Section 5 Neurpsychological Rehabilitation: 34, 35, 36, 37

Question 1

What is neuroplasticity?

Answer 1

The neural functional and structural changes in response to
experience and environmental stimulation

Question 2

What is computer-based cognitive retraining (CBCR)?

Answer 2

CBCR is a type of retraining aimed at improving cognitive skills through repetitive computer-based tasks, used for individuals with brain damage and for people in the general population who want to improve their cognitive functioning.

Question 3

Why are brain games used in a clinical context?

Answer 3

Brain games are used in a clinical context to improve cognitive functions after brain damage has occurred, through the use of repetitive, bottom-up training methods.

Question 4

Which cognitive domains are the focus of most CBCR (computer-based cognitive retraining) studies?

Answer 4

Most CBCR studies focus on attention and working memory (executive functions)

Question 5

What have studies shown about the effectiveness of CBCR working memory training in individuals with brain injury?

Answer 5

Studies have shown that working memory training can be effective in improving cognitive functioning related to the tasks trained, but the generalization of training effects to daily life functioning has yet to be consistently demonstrated.

Question 6

The effectiveness of CBCR can be influenced by numerous factors, for example:

Answer 6

Frequency and duration of the training, targeted functions (e.g. working memory or attention), type of training (home-based or group-based), type of outcome measure and age of participants

Question 7

What was the previous aim of NIBS (non-invasive brain stimulation) studies in patients with neglect?

Answer 7

The previous aim of NIBS studies in patients with neglect was to inhibit the left hemisphere.

Question 8

Why has the approach of NIBS (non-invasive brain stimulation) changed in patients with neglect?

Answer 8

Because evidence showed that there occurs depression of activity in the parietal areas of the right (lesioned) hemisphere and overactivation of these homologous areas in the left hemisphere, leading to interhemispheric rivalry.

Question 9

What is Non-invasive Brain Stimulation (NIBS) and how does it work?

Answer 9

Non-invasive Brain Stimulation (NIBS) is a method of modulating brain plasticity in humans using different neurophysiologic strategies to increase the activity of the injured brain area.

Question 10

What are the two main neurophysiologic strategies used in NIBS (non-invasive brain stimulation)

Answer 10

The two main neurophysiologic strategies used in NIBS are Transcranial Magnetic Stimulation (TMS) and Transcranial Direct Current Stimulation (tDCS).

Question 11

How does rTMS (Transcranial Magnetic Stimulation) differ from tDCS (Transcranial Direct Current Stimulation)?

Answer 11

rTMS is a train of TMS pulses delivered at constant intervals on the same intensity and is thought to be more effective in interacting with cortical activity, while tDCS consists of placing two electrodes on the scalp to allow a weak direct current to flow from anode to cathode, it is easier to apply and less expensive than TMS.

Question 12

What is the potential risk of using NIBS?

Answer 12

The risk of evoking seizures is an important drawback of using NIBS.

Question 13

1. Does NIBS show potential in treating impairments from neurological diseases like stroke? If yes what impairments?
2. Does NIBS improve memory function in healthy participants?

Answer 13

1. Yes, impairments like unilateral neglect and aphasia after stroke.
2. Yes

Question 14

What are the results of tDCS in traumatic brain injury (TBI) patients?

Answer 14

The results of tDCS in TBI patients are inconclusive and there is no evidence for functional gains.

Question 15

What is virtual reality (VR)?

Answer 15

VR is an advanced form of human-computer interface that allows the user to interact with and become immersed in a computer-generated environment in a naturalistic fashion.

Question 16

What does VR measures?

Answer 16

VR is programmed to record accurate measurements of the individual’s performance assessing the underlying function.

Question 17

What does an fMRI study indicate about virtual-based environments?

Answer 17

An fMRI study indicated that virtual-based environments are able to activate the same related brain parts as those activated in the real environment.

Question 18

What type of rehabilitation has VR mainly been used for?

Answer 18

VR has mainly been used for training motor functioning in stroke rehabilitation.

Question 19

What did Larson et al. conclude in their systematic review of VR interventions in cognitive rehabilitation?

Answer 19

Larson et al. concluded that some applications of VR interventions in cognitive rehabilitation are effective in treating cognitive deficits following neurological conditions, but further study is necessary

Question 20

Does the evidence support the use of NIBS for improving memory or language function in ABI patients?

Answer 20

No

Question 21

What is the goal of neuropsychological rehabilitation?

Answer 21

The goal of neuropsychological rehabilitation is to optimize the participation and quality of life of both patients and caregivers by addressing a broader spectrum of human functioning, including emotional, behavioral, and social functioning.

Question 22

Did Park et al. (2014) find that a combination of CBCR and anodal tDCS led to better outcomes compared to CBCR combined with sham tDCS in healthy older adults?

Answer 22

Yes, Park et al. (2014) found that a combination of CBCR and anodal tDCS led to higher accuracy of the verbal working memory task and better performance of the digit span forward test than CBCR combined with sham tDCS in healthy older adults.

Question 23

What does neuropsychological assessment do?

Answer 23

It allows identification of mental function impairments that limit
independent activity and social participation

Question 24

What is the purpose of assistive technology for cognition (ATC)?

Answer 24

The purpose of ATC is to compensate for cognitive impairment as part of neuropsychological rehabilitation.

Question 25

What is the purpose of reminder applications in assistive technology for cognition?

Answer 25

The purpose of reminder applications in ATC is to support the executive function of organization.

Question 26

What is the International Classification of Functioning, Health and Disability (ICF)?

Answer 26

The ICF is a framework that describes how health and disability are related to an individual’s functioning in different areas of life, including physical, psychological, and social well-being. It includes a classification system for describing an individual’s level of functioning and contextual factors that may impact functioning.

Question 27

What is the purpose of the ICF division of mental functions into seven global functions and 11 specific mental functions in assistive technology for cognition?

Answer 27

It is meant to provide a neuropsychological level of explanation and allow the cross diagnostic use of effective technologies and also indicates potential solutions, including the prescription of technologies.

Question 28

What are some examples of how assistive technology for cognition (ATC) has been used to support attention?

Answer 28

ATC has been used to shift visuospatial attention, support sustained attention, and direct attention to internal representations, such as goals.

Question 29

What is unilateral neglect?

Answer 29

Unilateral neglect is a common consequence of stroke that involves difficulty directing attention to the contralesional body or extrapersonal space.

Question 30

What does the Limb Activation Device do?

Answer 30

The Limb Activation Device shifts attention to neglected areas of the body by emitting tones when the user has not moved the neglected limb within a prescribed period of time.

Question 31

What is the purpose of alerting technologies used in assistive technology for cognition?

Answer 31

Alerting technologies used in ATC redirect attention from external stimuli to internal representations or engage the supervisory attentional system to shift attention to internally represented goal states.

Question 32

What are the two main types of assistive technology for cognition that support episodic memory?

Answer 32

Cameras and multimedia reminiscence devices

Question 33

What is SenseCam and how does it work?

Answer 33

SenseCam is a stills camera combined with a sensor that is worn around the neck and outward facing to augment long-term memory by taking regular photographs. The wearer reviews the information captured by the device.

Question 34

What are the functions of technologies tested to support emotions?

Answer 34

Distraction and biofeedback devices.

Question 35

How have personal stereos been used to support emotions?

Answer 35

Personal stereos have been used to distract users with schizophrenia from the distressing effects of auditory hallucinations.

Question 36

What conditions have biofeedback devices been used for?

Answer 36

Biofeedback devices have been used for people with anxiety-related conditions.

Question 37

What is the approach of the robot seal Paro in supporting emotions?

Answer 37

It is to combine affect awareness and distraction by sensing aspects of the user’s physiology and behavior to give feedback to reinforce anxiety-alleviating behaviors, such as stroking, and to have a form factor (a furry big-eyed harp seal pup) that provides care and distracts from other concerns.

Question 38

What is the most common mental function targeted by assistive technology for cognition?

Answer 38

Time management (i.e. prospective memory functions that ensure one behaviour stops and another begins at a specific time.)

Question 39

What was the conclusion of Jamieson et al. (2014) after performing a meta-analysis on the use of prospective memory prompting devices for people with ABI or degenerative diseases?

Answer 39

Jamieson et al. (2014) performed a meta-analysis and concluded that there was strong evidence for the efficacy of prospective memory prompting devices for people with ABI or degenerative diseases. (not for people with MS)

Question 40

What is the COACH system developed by Mihailidis (2008)?

Answer 40

To support users with dementia in performing hand washing.

Question 41

What is the VICAID palm top system developed by Lancioni et al. (2000)?

Answer 41

To micro-prompt people with intellectual disability through vocational tasks.

Question 42

How do assistive technology for cognition provide context-dependent directions to the user?

Answer 42

Some ATCs use information in the environment, such as tags or symbols, to provide context-dependent directions to the user.

Question 43

What is the purpose of the Wander-Reminder device developed by Brown et al. (2013)?

Answer 43

Brown et al. (2013) developed a Wander-Reminder device to help reduce the frequency of nocturnal wanderings for a man with a history of right intracerebral haemorrhage who was frequently distressed when wandering at night.

Question 44

What were the findings of Wilson and Watson (1996) and Evans et al. (2003) regarding the factors that predicted use of memory support?

Answer 44

The people who used more memory aids were younger, had a greater amount of time since injury, used more memory aids prior to injury, had a higher level of independence, and showed better attentional functioning.

Question 45

What is the ‘neuro-socio-technical’ model for assistive technology for cognition about?

Answer 45

It is about understanding the environment, the user, and the technology in order to fully understand assistive technology use.

Question 46

What does the total circuit model refer to?

Answer 46

The total circuit model refers to a functional loop comprising the brain, other people, and technologies.

It suggests that the mind should be viewed as a dynamic system that extends beyond the boundaries of the individual brain and includes the environment and other people. The environment and tools we use to interact with the world are seen as part of our cognitive system, and they are considered to be external aids to our mental processes.

Question 47

What is the goal of zero effort technologies?

Answer 47

The goal of zero effort technologies is seamless interaction with the world where cognition and device work together effortlessly.

Question 48

What are the broad technology trends that suggest useful assistive technology for cognition will arise?

Answer 48

The broad technology trends that suggest useful ATC will arise are technology that recognizes objects, actions, emotions, and faces, is affect aware, and facilitates everyday life navigation.

Question 49

How can assistive technology for cognition use data to support users?

Answer 49

ATC can use data to be aware of what the user is probably trying to achieve, and thus may make suggestions as to activities when these do not come to mind, and then help support achievement of those goals.

Question 50

How can recognition systems be used to support emotion regulation?

Answer 50

Recognition systems can be used to recognise emotional states in the user, overcoming the barrier of alexithymia (i.e.
the inability to recognize or describe one’s own emotions). Feeding back to users their own emotional state may be used to support their emotion regulation.

Question 51

What are the areas of cognitive function that have yet to be assisted by technology (ACT)?

Answer 51

The areas of cognitive function that have yet to be assisted by technology include working memory, judgement, and problem solution.

Question 52

What is telerehabilitation and what is its purpose?

Answer 52

Telerehabilitation is the delivery of rehabilitation services through information and communication technologies by rehabilitation professionals. It is aimed at decreasing health disparities and increasing access to care for people with neurological disorders.

Question 53

What are the most well-researched neurological conditions for telerehabilitation interventions?

Answer 53

The most well-researched conditions are traumatic brain injury (TBI), stroke and multiple sclerosis (MS).

Question 54

What are some examples of interventions used in telerehabilitation?

Answer 54

• Self-guided interventions
• Virtual reality (VR) protocols
• Social media
• Hybrid interventions (mixed telerehabilitation interventions that include a combination of self-guided, therapist-facilitated, or in-clinic delivery components)

Question 55

What are psychosocial interventions?

Answer 55

Psychosocial interventions aim to improve quality of life and to maximize physical, cognitive, and social functioning. They include behavioural therapy, cognitive and social stimulation, animal therapy and physical activity.

Question 56

What is the purpose of developing robots for people with dementia?

Answer 56

To enhance quality of care and to fulfill the need for personalized care of a growing aged population.

Question 57

What are some ethical concerns raised about the use of social robots in the care of people with dementia?

Answer 57

The potential for robots to replace human care, reduce opportunities, freedom and autonomy of care, dehumanize relationships, and raise privacy concerns.

Question 58

What are some of the potential benefits of using social robots in the care of people with dementia?

Answer 58

Reducing social isolation, improving mood and communication, protecting people from harm, and helping people maintain their social skills.