Intelligent Assistive Technology and Systems Lab - click to go to homepage
IATSL develops assistive technology that is adaptive, flexible, and intelligent, enabling users to participate fully in their daily lives. Learn more about our research

Visit us:

Room 438

500 University Ave.

Toronto, Canada

P 416.946.8573

F 416.946.8570


Send us mail:

160 - 500 University Ave.

Toronto, ON, M5G 1V7



email us!


Follow IATSL on Twitter


Cognitive Telerehabilitation through New Computing Technologies: A Focus on Traumatic Brain Injury

Keywords: Cognitive rehabilitation, human-computer interaction (HCI), pervasive health, telerehabilitation, traumatic brain injury (TBI).

In collaboration with: Toronto Rehabilitation Institute

Overview of Research

Telerehabilitation is the ability to conduct rehabilitative therapy, assessment, or training over a distance through the use of information and communication technology [1]. When applied to brain injury, this is referred to as cognitive telerehabilitation. Each year, it is estimated that 187,000 Canadians are afflicted by traumatic brain injury (TBI) [2]. In moderate-to-severe cases of TBI, individuals must cope with chronic cognitive/physical impairments that limit their quality of life [3,4]. Cognitive rehabilitation attempts to restore or compensate for these impairments with therapies that target specific cognitive deficits (e.g., memory, attention, etc) [5]. One challenge though, is extending the benefits of this rehabilitation beyond the clinical setting [6]. There is a limitation in resources for outpatient care [7], and difficulty generalizing improvements to real-world performance. Telerehabilitation is regarded as one way to remediate this issue by providing effective access to clinical experts and providing a means to enable therapy/assessment outside of the clinic [8].

Typically, cognitive telerehabilitation has used technology as a means of communication (e.g., phone, videoconferencing) [9]. However, as technology progresses, the opportunities to expand the rehabilitation process are growing [10,11]. Wearable sensors, natural interaction, and smartphones are just some examples of how technology is shifting from a medium for communication, to an active intervener in the rehabilitation process. Technology can now facilitate rehabilitation within the context of a patient’s everyday environment. Examples of this concept are emerging within physical rehabilitation (e.g., a mobile device used to improve walking for Parkinson’s patients in their everyday environment [12]). Yet, this concept remains largely unexplored for cognitive rehabilitation. The purpose of this research is to explore how advances in computing technology can be applied to cognitive telerehabilitation.

Research Objectives

  1. To explore how new computing technology can be used to contextualize cognitive telerehabilitation; and
  2. To investigate the acceptance and clinical feasibility of the cognitive telerehabilitation system that this research has built.


The ability to treat and assess patients in real-world settings is a powerful tool for rehabilitation. This research will produce a novel cognitive telerehabilitation system that can be evaluated in how it meets clinical needs.

For more information, please contact: Tuck-Voon How

Funding Source

Graduate funding provided by NSERC CARE.

Research Team

Tuck-Voon How, University of Toronto
Alex Mihailidis, University of Toronto
Robin Green, Toronto Rehabilitation Institute
Gary Turner, York University
Geoff Fernie, Toronto Rehabilitation Institute


  1. Rosen, M. J. (1999). Telerehabilitation. NeuroRehabilitation-An Interdisciplinary Journal, 12(1), 11–26.
  2. Caro, D. (2011). Towards sustainable traumatic brain injury care systems: Healthcare leadership imperatives in Canada. Healthcare Management Forum, 24(1), 25–30.
  3. National Institutes of Health. (1998). Rehabilitation of persons with traumatic brain injury. Am Med Assoc.
  4. Ponsford, J. L., Olver, J. H. & Curran, C. (1995). A profile of outcome: 2 years after traumatic brain injury. Brain Injury, 9(1), 1–10.
  5. Cicerone, K. D., Dahlberg, C., Kalmar, K., Langenbahn, D. M., Malec, J. F., Bergquist, T. F., Felicetti, T., et al. (2000). Evidence-based cognitive rehabilitation: recommendations for clinical practice. Archives of physical medicine and rehabilitation, 81(12), 1596–1615.
  6. Adams, K. M. (2003). Realising the Potential of Cognitive Rehabilitation for the Brain-Injured: Next Steps. Brain Impairment, 4(01), 31–35.
  7. Cullen, N. (2007). Canadian healthcare perspective in traumatic brain injury rehabilitation. The Journal of Head Trauma Rehabilitation, 22(4), 214–220.
  8. McCue, M., Fairman, A. & Pramuka, M. (2010). Enhancing quality of life through telerehabilitation. Physical medicine and rehabilitation clinics of North America, 21(1), 195–206.
  9. Rogante, M., Grigioni, M., Cordella, D. & Giacomozzi, C. (2010). Ten years of telerehabilitation: a literature overview of technologies and clinical applications. NeuroRehabilitation, 27(4), 287–304.
  10. Maitland, J., McGee-Lennon, M. & Mulvenna, M. (2011). Pervasive healthcare: from orange alerts to mindcare. ACM SIGHIT Record, 1(1), 38–40.
  11. Harper, R., Rodden, T., Rogers, Y. & Sellen, A. (2008). Being human: Human-computer interaction in the year 2020. Cambridge, England: Microsoft Research Ltd.
  12. Bachlin, M., Plotnik, M., Roggen, D., Maidan, I., Hausdorff, J. M., Giladi, N. & Troster, G. (2010). Wearable assistant for Parkinson’s disease patients with the freezing of gait symptom. IEEE Transactions on Information Technology in Biomedicine, 14(2), 436–446.