Article

PURPOSE: To describe the development of BrightBrainer integrative cognitive
rehabilitation system and determine clinical feasibility with nursing home-bound
dementia patients. METHOD: BrightBrainer cognitive rehabilitation simulations
were first played uni-manually, then bimanually.
Participants sat in front of a
laptop and interacted through a game controller that measured hand movements in
3D, as well as flexion of both index fingers. Interactive serious games were
designed to improve basic and complex attention (concentration, short-term
memory, dual tasking), memory recall, executive functioning and emotional
well-being. Individual simulations adapted automatically to each participant's
level of motor functioning. The system underwent feasibility trials spanning 16
sessions over 8 weeks. Participants were evaluated pre- and post-intervention,
using standardized neuropsychological measures. Computerized measures of movement
repetitions and task performance were stored on a remote server. RESULTS: Group
analysis for 10 participants showed statistically significant improvement in
decision making (p < 0.01), with trend improvements in depression (p < 0.056).
Improvements were also seen in processing speed (p < 0.13) and auditory attention
(p < 0.17); however, these were not statistically significant (partly
attributable to the modest sample size). Eight of nine neuropsychological tests
showed changes in the improvement direction indicating an effective
rehabilitation (p < 0.01). BrightBrainer technology was well tolerated with mean
satisfaction ratings of 4.9/5.0 across participants. CONCLUSIONS: Preliminary
findings demonstrate utility within an advanced dementia population, suggesting
that it will be beneficial to evaluate BrightBrainer through controlled clinical
trials and to investigate its application in other clinical populations.
Implications for Rehabilitation It is possible to improve cognitive function in
older low-functioning patients. Integrative rehabilitation through games
combining cognitive (memory, focusing, executive function) and physical (bimanual
whole arm movement, grasping, task sequencing) elements is enjoyable for this
population. The severity of depression in these elderly can be reduced through
virtual reality bimanual games. The number of upper extremity active repetitions
performed in the process of solving cognitive problems with the BrightBrainer
system is 600. This number is 18 times (1875%) larger than those observed by other researchers in conventional physical or occupational rehabilitation
sessions.

Langue : ANGLAIS