The primary purpose of the study was to compare the results of neuropsychological assessments with results obtained using a translated Cognitive Change Index (CCI) on patients with diagnosed brain ...pathology. Our study included 54 patients diagnosed with neurologic pathology (stroke, TBI, or brain tumor) at the University Rehabilitation Institute Soca (average age = 51 years, SD = 15 years). The results of neuropsychological evaluations and anamnestic data were also obtained for the clinical subsample. Confirmatory factor analysis of the translated CCI performed on responses of 151 normative elderly participants supported a one-factor structure of the questionnaire. Cronbach's α was 0.77 in the clinical sample. A significant correlation was found between lower scores for attention and visual abilities using objective measurement tools and a person's self-assessment of impairment in their own cognitive functions (score on CCI). Individuals can perceive that their attention and visual abilities are impaired when those abilities also score low in diagnostic tests.
Worldwide, there has been a marked increase in stress and anxiety, also among patients with traumatic brain injury (TBI). Access to psychology services is limited, with some estimates suggesting that ...over 50% of sufferers are not accessing the existing services available to them for reasons such as inconvenience, embarrassment, or stigmatization concerns around mental health. Health service providers have increasingly been turning to drug-free therapies, such as mindfulness programs, as complementary treatments.
Virtual reality (VR) as a new delivery method for meditation-based stress and anxiety reduction therapy offers configurable environments and privacy protection. Our objective was to design a serious learning-meditation environment and to test the feasibility of the developed telemindfulness approach based on cloud technologies.
We developed a cloud-based system, which consisted of a Web interface for the mindfulness instructor and remote clients, who had 3D VR headsets. The mindfulness instructor could communicate over the Web interface with the participants using the headset. Additionally, the Web app enabled group sessions in virtual rooms, 360-degree videos, and real interactions or standalone meditation. The mindfulness program was designed as an 8-week Mindfulness-Based Stress Reduction course specifically for the developed virtual environments. The program was tested with four employees and four patients with TBI. The effects were measured with psychometric tests, the Mindful Attention Awareness Scale (MAAS) and the Satisfaction With Life Scale (SWLS). Patients also carried out the Mini-Mental State Examination (MMSE). An additional objective evaluation has also been carried out by tracking head motion. Additionally, the power spectrum analyses of similar tasks between sessions were tested.
The patients achieved a higher level of life satisfaction during the study (SWLS: mean 23.0, SD 1.8 vs mean 18.3, SD 3.9) and a slight increase of the MAAS score (mean 3.4, SD 0.6 vs mean 3.3, SD 0.4). Particular insight into the MAAS items revealed that one patient had a lower MAAS score (mean 2.3). Employees showed high MAAS scores (mean 4.3, SD 0.7) and although their SWLS dropped to mean 26, their SWLS was still high (mean 27.3, SD 2.8). The power spectrum showed that the employees had a considerable reduction in high-frequency movements less than 0.34 Hz, particularly with the 360-degree video. As expected, the patients demonstrated a gradual decrease of high-frequency movements while sitting during the mindfulness practices in the virtual environment.
With such a small sample size, it is too early to make any specific conclusions, but the presented results may accelerate the use of innovative technologies and challenge new ideas in research and development in the field of mindfulness/telemindfulness.
The primary aim of this prospective pilot study was to assess feasibility of implementing goal-oriented attentional self-regulation (GOALS) training in Slovenia with patients with multiple cognitive ...deficits after acquired brain injury in acute phase of recovery. Seven patients with acquired brain injury (i.e. stroke, traumatic brain injury, and subarachnoid hemorrhage) with a mean postinjury time of 4.3 months (SD = 1.25) and mean age of 34.5 years (SD = 18.6) were recruited for the study. The group program consisted of 10 sessions twice a week and included cognitive strategy training, social skills training, and psychoeducation. Structured interviews and neuropsychological tests were used before and after the training to determine the influence of the interventions on daily life tasks and attentional networks performance involving cognitive and behavioral domains. GOALS influenced self-reports of positive effect on the individual goals set by the patients. Training had a positive influence on executive control and memory. The results from the present study suggest that it is feasible to implement GOALS manualized executive function training in Slovenia, with the patients in a somewhat more acute stage than in previous studies, and that GOALS training may be a promising nonpharmacological treatment for cognitive and behavioral difficulties after acquired brain injury. Further research is needed to extend these findings in a larger sample.
The objective of the study was to evaluate predictor variables stemming from different assessment approaches (medical documentation, neuropsychological assessment, and Mediatester driving assessment) ...on patient's ability to drive (passing the practical driving test with a qualified instructor) following a TBI (traumatic brain injury) or a stroke. The study included 63 participants (54 males), aged 20 to 80 years (M = 44.4; SD = 16.7). Majority of participants suffered a TBI and 18 participants were included after an ischemic stroke. Patients who passed a driving test had significantly higher composite index on Comprehensive Trail-Making Test (medium or large effect size) compared to those who did not pass a driving test, or those who passed the driving test with limitations. The results on the 18-light reaction test (18 LRT) suggest that the reaction time could also play a role in predicting the ability to drive. The model with these two predictors, along with Glasgow Coma Scale, successfully classified 90 % of participants in two respectful groups; passed vs. did not pass a driving test/passed the driving test with limitations. The results suggest that neuropsychological and driving assessments that measure a range of cognitive abilities are better predictors of regaining the ability to drive after a TBI or stroke than separate cognitive abilities.
Deficits in attentional and executive functioning may interfere with driving ability and result in a lower level of fitness to drive. Studies show mixed results in relation to the consistency of ...neuropsychological and driving simulator assessment. The objective of this study was to investigate the consistency of both types of assessment. Ninety-nine patients with various neurological impairments (72 males; M = 48.98 years; SD = 17.27) performed a 30-minute drive in a driving simulation in three different road settings; a (non-)residential rural area, a highway and an urban area. They also underwent neuropsychological assessment of attention and executive function. An exploratory correlational analysis was conducted. We found weak, but significant correlations between attention and executive function measures and more efficient driving in the driving simulator. Distractibility was associated with the most simulator variables in all three simulated road settings. Participants who were better at maintaining attention, eliminating irrelevant information and suppressing inappropriate responses, were less likely to drive above the speed limit, produced a less jerky ride, and used the rearview mirror more regularly. A lack of moderate or strong significant correlations (inconsistency) between traditional neuropsychological and simulator assessment variables may indicate that they don't evaluate the same cognitive processes.
Objective: To identify driving characteristics of fit-, unfit-, and conditionally fit-to-drive neurological patient populations using a driving simulator with three high-risk scenarios comprising ...rural, highway, and urban environments.
Methods: The study included 91 neurological patients undergoing a multidisciplinary assessment for driver's license revalidation, consisting of a clinical, neuropsychological, functional, and on-road evaluation. The groups drove through three independent driving scenarios, during which a variety of measures describing reaction time, vehicular control, and traffic rule compliance were performed. One-way analysis of variance (ANOVA) with Bonferroni correction was used for group comparison, independently for each driving scenario, and Pearson correlations were calculated between simulator variables and neuropsychological test scores.
Results: The fit- and unfit-to-drive population significantly differed (p < .05) in reaction times, regardless of the scenario. No significant differences in traffic rule compliance or vehicular control parameters were observed in the rural environment (p > .05). On the highway, the unfit group exhibited greater variability of steering wheel angle, higher steering reversal rate, and a higher rate of turn signal errors. In the urban environment, the unfit group oversped more, had more collisions, and exhibited greater lane position variability. The latter, along with reaction times in the rural and highway scenarios, was also shown to significantly differ between the conditional and unfit group (p < .05). No significant differences were observed between the fit and the conditional group (p > .05). Weak to moderate associations (range: −0.5 to 0.29) between neuropsychological tests and various simulator variables were also observed.
Conclusions: Our results show that driving simulators are able to capture differences between (fit- and unfit-to-drive) neurological patient populations and therefore bear the potential for being used as a deficit-independent screening, assessment, or rehabilitation tool. The conditionally-fit-to-drive group exhibited less discriminative features, which points to greater importance of human judgment for this population. The observation that differences in most of the parameters were environment-dependent suggests that developers of future driver simulation tools should carefully design scenarios in order to fully exploit their assessment potential.
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