective events were assessed in the intervention phase but the targeted-events were cued by Google Calendar while the control-events were not. Results showed less omission of the targeted events in the training phase than in the baseline phase, suggesting a positive effect of Google Calendar. This case report offers a unique view into how smartphone calendars may alleviate prospective memory compromise in patients with mild Alzheimer's disease.
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Affiliation(s)
- Mohamad El Haj
- University of Lille, CNRS, CHU Lille, UMR 9193 - SCALab - Sciences Cognitives et Sciences Affectives, Lille, France
| | - Karim Gallouj
- Department of Geriatrics, Tourcoing Hospital, France
| | - Pascal Antoine
- University of Lille, CNRS, CHU Lille, UMR 9193 - SCALab - Sciences Cognitives et Sciences Affectives, Lille, France
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21
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Krasny-Pacini A, Evans J. Single-case experimental designs to assess intervention effectiveness in rehabilitation: A practical guide. Ann Phys Rehabil Med 2017; 61:164-179. [PMID: 29253607 DOI: 10.1016/j.rehab.2017.12.002] [Citation(s) in RCA: 146] [Impact Index Per Article: 20.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Revised: 11/29/2017] [Accepted: 12/10/2017] [Indexed: 11/15/2022]
Abstract
Single-case experimental designs (SCED) are experimental designs aiming at testing the effect of an intervention using a small number of patients (typically one to three), using repeated measurements, sequential (±randomized) introduction of an intervention and method-specific data analysis, including visual analysis and specific statistics. The aim of this paper is to familiarise professionals working in different fields of rehabilitation with SCEDs and provide practical advice on how to design and implement a SCED in clinical rehabilitation practice. Research questions suitable for SCEDs and the different types of SCEDs (e.g., alternating treatment designs, introduction/withdrawal designs and multiple baseline designs) are reviewed. Practical steps in preparing a SCED design are outlined. Examples from different rehabilitation domains are provided throughout the paper. Challenging issues such as the choice of the repeated measure, assessment of generalisation, randomization, procedural fidelity, replication and generalizability of findings are discussed. Simple rules and resources for data analysis are presented. The utility of SCEDs in physical and rehabilitation medicine (PRM) are discussed.
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Affiliation(s)
- Agata Krasny-Pacini
- Institut universitaire de réadaptation Clemenceau-Strasbourg, 45, boulevard Clemenceau, 67082 Strasbourg, France; Service de chirurgie orthopédique infantile, hôpital de Hautepierre, CHU de Strasbourg, avenue Molière, 67098 Strasbourg, France; GRC handicap cognitif et réadaptation (HanCRe), hôpitaux universitaires Pitié-Salpêtière, 75013 Paris, France.
| | - Jonathan Evans
- Institute of Health and Wellbeing, University of Glasgow, The Academic Centre, Gartnavel Royal Hospital, 1055 Great Western Road, Glasgow G12 0XH, United Kingdom
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22
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Abstract
PURPOSE The aim of the present study was to investigate the effectiveness of a prospective memory aid that combines smartphones with Internet-based calendars among community-dwelling patients with traumatic brain injury. METHOD An uncontrolled pre- and post-assessment design was employed to study the use of unmodified, low-cost, off-the-shelf smartphones combined with Internet-calendars as a compensatory memory strategy in community-dwelling patients with traumatic brain injury. Thirteen participants received a 6-week group-based intervention with pre-, post- and 2-month follow-up-assessments by questionnaires and by daily assessment of target behaviors for 2-week periods. RESULTS Participants reported significantly fewer retro- and prospective memory problems on questionnaires after the intervention and at follow-up with large effect sizes. The performance of target behaviors, however, improved insignificantly with moderate effect sizes. There were no changes in quality of life or symptoms of emotional distress. CONCLUSIONS This study adds to a growing body of evidence that smartphones are a useful compensatory aid in rehabilitation of prospective memory that should routinely be considered in rehabilitation of traumatic brain injury patients. Implication for rehabilitation Smartphones are easy-to-use and accessible assistive technology for compensatory memory rehabilitation to most traumatic brain injury patients. By using low-cost, off-the-shelf devices, the technology becomes available to a broader range of patients. By combining smartphones with Internet-based and cross-platform services (e.g., calendars, contacts) the participants are less device-dependent and less vulnerable to data loss. Smartphones should routinely be considered as compensatory aid in rehabilitation of prospective memory of traumatic brain injured patients.
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Affiliation(s)
- Lars Evald
- a Central Denmark Region , Hammel Neurorehabilitation Centre and University Research Clinic , Hammel , Denmark.,b Department of Psychology and Behavioural Sciences , Aarhus University , Aarhus , Denmark.,c Cognitive Neuroscience Research Unit (CNRU), CFIN, MINDLAB , Aarhus University and Aarhus University Hospital , Aarhus , Denmark
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23
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Abstract
Management of cognitive difficulties is a significant unmet need for individuals with stroke. Incorporating multiple functions, including memory aids and communication tools, smartphones have potential to improve everyday cognitive function and independence in daily activities post-stroke. We aimed to investigate patterns of smartphone use, facilitators and barriers to use, and relationships between smartphone use and daily functioning. Twenty-nine participants with stroke and 29 comparison participants with no history of neurological conditions completed measures of smartphone use, objective and subjective cognitive function, mood and community integration. The majority of participants used smartphones, though the proportion of users was lower in the stroke group (62%) than the comparison group (86%). Older participants were less likely to use smartphones. Using apps that support memory was a main benefit of smartphone use post-stroke. In the stroke group, frequent users of memory apps had significantly fewer motor symptoms (d = 1.20), and higher productivity (d = 0.84). Stroke survivors identified difficulty learning how to use smartphones, but only one participant had assistance with this from a clinician. These results suggest that smartphones have potential as assistive technology post-stroke, however, support in using them is essential, particularly for older individuals with motor dysfunction.
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24
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Jamieson M, Monastra M, Gillies G, Manolov R, Cullen B, McGee-Lennon M, Brewster S, Evans J. The use of a smartwatch as a prompting device for people with acquired brain injury: a single case experimental design study. Neuropsychol Rehabil 2017; 29:513-533. [DOI: 10.1080/09602011.2017.1310658] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Matthew Jamieson
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, Scotland
- Human Computer Interaction, Department of Computing Science, University of Glasgow, Glasgow, Scotland
| | - Mattia Monastra
- Acquired Brain Injury Team, West Dunbartonshire, Glasgow, Scotland
| | - Graeme Gillies
- Acquired Brain Injury Team, West Dunbartonshire, Glasgow, Scotland
| | - Rumen Manolov
- Faculty of Psychology, University of Barcelona, Barcelona, Spain
| | - Breda Cullen
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, Scotland
| | | | - Stephen Brewster
- Human Computer Interaction, Department of Computing Science, University of Glasgow, Glasgow, Scotland
| | - Jonathan Evans
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, Scotland
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25
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Wong D, Sinclair K, Seabrook E, McKay A, Ponsford J. Smartphones as assistive technology following traumatic brain injury: a preliminary study of what helps and what hinders. Disabil Rehabil 2016; 39:2387-2394. [DOI: 10.1080/09638288.2016.1226434] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Dana Wong
- School of Psychological Sciences and Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Melbourne, Australia
- Monash-Epworth Rehabilitation Research Center, Melbourne, Australia
| | - Kelly Sinclair
- Monash-Epworth Rehabilitation Research Center, Melbourne, Australia
| | - Elizabeth Seabrook
- School of Psychological Sciences and Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Melbourne, Australia
| | - Adam McKay
- School of Psychological Sciences and Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Melbourne, Australia
- Monash-Epworth Rehabilitation Research Center, Melbourne, Australia
- Epworth Hospital, Melbourne, Australia
| | - Jennie Ponsford
- School of Psychological Sciences and Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Melbourne, Australia
- Monash-Epworth Rehabilitation Research Center, Melbourne, Australia
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Dewar BK, Kapur N, Kopelman M. Do memory aids help everyday memory? A controlled trial of a Memory Aids Service. Neuropsychol Rehabil 2016; 28:614-632. [PMID: 27267491 DOI: 10.1080/09602011.2016.1189342] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
There is a growing body of knowledge about the use of compensatory memory aids in memory rehabilitation, but relatively few controlled trials on how to train the use of such aids. This study investigated the effects of systematic training in the use of compensatory memory aids on everyday memory functioning within a Memory Aids Service. In a controlled clinical trial, a comparison was made between treatment participants and waiting list controls. Participants had everyday memory problems secondary to progressive or non-progressive neurological conditions. Following baseline assessment and goal setting, treatment participants underwent three training sessions, in which memory aids were matched to goals, across a six week period, with a follow-up assessment 12 weeks later. Outcome was measured by a goal attainment diary, neuropsychological test performance, psychosocial questionnaires and a problem solving inventory. There was a significant treatment effect of training on the goal attainment diary but only at 12 weeks follow-up. A post-hoc analysis indicated that treatment was effective for participants with a non-progressive condition but not for participants with a progressive condition. We conclude that a Memory Aids Service can be beneficial for patients with a non-progressive neurological condition, and make suggestions that might inform future applications of memory aids with those who have a progressive neurological disorder.
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Affiliation(s)
- Bonnie-Kate Dewar
- a Academic Neuropsychiatry, Psychological Medicine CAG, Kings College London (Institute of Psychiatry, Psychology and Neuroscience) , London , UK
| | - Narinder Kapur
- b Research Department of Clinical, Educational and Health Psychology , University College London , London , UK
| | - Michael Kopelman
- a Academic Neuropsychiatry, Psychological Medicine CAG, Kings College London (Institute of Psychiatry, Psychology and Neuroscience) , London , UK
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27
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Rivest J, Svoboda E, McCarthy J, Moscovitch M. A case study of topographical disorientation: behavioural intervention for achieving independent navigation. Neuropsychol Rehabil 2016; 28:797-817. [DOI: 10.1080/09602011.2016.1160833] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Josée Rivest
- Neuropsychology and Cognitive Health Program, Baycrest, Toronto, ON, Canada
- Department of Psychology, Glendon College, and Centre for Vision Research, York University, Toronto, ON, Canada
| | - Eva Svoboda
- Neuropsychology and Cognitive Health Program, Baycrest, Toronto, ON, Canada
| | - Jeff McCarthy
- Neuropsychology and Cognitive Health Program, Baycrest, Toronto, ON, Canada
- Department of Psychology, University of Windsor, Ontario, Canada
| | - Morris Moscovitch
- Neuropsychology and Cognitive Health Program, Baycrest, Toronto, ON, Canada
- Department of Psychology, University of Toronto, Toronto, ON, Canada
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28
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Imbeault H, Langlois F, Bocti C, Gagnon L, Bier N. Can people with Alzheimer's disease improve their day-to-day functioning with a tablet computer? Neuropsychol Rehabil 2016; 28:779-796. [DOI: 10.1080/09602011.2015.1133431] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Hélène Imbeault
- Health and Social Services Centre, University Institute of Geriatrics of Sherbrooke, Québec, Canada
| | - Francis Langlois
- Health and Social Services Centre, University Institute of Geriatrics of Sherbrooke, Québec, Canada
| | - Christian Bocti
- Health and Social Services Centre, University Institute of Geriatrics of Sherbrooke, Québec, Canada
| | - Lise Gagnon
- Department of Psychology, Université de Sherbrooke, Sherbrooke, Canada
| | - Nathalie Bier
- School of Rehabilitation, Université de Montréal, Quebec, Canada
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29
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Plackett R, Thomas S, Thomas S. Professionals' views on the use of smartphone technology to support children and adolescents with memory impairment due to acquired brain injury. Disabil Rehabil Assist Technol 2016; 12:236-243. [PMID: 26730647 DOI: 10.3109/17483107.2015.1127436] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Purpose To identify from a health-care professionals' perspective whether smartphones are used by children and adolescents with acquired brain injury as memory aids; what factors predict smartphone use and what barriers prevent the use of smartphones as memory aids by children and adolescents. Method A cross-sectional online survey was undertaken with 88 health-care professionals working with children and adolescents with brain injury. Results Children and adolescents with brain injury were reported to use smartphones as memory aids by 75% of professionals. However, only 42% of professionals helped their clients to use smartphones. The only factor that significantly predicted reported smartphone use was the professionals' positive attitudes toward assistive technology. Several barriers to using smartphones as memory aids were identified, including the poor accessibility of devices and cost of devices. Conclusion Many children and adolescents with brain injury are already using smartphones as memory aids but this is often not facilitated by professionals. Improving the attitudes of professionals toward using smartphones as assistive technology could help to increase smartphone use in rehabilitation. Implications for Rehabilitation Smartphones could be incorporated into rehabilitation programs for young people with brain injury as socially acceptable compensatory aids. Further training and support for professionals on smartphones as compensatory aids could increase professionals' confidence and attitudes in facilitating the use of smartphones as memory aids. Accessibility could be enhanced by the development of a smartphone application specifically designed to be used by young people with brain injury.
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Affiliation(s)
- Ruth Plackett
- a School of Medicine , University of Nottingham , Nottingham , UK
| | - Sophie Thomas
- b Paediatric Neuropsychology Department , Nottingham Children's Hospital , Nottingham , UK
| | - Shirley Thomas
- a School of Medicine , University of Nottingham , Nottingham , UK
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Ferguson S, Friedland D, Woodberry E. Smartphone technology: Gentle reminders of everyday tasks for those with prospective memory difficulties post-brain injury. Brain Inj 2015; 29:583-91. [PMID: 25625598 DOI: 10.3109/02699052.2014.1002109] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Prospective memory is a common deficit following brain injury that can reduce an individuals' ability to complete everyday tasks. The smartphone is a device that may compensate for these difficulties using the calendar's prompting function. Reminders can be programmed remotely using email to phone synchronization. OBJECTIVE To explore whether smartphone reminders help people complete pre-identified tasks as compared to when reminders are not provided. METHODS An ABAB case series design compared reminder present vs. reminder absent phases with regards completion of pre-set tasks. Six participants aged 24-55 with Acquired Brain Injury (ABI) and five caregivers participated in the study. Both completed a series of questionnaires looking at the impact of the smartphone reminders on everyday memory functioning at pre, post and follow-up. A 3-month follow-up questionnaire assessed continued use of the system. RESULTS There was a significant improvement in task completion rates when smartphone reminders were provided. A thematic analysis identified that smartphone reminders improved independence, confidence in coping with memory difficulties and general mood. All participants were still using the system at 3-month follow-up. CONCLUSIONS Smartphone reminders may provide a cost-effective, accessible and non-stigmatizing tool for participants to compensate for prospective memory difficulties.
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Affiliation(s)
- Scott Ferguson
- DclinPsy, Psychology Department, University of Hertfordshire , Hatfield , UK
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Evald L. Prospective memory rehabilitation using smartphones in patients with TBI: What do participants report? Neuropsychol Rehabil 2014; 25:283-97. [DOI: 10.1080/09602011.2014.970557] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Baldwin VN, Powell T. Google Calendar: A single case experimental design study of a man with severe memory problems. Neuropsychol Rehabil 2014; 25:617-36. [PMID: 25263266 PMCID: PMC4487547 DOI: 10.1080/09602011.2014.956764] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
A single case experimental design across behaviours was utilised to explore the effectiveness of Google Calendar text alerts delivered to a mobile phone as a memory aid. The participant was a 43-year-old man (JA) with severe memory problems and executive difficulties caused by a traumatic brain injury (TBI). JA was initially very unwilling to use any memory aid and so a detailed assessment of his beliefs about memory aids, his cognitive difficulties and his social context was performed and a set of specifications for an aid was produced collaboratively. Six weeks of baseline data and six weeks of intervention data were collected for three target memory behaviours and three control memory behaviours. Results were analysed using nonoverlap of all pairs (NAP) analysis which showed a reduction in forgetting in the three target behaviours and no change in two of the three control behaviours. A subjective measure (the revised Everyday Memory Questionnaire) also suggested improvement. This study illustrates that Google Calendar is a highly effective memory aid and emphasises the importance of choosing a memory aid to suit the person's lifestyle and beliefs.
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Nam SZ. Comparative Study of U-Healthcare Applications between Google Play Store and Apple iTunes App Store in Korea. INTERNATIONAL JOURNAL OF CONTENTS 2014. [DOI: 10.5392/ijoc.2014.10.3.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Park M, Ahn YJ, Kim SJ, You J, Park KE, Kim SR. Changes in Accommodative Function of Young Adults in their Twenties following Smartphone Use. ACTA ACUST UNITED AC 2014. [DOI: 10.14479/jkoos.2014.19.2.253] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Svoboda E, Richards B, Yao C, Leach L. Long-term maintenance of smartphone and PDA use in individuals with moderate to severe memory impairment. Neuropsychol Rehabil 2014; 25:353-73. [DOI: 10.1080/09602011.2014.927368] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Abstract
Mild cognitive impairment (MCI) is a unique entity in the spectrum of syndromes of cognitive loss. Many patients referred for evaluation of memory loss come with an assumption that they already have dementia. When patients are diagnosed with MCI, they and their caregivers have to deal with the challenge of uncertainties. Patient and family education must stress the uncertainty of whether the deficits will progress. This article aims to guide the clinician who has reached a diagnosis of MCI and is working with the patient and family on coping with the uncertainties of MCI.
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Affiliation(s)
- Donald L Courtney
- Section of Geriatric Medicine (11G), Division of General and Geriatric Medicine, Department of Medicine, Ralph H. Johnson VA Medical Center, Medical University of South Carolina, 109 Bee Street, Charleston, SC 29401, USA.
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Fish JE, Manly T, Kopelman MD, Morris RG. Errorless learning of prospective memory tasks: An experimental investigation in people with memory disorders. Neuropsychol Rehabil 2014; 25:159-88. [PMID: 24894460 PMCID: PMC4311953 DOI: 10.1080/09602011.2014.921204] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The term prospective memory (PM) refers to memory for future intentions. PM problems are frequent in people with cognitive impairment and, because they are central to the realisation of many everyday goals, are important in rehabilitation. Event-based PM tasks (EBPM) are environmentally-cued and have primarily mnemonic demands, whereas time-based PM tasks (TBPM) require self-initiated retrieval, and have greater executive demands. Errorless learning (EL) is an encoding method that results in superior retrospective memory compared with “errorful” learning (EF). As this EL advantage (ELA) likely stems from its reduced explicit memory demands, and there is no such advantage for executive tasks, a greater ELA for EBPM than TBPM was predicted. Fourteen adults with neurological memory impairment completed PM tasks under four counterbalanced conditions: EL of EBPM, EL of TBPM, EF of EBPM, and EF of TBPM. A significant ELA was observed for EBPM (d = .63), but not TBPM (d = –.01). These results extend the evidence for EL within cognitive rehabilitation, by showing for the first time that the method can benefit future action in addition to retrospective memory. The clinical implications are also clear: errorless learning techniques may be usefully employed to support completion of day-to-day EBPM tasks.
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Affiliation(s)
- Jessica E Fish
- a King's College London Institute of Psychiatry , London , UK
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Madan CR. Augmented memory: a survey of the approaches to remembering more. Front Syst Neurosci 2014; 8:30. [PMID: 24624063 PMCID: PMC3939671 DOI: 10.3389/fnsys.2014.00030] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2014] [Accepted: 02/10/2014] [Indexed: 11/13/2022] Open
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Lannin N, Carr B, Allaous J, Mackenzie B, Falcon A, Tate R. A randomized controlled trial of the effectiveness of handheld computers for improving everyday memory functioning in patients with memory impairments after acquired brain injury. Clin Rehabil 2014; 28:470-81. [DOI: 10.1177/0269215513512216] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective: To determine the effectiveness of personal digital assistant devices on achievement of memory and organization goals in patients with poor memory after acquired brain injury. Design: Assessor blinded randomized controlled trial. Setting: Specialist brain injury rehabilitation hospital (inpatients and outpatients). Participants: Adults with acquired brain impairments (85% traumatic brain injury; aged ≥17 years) who were assessed as having functional memory impairment on the Rivermead Behavioural Memory Test (General Memory Index). Interventions: Training and support to use a personal digital assistant for eight weeks to compensate for memory failures by an occupational therapist. The control intervention was standard rehabilitation, including use of non-electronic memory aids. Main outcome measures: Goal Attainment Scale which assessed achievement of participants’ daily memory functioning goals and caregiver perception of memory functioning; and General Frequency of Forgetting subscale of the Memory Functioning Questionnaire administered at baseline (pre-randomization) and post intervention (eight weeks later). Results: Forty-two participants with memory impairment were recruited. Use of a personal digital assistant led to greater achievement of functional memory goals (mean difference 1.6 (95% confidence interval (CI) 1.0 to 2.2), P = 0.0001) and improvement on the General Frequency of Forgetting subscale (mean difference 12.5 (95% CI 2.0 to 22.9), P = 0.021). Conclusions: Occupational therapy training in the use of a handheld computer improved patients’ daily memory function more than standard rehabilitation.
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Affiliation(s)
- Natasha Lannin
- Occupational Therapy Department, La Trobe University, Prahran, Victoria, Australia
- Occupational Therapy Department, Alfred Health, Prahran, Victoria, Australia
- Rehabilitation Studies Unit, Northern Clinical School, Faculty of Medicine, The University of Sydney, Ryde, NSW, Australia
| | - Belinda Carr
- Royal Rehabilitation Centre Sydney, Ryde, NSW, Australia
| | | | | | - Alex Falcon
- Royal Rehabilitation Centre Sydney, Ryde, NSW, Australia
| | - Robyn Tate
- Rehabilitation Studies Unit, Northern Clinical School, Faculty of Medicine, The University of Sydney, Ryde, NSW, Australia
- Royal Rehabilitation Centre Sydney, Ryde, NSW, Australia
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Ferland MB, Larente J, Rowland J, Davidson PSR. Errorless (re)learning of daily living routines by a woman with impaired memory and initiation: Transferrable to a new home? Brain Inj 2013; 27:1461-9. [DOI: 10.3109/02699052.2013.823661] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Galioto R, Garcia S, Spitznagel MB, Strain G, Devlin M, Crosby RD, Mitchell JE, Gunstad J. The Mini-Mental State Exam (MMSE) is not sensitive to cognitive impairment in bariatric surgery candidates. Surg Obes Relat Dis 2013; 10:553-7. [PMID: 24355321 DOI: 10.1016/j.soard.2013.09.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2013] [Revised: 08/27/2013] [Accepted: 09/08/2013] [Indexed: 11/28/2022]
Abstract
BACKGROUND Cognitive dysfunction is common among bariatric surgery candidates and associated with poorer weight loss outcomes. Identification of a brief screening measure to detect cognitive impairment in this population is needed, because comprehensive neuropsychological evaluations may not be available in all clinical settings. METHODS The present study examined the utility of the Mini-Mental State Examination (MMSE) for detecting cognitive impairment in 30 bariatric surgery candidates by comparing impairment on the MMSE (at varying cutoffs) to impairment on a comprehensive neuropsychological test battery. RESULTS Results indicated that the MMSE showed low sensitivity and specificity in identifying impairment, even at the more stringent MMSE cutoffs of 27 and 28. CONCLUSION These findings suggest that the MMSE is a poor screener for cognitive impairment in bariatric surgery candidates. Future research is needed to identify or develop cognitive screeners for use in this population.
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Affiliation(s)
| | | | | | | | - Michael Devlin
- Columbia University College of Physicians and Surgeons, New York, New York
| | - Ross D Crosby
- Neuropsychiatric Research Institute, Fargo, North Dakota; University of North Dakota School of Medicine and Health Sciences, Fargo, North Dakota
| | - James E Mitchell
- Neuropsychiatric Research Institute, Fargo, North Dakota; University of North Dakota School of Medicine and Health Sciences, Fargo, North Dakota
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Jamieson M, Cullen B, McGee-Lennon M, Brewster S, Evans JJ. The efficacy of cognitive prosthetic technology for people with memory impairments: A systematic review and meta-analysis. Neuropsychol Rehabil 2013; 24:419-44. [DOI: 10.1080/09602011.2013.825632] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Jang SH, Jung HY, Jang DH, Kim YT, Seo JP, Jang WH. The Effect of a Memory Training Application for a Patient with Traumatic Brain Injury. J Phys Ther Sci 2013. [DOI: 10.1589/jpts.25.143] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Affiliation(s)
- Sung Ho Jang
- Department of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam University
| | - Ho Youl Jung
- Yeungnam University of Information and Communication Engineering
| | - Dal Hyun Jang
- Regional Innovation Center for Wireless Multimedia of Yeungnam University
| | - Young Tak Kim
- Regional Innovation Center for Wireless Multimedia of Yeungnam University
| | - Jeong Pyo Seo
- Department of Physical Therapy, Graduate School, Daegu University
| | - Woo Hyuk Jang
- Department of Occupational therapy, Graduate School, Daegu University
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Savage KR, Svoboda E. Long-term benefits of the Memory-Link programme in a case of amnesia. Clin Rehabil 2012; 27:521-6. [DOI: 10.1177/0269215512464230] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective: To systematically evaluate the maintenance of clinical gains from a structured memory intervention programme. Efficacy of the programme was initially demonstrated in RR, a woman with moderate-to-severe memory impairment following colloid cyst removal. In the current study (Svoboda and Richards, 2009), we examined RR’s day-to-day memory functioning 18 months after completion of the intervention programme. Design: Within-subject A1B1A2B2B3 single-case experimental design. Setting: Outpatient memory rehabilitation clinic. Intervention: A theory-driven training programme in the use of commercially available smartphones for individuals with moderate-to-severe memory impairment. Main measures: A phone call task was used as an objective measure of prospective memory function. Self-report, ecologically valid questionnaires were also completed to further assess generalization of smartphone use to day-to-day memory function. Results: Eighteen months after intervention, RR completed 80% of scheduled calls using the smartphone, a rate significantly higher than at baseline (40%) and comparable to her success rate immediately following intervention (90%) and at the four-month follow-up (90%). Responses to questionnaires indicated that RR felt more confident in her ability to handle memory-demanding situations and was making fewer memory mistakes. This favourable outcome was not found with the use of another smartphone brand for which training was not received. Conclusions: Results from ecologically valid measures of memory functioning demonstrated robust maintenance of independent commercial smartphone use over an 18-month period, with increases observed in independence, confidence and real-life memory functioning. The findings further suggest poor cross-device generalizability.
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Affiliation(s)
- Kimberley R Savage
- Neuropsychology and Cognitive Health Program, Baycrest, Toronto, Canada
- The Graduate Center and Queens College, City University of New York, New York, USA
| | - Eva Svoboda
- Neuropsychology and Cognitive Health Program, Baycrest, Toronto, Canada
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