Computer-Assisted Cognitive Stimulation Therapy (1)

MED ANIMA – INNOVATION AND TECHNOLOGY:

Computer Assisted Cognitive Stimulation Therapy

✔️Clinically Proven

In response to the need for patients to improve their quality of life by alleviating or relieving symptoms of certain conditions, Med Anima Clinic continues to expand its line of high-tech, innovative services by introducing computer-assisted cognitive stimulation therapy for the first time in Romania.This therapy serves as an optimal support for the recovery of various cognitive deficits.

At Med Anima, the treatment of cognitive disorders is approached in a convenient, pleasant, and non-invasive manner using the LATEST TECHNOLOGY, for the first time ever in Romania. We use the most important and advanced European computer-based cognitive rehabilitation tool, widely used in the daily treatment of over 95% of rehabilitation clinics in Germany. This tool has been developed by therapists over a period of 25 years, and the effectiveness of this type of therapy has been documented and highlighted in over 60 studies.

As a result, a consensus has been reached regarding the outcomes of this type of therapy, as well as the fact that the frequency and intensity of training sessions are essential factors in achieving notable improvements. Based on numerous studies, the system currently used exclusively at Med Anima Clinic is recommended by the German Society of Neuropsychology (PNB) and the German Association of Occupational Therapists (DVE).

What is cognition and what is cognitive deficit?

COGNITION

Cognition is a term that encompasses thinking, memory, perception, motivation, and language. Among its specific functions are orientation, the ability to learn necessary skills, problem-solving, abstract thinking, reasoning, and judgment, the ability to retain and recall events, mathematical ability, symbol manipulation, control over reactions and behavior, language use and comprehension, attention, and perception.

COGNITIVE DEFICIT

Cognitive deficit is a term used to describe impairment in various domains of cognition. It can be a temporary or permanent and progressive condition. Cognitive deficit is not a condition in itself but a manifestation of an underlying condition. Patients may notice these changes themselves or they are often observed by family and friends. Individuals with cognitive deficits experience a wide range of behavioral manifestations.

Treatment of cognitive deficits at Med Anima

THE SYSTEM – INTRODUCED FOR THE FIRST TIME IN ROMANIA AT MED ANIMA – is a complex and sophisticated one, aimed at computer-assisted cognitive rehabilitation. This practical tool assists therapists in the rehabilitation process of cognitive disorders that affect aspects such as attention, concentration, memory, perception, daily activities, and more.

By solving tasks within computer-assisted cognitive stimulation, brain processes are activated, and important brain functions are improved or completely restored on a case-by-case basis. The success of this treatment means that the user will be better able to cope with challenges in daily life. The system can be used in all stages of recovery.

Computer-Assisted Cognitive Stimulation Therapy (2)

This system is intended for both the analysis and treatment of various cognitive deficits in patients:

  • Attention deficits: vigilance, selective attention, spatial attention, divided attention, attentional focus;
  • Memory deficits: working memory, short-term memory, long-term memory, memory for figural content, memory for verbal content, face memory;
  • Executive function deficits: planning, logical reasoning, activities of daily living;
  • Visual field deficits: anopsias and scotomas (anopsia – loss of vision for a period of time without affecting the receptor apparatus, scotoma – visual impairment characterized by blind spots in the individual’s visual field).

The technology used makes cognitive stimulation treatment patient-centered and tailored to individual deficits. Years of research, testing, and adaptation have optimized the software used for treating cognitive deficits at all stages of recovery and at any age. Computer-assisted cognitive stimulation therapy is available to help patients improve cognitive functions such as attention, memory, executive functions, and visual field. This type of therapy can also be applied to children and adolescents.

Therapeutic indications:

1. Attention disorders:

They are very common in patients with neurological and psychiatric conditions and affect all areas of life. While we generally refer to “attention” in everyday life, science defines this concept in a more complex manner, distinguishing between its different subfunctions, such as vigilance, sustained attention, and selective attention. Depending on the disorder or the location of brain lesions, different types of attention and their qualities may be affected, requiring specific training.

Indications:

  • Symptoms of attention deficit disorder, chronic fatigue syndrome, depression;
  • Reduced reaction time for patients with dementia, traumatic brain injuries (TBI), ischemia;
  • Impaired sensitivity after brain injuries;
  • Selective attention disorders;
  • Disorders of visual and spatial perception;
  • Apraxia (a neurological speech disorder affecting coherent and consistent expression), amnesia, concentration disorders.

2. Memory disorders:

They can occur after brain injuries as well as psychiatric illnesses. Different forms of memory are distinguished (e.g., working memory, short-term memory, long-term memory). In most cases, the encoding and permanent storage of new information are affected, while the retrieval of previously stored information is maintained. Such memory deficits often have severe consequences for affected patients. These deficits can be managed through cognitive stimulation training and the provision of compensatory strategies.

Indications:

  • Mild to moderate working memory disorders caused by neurological and psychiatric pathologies;
  • Disorders of complex attention formation and executive functions;
  • Mild, moderate, or severe learning disabilities;
  • Vocabulary deficiency and reduced recognition performance, especially in the early stage of amnestic syndrome;
  • Visual prosopagnosia – impairment or loss of the ability to recognize faces and establish meaningful associations.

3. Executive function disorders:

Impairment of various higher-level mental processes related to action planning and goal-oriented behavior. Patients with deficits in executive functions often have difficulties in planning and adhering to rules, and they may have an underdeveloped capacity to adhere to social norms and suppress unwanted behavior. Executive functions are closely linked to the frontal lobe of the brain. Neurological diseases or frontal brain injuries, as well as psychiatric disorders (e.g., schizophrenia), lead to abnormalities in patients

Indications:

  • Deficits in reasoning, often resulting from chronic alcohol abuse, dementia, schizophrenia;
  • Deficits in working memory and difficulties in action planning, resulting from traumatic brain injury (TBI), stroke, brain tumor surgery, or cerebral hemorrhage;
  • Deficits in cognitive arithmetic skills.

4. Visual field disorders:

Loss of the visual field is a common side effect in stroke or hypoxic brain injuries. Visual information is transmitted from the eyes through the optic nerve and optic radiations to the occipital lobe for processing. If these nerve tracts are damaged, the necessary visual information no longer reaches the lobe and cannot be processed, resulting in a loss of the visual field. Affected individuals have difficulties in reading and visual orientation. Targeted cognitive stimulation training for this problem can significantly reduce the negative impact on quality of life.

Indications:

  • Disorders occurring in extensive cerebral infarctions, other organic brain disorders;
  • Homonymous visual field disorders;
  • Visual exploration or visual neglect disorders;
  • Neurological visual impairments such as hemianopia and resulting perception;
  • Processing disorders, reading and attention problems, and visual neglect, coordination;
  • Hand and finger movement disorders.

5. Hand-eye coordination disorders:

Human movements rely on the coordination of motor, visual, and proprioceptive systems. In numerous fine motor activities, such as using cutlery or various tools, precise coordination of the eyes, head, and hands is essential. During motor actions, visual control plays an important role, especially in the learning phase of the movement. Damage to the motor or sensory areas of the brain, as well as spatial or visual systems, can lead to hand-eye coordination problems.

Indications:

  • mpairment of the motor cortex (frontal lobe) causing deficits in fine motor control, resulting from cerebro-organic diseases, brain injuries, hemorrhages, tumors, or trauma.

This procedure has demonstrated exceptional usefulness in the TREATMENT OF SCHIZOPHRENIA

Providing a computer-assisted cognitive stimulation therapy program to patients with schizophrenia improves cognitive functioning and can also influence psychotic symptoms. Several studies have shown significant cognitive improvement after implementing this therapy program. Computerized cognitive stimulation enhances the capacity and efficiency of cognitive function and is beneficial in improving cognitive impairments in patients with schizophrenia. This therapy has shown positive results in enhancing cognitive functions, interpersonal problem-solving skills, as well as achieving autonomy and alleviating symptomatology.

You can learn more about this in the article: Cognitive Rehabilitation in Schizophrenia and Psychosis | Med Anima

Request an Appointment

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Benefits of Computer-Assisted Cognitive Stimulation

1. Improvement of Cognitive Functioning

Through consistent use, the patient experiences a significant improvement in their cognitive deficits. The tasks performed in cognitive training are correlated with the therapeutic strategy and expedite recovery.

2. Individualization

The cognitive stimulation software used in the training sessions is adaptable to the patient’s needs. It can even be used for visual impairments, and familiar stimuli (e.g., family pictures) can be incorporated into the training.

3. Home-based Work

The system can be safely used at home, under the online supervision of the therapist. This allows for the continuous engagement with the stimulation modules, reinforcing therapy strategies outside of regular sessions and enhancing recovery through increased frequency of training.

4. Automatic Adaptation to the Patient

The stimulation modules generate exercises of varying difficulty based on the patient’s previous performance. For example, when a task becomes challenging, the difficulty level will be reduced until the patient can handle it. Conversely, the software will introduce more challenges to prevent boredom and increase the effectiveness of the treatment.

How Cognitive Stimulation Therapy Works

At the beginning and end of each cognitive stimulation session, the client and therapist jointly determine the therapy’s objective and discuss the outcomes face-to-face. The software used is self-adaptive, meaning it automatically adjusts the complexity of each task according to the patient’s actual performance. The program provides the appropriate level of challenge for each individual, ensuring the demands are neither too high nor too low. This makes computer-assisted cognitive stimulation therapy highly motivating and user-friendly.

keyboard for computer assisted cognitive stimulation

Additionally, since a conventional computer keyboard may be inadequate for some patients, we have a special keyboard available that allows patients with severe motor deficits to use the computer without significant difficulties.

Steps in Cognitive Stimulation Therapy:

1. Initial Assessment:

Medical history, identification of problems to address, initial computerized screening to automatically identify the training modules to follow.

2. Selection of Training Modules:

Among the 27 available modules, the therapist, assisted by the cognitive stimulation program, will choose the most appropriate ones based on the identified problems and desired outcomes.

3. Personalization of Therapy:

The program measures the patient’s current performance during therapy and automatically selects the appropriate level of difficulty. This ensures the best results for each patient.

4. Patient Instruction:

Before starting therapy, the therapist presents the task to be performed. The training module monitors the patient’s behavior, reaction times, errors, etc., providing feedback and automatically adjusting the difficulty level.

5. Conducting the Therapy Session:

Working sessions of 15-60 minutes, 3-5 times per week.

6. Data Analysis:

All the results from the initial assessment (screening) and therapy are automatically stored in the patient’s electronic record. The therapist can evaluate and print the results, easily tracking the therapy’s progress due to the detailed recording of the outcomes achieved in each session.

Computer-Assisted Cognitive Stimulation Therapy (1)
Computer-Assisted Cognitive Stimulation Therapy (2)

Clinical Studies

Over 60 clinical studies have been conducted over a period of 21 years (1998-2019), both in medical fields where cognitive deficit recovery is imperative (neurology, psychiatry, geriatrics, and cognitive disorders in children and adults) and in studies involving healthy individuals to observe the effects of cognitive stimulation training on memory and attention. Examples include:

  • Cicerone, KD et al 2011 – Evidence based cognitive rehabilitation: updated review of the literature from 2003 through 2008. Arch Physmed Rehabil 2011: 92: 519-30
  • AimolaL, Lane AR, Smith DT, Kerkhoff G, Ford GA, SchenkT. – Efficacy and feasibility of home-based training for individuals with homonymous visual field defects. Neurorehabil Neural Repair. 2014; 28: 207-218.
  • García-Molina A, Rajo… PR. – Clinical program of cognitive tele-rehabilitation for traumatic brain injury. eChallenges. 20101-10.
  • HelmstaedterC, LoerB, WohlfahrtR et al.- The effects of cognitive rehabilitation on memory outcome after temporal lobe epilepsy surgery. Epilepsy& Behavior. 2008; 12: 402-409.
  • Lee YM, JangC, BakIH, YoonJS. – Effects of Computer-assisted Cognitive Rehabilitation Training on the Cognition and Static Balance of the Elderly. JnlPhysTherSci. 2013; 25: 1475-1477.
  • Fernandez, E et al 2012 – Clinical Impact of RehaCom software for cognitive rehabilitation of patients with acquired brain injury MEDICC Review; October2012, Vol14, No 4, p 32-35

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