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Jamieson M, McClelland H, Goudie N, McFarlane J, Cullen B, Lennon M, Brewster S, Stanley B, McConnachie A, Evans J. AppReminders - a pilot feasibility randomized controlled trial of a memory aid app for people with acquired brain injury. Neuropsychol Rehabil 2024; 34:535-571. [PMID: 37310032 PMCID: PMC11166046 DOI: 10.1080/09602011.2023.2220969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 05/26/2023] [Indexed: 06/14/2023]
Abstract
Mobile phone reminding apps can be used by people with acquired brain injury (ABI) to compensate for memory impairments. This pilot feasibility trial aimed to establish the feasibility of a randomized controlled trial comparing reminder apps in an ABI community treatment setting. Adults with ABI and memory difficulty who completed the three-week baseline were randomized (n = 29) and allocated to Google Calendar or ApplTree app. Those who attended an intervention session (n = 21) watched a 30-minute video tutorial of the app then completed reminder setting assignments to ensure they could use the app. Guidance was given if needed from a clinician or researcher. Those who passed the app assignments (n = 19) completed a three-week follow up. Recruitment was lower than target (n = 50), retention rate was 65.5%, adherence rate was 73.7%. Qualitative feedback highlighted issues that may impact usability of reminding apps introduced within community brain injury rehabilitation. Feasibility results indicate a full trial would require 72 participants to demonstrate the minimally clinically important efficacy difference between apps, should a difference exist. Most participants (19 of 21) given an app could learn to use it with the short tutorial. Design features implemented in ApplTree have potential to improve the uptake and utility of reminding apps.
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Affiliation(s)
- Matthew Jamieson
- School of Health and Wellbeing, University of Glasgow, Glasgow, UK
- Human Computer Interaction, Department of Computing Science, University of Glasgow, Glasgow, UK
| | | | - Nicola Goudie
- Community Treatment Centre for Brain Injury, NHS Greater Glasgow and Clyde, Glasgow, UK
| | - Jean McFarlane
- Acquired Brain Injury (ABI) Service, West Dunbartonshire HSPC, Dumbarton, UK
| | - Breda Cullen
- School of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Marilyn Lennon
- Computer and Information Science, University of Strathclyde, Glasgow, UK
| | - Stephen Brewster
- Human Computer Interaction, Department of Computing Science, University of Glasgow, Glasgow, UK
| | - Bethany Stanley
- Robertson Centre for Biostatistics, University of Glasgow, Glasgow, UK
| | - Alex McConnachie
- Robertson Centre for Biostatistics, University of Glasgow, Glasgow, UK
| | - Jonathan Evans
- School of Health and Wellbeing, University of Glasgow, Glasgow, UK
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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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Jamieson M, Lennon M, Cullen B, Brewster S, Evans J. Supporting People with Acquired Brain Injury to Use a Reminding App; Narrow-deep vs. Broad-shallow User Interfaces. ACM TRANSACTIONS ON ACCESSIBLE COMPUTING 2022. [DOI: 10.1145/3501275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
People with memory impairments following an acquired brain injury stand to benefit from smartphone apps as memory aids. Due, in part, to usability issues they use smartphone-based reminding less than the general population. Evidence suggests this group may benefit from user interface (UI) designs with more screens with less information per screen (narrow-deep UI) rather than fewer screens with more information per screen (broad-shallow UI). This study compared the difference in speed, accuracy, guidance needed, and task load for 32 people with acquired brain injury when setting reminders using narrow-deep and broad-shallow UI. They were also given cognitive assessments (measuring selective attention, executive functioning, and overall executive and memory ability) and interviewed about their UI preference. There was a significant difference in accuracy; participants were less accurate (they made two more errors on average for every three reminders set) using a broad-shallow compared to narrow-deep UI. The reason for this difference was that participants omitted more information when using broad-shallow UI. There were no differences in speed, guidance required, and overall task-load. Participants with better selective attention and more experience with smartphones benefited the most from narrow-deep UI compared to broad-shallow UI. Most participants preferred one UI over the other. Those who preferred narrow-deep found it easier to use, that they missed less information and liked having one piece of information at a time. Those who preferred broad-shallow found it easier to review the information and felt less likely to lose track. The findings can inform that implementation of UI choices to make apps more accessible for those with cognitive impairments.
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Affiliation(s)
- Matthew Jamieson
- University of Glasgow College of Medical Veterinary and Life Sciences, Institute of Health and Wellbeing
| | | | - Breda Cullen
- University of Glasgow College of Medical Veterinary and Life Sciences, Institute of Health and Wellbeing
| | | | - Jonathan Evans
- University of Glasgow College of Medical Veterinary and Life Sciences, Institute of Health and Wellbeing
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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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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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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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Cognitive rehabilitation for executive dysfunction in brain tumor patients: a pilot randomized controlled trial. J Neurooncol 2019; 142:565-575. [DOI: 10.1007/s11060-019-03130-1] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Accepted: 02/21/2019] [Indexed: 11/25/2022]
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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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Bier N, Sablier J, Briand C, Pinard S, Rialle V, Giroux S, Pigot H, Quillion Dupré L, Bauchet J, Monfort E, Bosshardt E, Courbet L. Special issue on technology and neuropsychological rehabilitation: Overview and reflections on ways to conduct future studies and support clinical practice. Neuropsychol Rehabil 2018; 28:864-877. [PMID: 29544391 DOI: 10.1080/09602011.2018.1437677] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
In this editorial, we wish to highlight and reflect on research advances presented in the articles comprising this special issue on technology and neuropsychological rehabilitation, which happens to be published more than a decade after the first special issue on the subject. In 2004, the journal recognised the great potential of information technology for increasing the support provided to people with cognitive deficits, and published emerging state-of-the art practices in the field. Since that time, research and technology have made tremendous progress, and the influence of information technology on research methods has transformed the field of neurorehabilitation. The aim of this editorial is thus to shed light on methodological and conceptual issues requiring further attention from researchers and clinicians in the fields of neuropsychological rehabilitation and technology, and to stimulate debate on promising avenues in clinical research.
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Affiliation(s)
- Nathalie Bier
- a Faculty of Medecine, École de réadaptation, Université de Montréal , Montréal , Canada.,b Centre de recherche de l'Institut universitaire de gériatrie de Montréal , Montréal , Canada
| | - Juliette Sablier
- c Institut des Sciences et Techniques de la Réadaptation , Lyons , France
| | - Catherine Briand
- a Faculty of Medecine, École de réadaptation, Université de Montréal , Montréal , Canada.,d Centre de recherche de l'Institut universitaire en santé mentale de Montréal , Montréal , Canada
| | - Stéphanie Pinard
- a Faculty of Medecine, École de réadaptation, Université de Montréal , Montréal , Canada
| | - Vincent Rialle
- e CHU Grenoble Alpes, Université Grenoble Alpes , Grenoble , France
| | - Sylvain Giroux
- f Université de Sherbrooke, Laboratoire DOMUS , Sherbrooke , Canada
| | - Hélène Pigot
- f Université de Sherbrooke, Laboratoire DOMUS , Sherbrooke , Canada
| | | | | | | | - Esther Bosshardt
- e CHU Grenoble Alpes, Université Grenoble Alpes , Grenoble , France
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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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Abstract
BACKGROUND This interview study is a part of a project that evaluated sensor technology as a support in everyday activities for patients with memory impairment. AIM To explore patients with memory impairment and their partners' experiences of using sensor technology in their homes. METHODS AND MATERIAL Five patients with memory impairment after stroke and three partners were interviewed. Individual semi-structured interviews were analyzed with qualitative content analysis. RESULTS Installing sensor technology with individually prerecorded voice reminders as memory support in the home had a broad impact on patients' and their families' lives. These effects were both positive and negative. The sensor technology not only supported activities but also influenced the patients by changing behavior, providing a sense of security, independence and increased self-confidence. For the partners, the sensor technology eased daily life, but also gave increased responsibility for maintenance. Technical problems led to frustration and stress for the patients. CONCLUSION The results indicate that sensor technology has potential to increase opportunities for persons with memory impairment to perform and participate in activities and to unburden their partners. The results may promote an understanding of how sensor technology can be used to support persons with memory impairment in their homes.
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Affiliation(s)
- Anna Olsson
- a Division of Rehabilitation Medicine , Danderyd Hospital , Stockholm , Sweden
| | | | - Aniko Bartfai
- a Division of Rehabilitation Medicine , Danderyd Hospital , Stockholm , Sweden.,b Department of Clinical Sciences , Danderyd Hospital, Karolinska Institutet , Stockholm , Sweden
| | - Inga-Lill Boman
- a Division of Rehabilitation Medicine , Danderyd Hospital , Stockholm , Sweden.,b Department of Clinical Sciences , Danderyd Hospital, Karolinska Institutet , Stockholm , Sweden
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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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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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El Haj M, Kessels RPC, Allain P. Source Memory Rehabilitation: A Review Toward Recommendations for Setting Up a Strategy Training Aimed at the "What, Where, and When" of Episodic Retrieval. APPLIED NEUROPSYCHOLOGY-ADULT 2015; 23:53-60. [PMID: 25996602 DOI: 10.1080/23279095.2014.992071] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Source memory is a core component of episodic recall as it allows for the reconstruction of contextual details characterizing the acquisition of episodic events. Unlike episodic memory, little is known about source memory rehabilitation. Our review addresses this issue by emphasizing several strategies as useful tools in source memory rehabilitation programs. Four main strategies are likely to improve source recall in amnesic patients-namely, (a) contextual cueing, (b) unitization, (c) errorless learning, and (d) executive function programs. The rationale behind our suggestion is that: (a) reinstating contextual cues during retrieval can serve as retrieval cues and enhance source memory; (b) unitization as an encoding process allows for the integration of several pieces of contextual information into a new single entity; (c) errorless learning may prevent patients from making errors during source learning; and (d) as source memory deteriorations have been classically attributed to executive dysfunction, the rehabilitation of the latter ability is likely to maintain the former ability. Besides these four strategies, our review suggests several additional rehabilitation techniques such as the vanishing cues and spaced retrieval methods. Another additional strategy is the use of electronic devices. By gathering these strategies, our review provides a helpful guideline for clinicians dealing with source memory impairments. Our review further highlights the lack of randomized and controlled studies in the field of source memory rehabilitation.
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Affiliation(s)
- Mohamad El Haj
- a Research Unit on Cognitive and Affective Sciences, Department of Psychology , University of North of France , Lille , France
| | - Roy P C Kessels
- b Donders Institute for Brain, Cognition, and Behaviour , Radboud University Nijmegen , Nijmegen.,c Vincent van Gogh Institute for Psychiatry , Korsakoff Clinic , Venray.,d Department of Medical Psychology , Radboud University Nijmegen Medical Centre , Nijmegen , The Netherlands
| | - Philippe Allain
- e LUNAM Université, Laboratoire de Psychologie des Pays de la Loire (EA 4638), Université de Nantes et Angers, and Centre Mémoire de Ressources et de Recherches , CHU Angers , Angers , France
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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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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: 13] [Impact Index Per Article: 1.3] [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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Migo EM, Haynes BI, Harris L, Friedner K, Humphreys K, Kopelman MD. mHealth and memory aids: levels of smartphone ownership in patients. J Ment Health 2014; 24:266-70. [PMID: 25188922 DOI: 10.3109/09638237.2014.951479] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND The use of mobile devices to deliver healthcare has not yet been exploited in neuropsychological rehabilitation. Smartphones have the potential to serve as multi-functional memory aids. AIMS To investigate whether patients attending a clinic for mixed memory problems own smartphones, to determine whether this could be a widely applicable medium to use as a memory aids device. METHODS A questionnaire on smartphone ownership was given to an opportunity sample of consecutive patients attending a neuropsychiatry and memory disorders outpatient clinic. Data were collected in 2012 and repeated 12 months later in 2013 to assess changes over time. RESULTS Ownership of mobile phones was stable between 2012 (81%) and 2013 (85%), but ownership of smartphones showed a significant increase (from 26% to 40%). Age negatively predicted smartphone ownership. CONCLUSION Despite cognitive or psychiatric problems, our patient group are as likely to own a mobile phone as a member of the general population. Ownership levels are at 40% and likely to increase in the future. Exploring how smartphones and their apps could function as memory aids is likely to be useful for a large enough number of patients to be clinically worthwhile.
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Affiliation(s)
- Ellen M Migo
- a Academic Unit of Neuropsychiatry, Department of Psychological Medicine , Institute of Psychiatry, King's College London , London , UK and
| | - Becky I Haynes
- a Academic Unit of Neuropsychiatry, Department of Psychological Medicine , Institute of Psychiatry, King's College London , London , UK and
| | - Lara Harris
- a Academic Unit of Neuropsychiatry, Department of Psychological Medicine , Institute of Psychiatry, King's College London , London , UK and
| | - Kim Friedner
- a Academic Unit of Neuropsychiatry, Department of Psychological Medicine , Institute of Psychiatry, King's College London , London , UK and
| | - Kate Humphreys
- b Neuropsychiatry and Memory Disorders Clinic, South London and Maudsley NHS Foundation Trust, St Thomas's Hospital , London , UK
| | - Michael D Kopelman
- a Academic Unit of Neuropsychiatry, Department of Psychological Medicine , Institute of Psychiatry, King's College London , London , UK and.,b Neuropsychiatry and Memory Disorders Clinic, South London and Maudsley NHS Foundation Trust, St Thomas's Hospital , London , UK
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Charters E, Gillett L, Simpson GK. Efficacy of electronic portable assistive devices for people with acquired brain injury: a systematic review. Neuropsychol Rehabil 2014; 25:82-121. [PMID: 25121394 DOI: 10.1080/09602011.2014.942672] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
A systematic review was conducted to evaluate the efficacy of electronic portable assistive devices (EPADs) for people with acquired brain injury. A systematic database search (OVID, CINAHL) found 541 citations published between 1989 and the end of 2012. A total of 23 reports met the inclusion/exclusion criteria, namely intervention studies (group, n-of-1) testing the efficacy of EPADs as compensatory devices for cognitive impairment for people with acquired brain injury aged 16-65 years. Study quality was rated by the PEDro (Physiotherapy Evidence Database) scale, (randomised controlled trials), the Downes and Black tool (other group intervention studies), and the Single Case Experimental Design tool (single participant studies). Levels of evidence were determined using five levels of classification based on the Spinal Cord Injury Rehabilitation Evidence table. Results found no Level 1 studies (RCTs with PEDro score ≥ 6), four Level 2 studies and 10 Level 3 studies. There was insufficient evidence to recommend any practice standards, but sufficient evidence to recommend the use of electronic reminder systems in supporting the everyday functioning of people with acquired brain injury as a practice guideline. Higher quality studies are required to support a broader range of compensatory roles that EPADs have the potential to play in neurorehabilitation and the long-term support of people with acquired brain injury.
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Affiliation(s)
- E Charters
- a Department of Speech Pathology , Royal Prince Alfred Hospital , Camperdown , NSW , Australia
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INCOG Recommendations for Management of Cognition Following Traumatic Brain Injury, Part V. J Head Trauma Rehabil 2014; 29:369-86. [DOI: 10.1097/htr.0000000000000069] [Citation(s) in RCA: 80] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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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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21
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Souchay C, Guillery-Girard B, Pauly-Takacs K, Wojcik DZ, Eustache F. Subjective experience of episodic memory and metacognition: a neurodevelopmental approach. Front Behav Neurosci 2013; 7:212. [PMID: 24399944 PMCID: PMC3872323 DOI: 10.3389/fnbeh.2013.00212] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2013] [Accepted: 12/10/2013] [Indexed: 12/21/2022] Open
Abstract
Episodic retrieval is characterized by the subjective experience of remembering. This experience enables the co-ordination of memory retrieval processes and can be acted on metacognitively. In successful retrieval, the feeling of remembering may be accompanied by recall of important contextual information. On the other hand, when people fail (or struggle) to retrieve information, other feelings, thoughts, and information may come to mind. In this review, we examine the subjective and metacognitive basis of episodic memory function from a neurodevelopmental perspective, looking at recollection paradigms (such as source memory, and the report of recollective experience) and metacognitive paradigms such as the feeling of knowing). We start by considering healthy development, and provide a brief review of the development of episodic memory, with a particular focus on the ability of children to report first-person experiences of remembering. We then consider neurodevelopmental disorders (NDDs) such as amnesia acquired in infancy, autism, Williams syndrome, Down syndrome, or 22q11.2 deletion syndrome. This review shows that different episodic processes develop at different rates, and that across a broad set of different NDDs there are various types of episodic memory impairment, each with possibly a different character. This literature is in agreement with the idea that episodic memory is a multifaceted process.
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Affiliation(s)
- Céline Souchay
- LEAD UMR CNRS 5022, Université de Bourgogne, Dijon, France
- Department of Experimental Psychology, University of Bristol, Bristol, UK
| | - Bérengère Guillery-Girard
- U1077, INSERM, Caen, France
- UMR-S1077, Université de Caen Basse-Normandie, Caen, France
- UMR-S1077, Ecole Pratique des Hautes Etudes, Caen, France
- UMR-S1077, CHU de Caen, Caen, France
| | - Katalin Pauly-Takacs
- School of Social, Psychological and Communication Sciences, Leeds Metropolitan University, Leeds, UK
| | | | - Francis Eustache
- U1077, INSERM, Caen, France
- UMR-S1077, Université de Caen Basse-Normandie, Caen, France
- UMR-S1077, Ecole Pratique des Hautes Etudes, Caen, France
- UMR-S1077, CHU de Caen, Caen, France
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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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23
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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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Svoboda E, Richards B, Leach L, Mertens V. PDA and smartphone use by individuals with moderate-to-severe memory impairment: Application of a theory-driven training programme. Neuropsychol Rehabil 2012; 22:408-27. [DOI: 10.1080/09602011.2011.652498] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Wilkening GN, Madden JR. Memory Disorders in Children With Central Nervous System Germ Cell Tumors. J Pediatr Oncol Nurs 2012; 29:161-70. [DOI: 10.1177/1043454212439938] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Memory disorders in children and adolescents with brain tumors are rare, but devastating to social, academic, and vocational development. Many pediatric patients with intracranial germ cell tumors (GCTs) complain of memory difficulties. This study investigated memory across a series of GCT patients. A total of 33 GCT patients were retrospectively examined for diagnosis, imaging results, intelligence quotient, treatment variables, evidence of increased intracranial pressure at diagnosis, and memory. The incidence of amnesia in GCT patients was 55%. Memory disturbance could not be predicted by intelligence quotient, treatment, location of lesion, or hydrocephalus at diagnosis. The high incidence of memory deficits in GCT patients suggests a risk to memory in patients with GCT. Formal memory assessment should be considered in all patients with central nervous system GCTs. Specific counseling and planning to assist in adjustment and to ensure safety should be considered standard care for those with memory deficits. The nurse should be instrumental in facilitating understanding of this specific injury in the brain tumor population.
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Abstract
The relationship between assistive technology for cognition (ATC) and cognitive function was examined using a systematic review. A literature search identified 89 publications reporting 91 studies of an ATC intervention in a clinical population. The WHO International Classification of Functioning, Disability and Health (ICF) was used to categorize the cognitive domains being assisted and the tasks being performed. Results show that ATC have been used to effectively support cognitive functions relating to attention, calculation, emotion, experience of self, higher level cognitive functions (planning and time management) and memory. The review makes three contributions: (1) It reviews existing ATC in terms of cognitive function, thus providing a framework for ATC prescription on the basis of a profile of cognitive deficits, (2) it introduces a new classification of ATC based on cognitive function, and (3) it identifies areas for future ATC research and development.
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McDonald A, Haslam C, Yates P, Gurr B, Leeder G, Sayers A. Google Calendar: A new memory aid to compensate for prospective memory deficits following acquired brain injury. Neuropsychol Rehabil 2011; 21:784-807. [DOI: 10.1080/09602011.2011.598405] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Ptak R, der Linden MV, Schnider A. Cognitive rehabilitation of episodic memory disorders: from theory to practice. Front Hum Neurosci 2010; 4:57. [PMID: 20700383 PMCID: PMC2914528 DOI: 10.3389/fnhum.2010.00057] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2010] [Accepted: 06/22/2010] [Indexed: 11/13/2022] Open
Abstract
Memory disorders are among the most frequent and most debilitating cognitive impairments following acquired brain damage. Cognitive remediation strategies attempt to restore lost memory capacity, provide compensatory techniques or teach the use of external memory aids. Memory rehabilitation has strongly been influenced by memory theory, and the interaction between both has stimulated the development of techniques such as spaced retrieval, vanishing cues or errorless learning. These techniques partly rely on implicit memory and therefore enable even patients with dense amnesia to acquire new information. However, knowledge acquired in this way is often strongly domain-specific and inflexible. In addition, individual patients with amnesia respond differently to distinct interventions. The factors underlying these differences have not yet been identified. Behavioral management of memory failures therefore often relies on a careful description of environmental factors and measurement of associated behavioral disorders such as unawareness of memory failures. The current evidence suggests that patients with less severe disorders benefit from self-management techniques and mnemonics whereas rehabilitation of severely amnesic patients should focus on behavior management, the transmission of domain-specific knowledge through implicit memory processes and the compensation for memory deficits with memory aids.
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Affiliation(s)
- Radek Ptak
- Department of Clinical Neurosciences, Division of Neurorehabilitation, University Hospitals GenevaGeneva, Switzerland
- Faculty of Medicine, University of GenevaGeneva, Switzerland
| | | | - Armin Schnider
- Department of Clinical Neurosciences, Division of Neurorehabilitation, University Hospitals GenevaGeneva, Switzerland
- Faculty of Medicine, University of GenevaGeneva, Switzerland
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