Recommendations for the non-pharmacological treatment of apathy in brain disorders

Apathy is a common neuropsychiatric syndrome observed across many neurocognitive and psychiatric disorders. Although there are currently no definitive standard therapies for the treatment of apathy, non-pharmacological treatment (NPT) is often considered to be at the forefront of clinical management. However, guidelines on how to select, prescribe and administer NPT in clinical practice are lacking. Furthermore, although new Information and Communication Technologies (ICT) are beginning to be employed in NPT, their role is still unclear. The objective of the present work is to provide recommendations for the use of NPT for apathy, and to discuss the role of ICT in this domain, based on opinions gathered from experts in the field. The expert panel included 20 researchers and healthcare professionals working on brain disorders and apathy. Following a standard Delphi methodology, experts answered questions via several rounds of web-surveys, and then discussed the results in a plenary meeting. The experts suggested that NPT are useful to consider as therapy for people presenting with different neurocognitive and psychiatric diseases at all stages, with evidence of apathy across domains. The presence of a therapist and/or a caregiver is important in delivering NPT effectively, but parts of the treatment may be performed by the patient alone. NPT can be delivered both in clinical settings and at home. However, while remote treatment delivery may be cost and time-effective, it should be considered with caution, and tailored based on the patient's cognitive and physical profile and living conditions

The VESPA Project: Virtual Reality Interventions for Neurocognitive and Developmental Disorders

VESPA is a financed project supported by the Sicilian Regional Research and Development funds, and it is structured by the development, research and validation of Virtual Reality (VR) based application for the diagnosis and treatment of neurocognitive conditions. In particular, this article presents its characteristics, referred to as the first (2013-2015) and second (2021-ongoing) generations of VESPA, with particular reference to literature regarding the VR technology application and development, the VR treatment of neurocognitive conditions and prior versions of this intervention. Through a comprehensive review of the research conducted over the last 5 years, evidence has emerged supporting VESPA’s aim and scopes, highlighting how the application of VR can be considered to add value to typical rehabilitation/therapeutic paths. VESPA project generations are then presented in detail, including specific session/task battery characteristics, 2.5D, 3D and 5D typologies, system usability and architecture and pathological domain-based dynamics and features. The discussion about VESPA will highlight the current advantages along with limitations and future directions

Homes of stroke survivors are a challenging environment for rehabilitation technologies

The design of digital technologies that support poststroke rehabilitation at home has been a topic of research for some time. If technology is to have a large-scale impact on rehabilitation practice, then we need to understand how to create technologies that are appropriate for the domestic environment and for the needs and motivations of those living there. This paper reflects on the research conducted in the Motivating Mobility project (UK Engineering and Physical Science Research Council: EP/F00382X/1). We conducted sensitizing studies to develop a foundational understanding of the homes of stroke survivors, participatory design sessions situated in the home, and experimental deployments of prototype rehabilitation technologies. We identified four challenges specific to the homes of stroke survivors and relevant to the deployment of rehabilitation technologies: identifying a location for rehabilitation technology, negotiating social relationships present in the home, avoiding additional stress in households at risk of existential stress, and providing for patient safety. We conclude that skilled workers may be needed to enable successful technology deployment, systematizing the mapping of the home may be beneficial, and education is a viable focus for rehabilitation technologies

Homes of Stroke Survivors Are a Challenging Environment for Rehabilitation Technologies

The design of digital technologies that support poststroke rehabilitation at home has been a topic of research for some time. If technology is to have a large-scale impact on rehabilitation practice, then we need to understand how to create technologies that are appropriate for the domestic environment and for the needs and motivations of those living there. This paper reflects on the research conducted in the Motivating Mobility project (UK Engineering and Physical Science Research Council: EP/F00382X/1). We conducted sensitizing studies to develop a foundational understanding of the homes of stroke survivors, participatory design sessions situated in the home, and experimental deployments of prototype rehabilitation technologies. We identified four challenges specific to the homes of stroke survivors and relevant to the deployment of rehabilitation technologies: identifying a location for rehabilitation technology, negotiating social relationships present in the home, avoiding additional stress in households at risk of existential stress, and providing for patient safety. We conclude that skilled workers may be needed to enable successful technology deployment, systematizing the mapping of the home may be beneficial, and education is a viable focus for rehabilitation technologies

Playing for better or for worse? Health and Social outcomes with electronic gaming

Of the many of Information and Communication Technology (ICT) products, electronic games are considered as having great potential for improving health and social outcomes. This chapter considers the factors that may be involved in facilitating health and social outcomes and also those factors that might be considered risk factors by reviewing studies that have shown both positive and detrimental effects on people’s physical and mental health. The authors also debate some research questions that remain unanswered and suggest guidelines for practitioners, researchers, and game designers.This work was supported by the Portuguese Foundation of Science and Technology (FCT) under the grant PTDC/PSI-PSO/099985/2008

Cognition in action C-i-A: Rethinking gesture in neuro-atypical young people: A conceptual framework for embodied, embedded, extended and enacted intentionality

The three aims of my interdisciplinary thesis are: -To develop a conceptual framework for re-thinking the gestures of neuro-atypical young people, that is non-traditional and non-representational -To develop qualitative analytical tools for the annotation and interpretation of gesture that can be applied inclusively to both neuro-atypical and neuro-typical young people -To consider the conceptual framework in terms of its theoretical implications and practical applications Learning to communicate and work with neuro-atypical young people provides the rationale and continued impetus for my work. My approach is influenced by the limited social, physical and communicative experiences of young people with severe speech and motor impairment, due to cerebral palsy (SSMI-CP). CP is described as: a range of non-progressive syndromes of posture and motor impairment. The aetiology is thought to result from damage to the developing central nervous system during gestation or in the neonate. Brain lesions involve the basal ganglia and the cerebellum; both these sites are known to support motor control and integration. However, gaps in theoretical research and empirical data in the study of corporeal expression in young people with SSMI-CP necessitated the development of both an alternative theoretical framework and new tools. Biological Dynamic Systems Theory is proposed as the best candidate structure for the reconsideration of gesture. It encompasses the global, synthetic and embodied nature of gesture. Gesture is redefined and considered part of an emergent dynamic, complex, non-linear and self-organizing system. My construct of Cognition-in-Action (C-i-A) is derived from the notion of knowing-as-doing influenced by socio-biological paradigms; it places the Action-Ready-Body centre stage. It is informed by a theoretical synthesis of knowledge from the domains of Philosophy, Science and Technology, including practices in the clinical, technology design and performance arts arenas. The C-i-A is a descriptive, non-computational feature-based framework. Its development centred around two key questions that served as operational starting points: What can gestures reveal about children’s cognition-in-action? and Is there the potential to influence gestural capacity in children? These are supported by my research objectives. Three case studies are presented that focus on the annotation and interpretative analyses of corporeal exemplars from two adolescent males aged 16.9 and 17.9 years, and one female girl aged 10.7 years. These exemplars were contributed to the Child Gesture Corpus by these young people with SSMI-CP. The Gesture-Action-Entity (GAE) is proposed as a unit of interest for the analysis of procedural, semantic and episodic aspects of our corporeal knowledge. A body-based-action-annotation-system (G-ABAS) and Interpretative Phenomenological Analysis methodology is applied for the first time to gesture (G-IPA). These tools facilitate fine-grained corporeal dynamic and narrative gesture feature analyses. Phenomenal data reveal that these young people have latent resources, capacities and capabilities that they can express corporeally. Iteration of these interpretative findings with the Cognition-in-Action framework allows for the inference of processes that may underlie the strategies they use to achieve such social-motor-cognitive functions. In summary, their Cognition-in-Action is brought-forth, carried forward and has the potential to be culturally embodied. The utility of C-i-A framework lies in its explanatory power to contribute to a deeper understanding of child gesture. Furthermore, I discuss and illustrate its potential to influence practice in the domains of pedagogy, rehabilitation and the design of future intimate, assistive and perceptually sensitive technologies. Such technologies are increasingly mediating our social interactions. My work offers an ecologically valid alternative to tradition conceptualization of perception, cognition and action. My thesis contributes both new knowledge and carries implications across the domains of movement science, gesture studies and applied participatory performance arts and health practices

Academic methods for usability evaluation of serious games: a systematic review

In the last years, there has been an increasing interest in the design of video games as a tool for education, training, health promotion, socialization, etc. Usability, which is a key factor in any video game, becomes even more important in these so-called Bserious games^, where the users’ special characteristics should be considered, and the game efficacy depends on the users’ adherence and engagement. However, evaluation of the usability of this kind of games requires a redefinition of techniques, methods and even terminology. In this paper, we elicit six research questions and conduct a systematic review of the scientific literature, which resulted in the selection of 187 papers that contained the most relevant responses. The conclusions of this systematic review illustrate the general status of current academic usability evaluations of these games and the main trends in the selection of methodologies and how are they applied. This view may be a very valuable foundation for future researchMinisterio de Ciencia e Innovación PROCUR@-IPT-2011-1038-90000