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
- To explore how new computing technology can be used to contextualize cognitive telerehabilitation; and
- To investigate the acceptance and clinical feasibility of the cognitive telerehabilitation system that this research has built.
Outcomes
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
References
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- Caro, D. (2011). Towards sustainable traumatic brain injury care systems: Healthcare leadership imperatives in Canada. Healthcare Management Forum, 24(1), 25–30.
- National Institutes of Health. (1998). Rehabilitation of persons with traumatic brain injury. Am Med Assoc.
- 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.
- 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.
- Adams, K. M. (2003). Realising the Potential of Cognitive Rehabilitation for the Brain-Injured: Next Steps. Brain Impairment, 4(01), 31–35.
- Cullen, N. (2007). Canadian healthcare perspective in traumatic brain injury rehabilitation. The Journal of Head Trauma Rehabilitation, 22(4), 214–220.
- 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.
- 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.
- Maitland, J., McGee-Lennon, M. & Mulvenna, M. (2011). Pervasive healthcare: from orange alerts to mindcare. ACM SIGHIT Record, 1(1), 38–40.
- Harper, R., Rodden, T., Rogers, Y. & Sellen, A. (2008). Being human: Human-computer interaction in the year 2020. Cambridge, England: Microsoft Research Ltd.
- 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.
