Musiquence – Design, Implementation and Validation of a Customizable Music and Reminiscence Cognitive Stimulation Platform for People with Dementia

Dementia is a neurodegenerative disease that affects millions of individuals worldwide and is challenging to diagnose as symptoms may only perceivable decades later. The disease leads to a gradual loss of memory, learning, orientation, language, and comprehension skills, which compromises activities of daily living. Health-related costs caused by dementia will continue to increase over the next few years; between the years 2005 and 2009, an increase of 34% (from $315 to$422 billion worldwide) was observed in treating dementia-related issues. Pharmaceutical approaches have been developed to treat dementia symptoms; unfortunately, the risk of side effects is high. For this reason, nonpharmaceutical methods such as music and reminiscence therapies have gained acceptance as patients with dementia positively respond to such approaches even at later stages of the disease. Nevertheless, further research is needed to understand how music and reminiscence therapy should be used and to quantify their impact on individuals with dementia. The development of serious games has gained attention as an alternative approach to stimulate patients. However, the clinical impact that serious games have on individuals with dementia is still unclear. In this dissertation, we contribute with new knowledge regarding the usage of music and reminiscence approaches in people with dementia through a theoretical model. Based on Baddeley’s working memory model, our model aims to explain how the therapeutic properties of music and reminiscence can have a beneficial effect. To test our model, we developed a novel interactive platform called Musiquence, in which healthcare professionals can create music and reminiscence based cognitive activities to stimulate people with dementia. In this dissertation, we present the results from several studies about the usage and effects that music and reminiscence have on such a population. We performed two studies using Musiquence to study the feasibility of a novel learning method based on musical feedback to aid people with dementia during task performance in virtual reality settings. Results show that participants relied more on music-based feedback during the task performance of virtual reality activities than in other forms of feedback. Also, data suggest that the music-based feedback system can improve task performance, compensating for some dementia-related deficits. We also used Musiquence in a longitudinal one-month-long pilot study to assess its efficacy when used for a cognitive stimulation intervention in dementia patients. The results of the study are promising. The 3 participants showed improvements in terms of general cognition, quality of life, mood, and verbal fluency

Customizing a cognitive stimulation program for individuals with dementia through a participatory design approach

Background: Different intervention strategies, such as reminiscence and music-based therapies, effectively mitigate the cognitive decline of individuals with dementia (IwD). An important challenge when implementing these approaches lies in the need for content customization. We de signed Musiquence platform, a framework that allows the customization of music and reminiscence content in cognitive stimulation activities. (2) Methods: Here, we present a participatory design methodology for designing a seven-week customized cognitive stimulation program (CCSP) for IwD using Musiquence. We ran focus groups with 19 formal caregivers, who provided information regarding themes and music to be used in activities for IwD, and gathered preferences from 20 IwD. (3) Results: The CCSP consists of seven cycles of tasks combining the activities available in Musiquence, the seven preferential themes of IwD, and the seven songs most frequently referenced by formal caregivers. (4) Conclusions: Finally, we provide a set of guidelines to implement a participatory design approach for content development together with IwD.info:eu-repo/semantics/publishedVersio

Feasibility, Acceptability, and Preliminary Impact of Full-Body Interaction on Computerized Cognitive Training Based on Instrumental Activities of Daily Living: A Pilot Randomized Controlled Trial with Chronic Psychiatric Inpatients

Objective: To conduct a pilot randomized control trial to assess the feasibility and acceptability of full-body interaction cognitive training (FBI-CT) inspired by instrumental activities of daily living in chronic psychiatric inpatients and to explore its preliminary impact on cognitive and noncognitive outcomes. Materials and Methods: Twenty psychiatric inpatients met the inclusion criteria and were randomly allocated to the FBI-CT group (n = 10) or the tablet-based CT group (T-CT) (n = 10). Neuropsychological assessments were performed at baseline, postintervention, and 3-month follow-up. Results: Both groups presented high completion rates at postintervention and follow-up. Participants reported high satisfaction following the interventions, with the FBI-CT group exhibiting slightly higher satisfaction. A within-group analysis showed significant improvements in the FBI-CT group for processing speed and sustained attention for short periods (P = 0.012), verbal memory (P = 0.008), semantic fluency (P = 0.027), depressive symptoms (P = 0.008), and quality of life (P = 0.008) at postintervention. At 3-month follow-up, this group maintained verbal memory improvements (P = 0.047) and depressive symptoms amelioration (P = 0.026). The T-CT group revealed significant improvements in sustained attention for long periods (P = 0.020), verbal memory (P = 0.014), and executive functions (P = 0.047) postintervention. A between-group analysis demon strated that the FBI-CT group exhibited greater improvements in depressive symptoms (P = 0.042). Conclusions: Overall, we found support for the feasibility and acceptability of both training approaches. Our findings show promise regarding the preliminary impact of the FBI-CT intervention, but due to study limitations such as the small sample size, we cannot conclude that FBI-CT is a more effective approach than T-CT for enhancing cognitive and noncognitive outcomes of chronic psychiatric inpatients. Clinical trials (number: NCT05100849).info:eu-repo/semantics/publishedVersio

Virtual Reality and Well-Being in Older Adults: Results from a Pilot Implementation of Virtual Reality in Long-Term Care

This paper describes the findings of a pilot implementation project that explored the potential of virtual reality (VR) technology in recreational programming to support the well-being of older adults in long-term care (LTC) homes

Envelhecer na perspetiva psicológica e social: promoção da saúde, qualidade de vida e estimulação cognitiva no idoso

Atualmente, o autocuidado, a prevenção na saúde e a melhoria da qualidade de vida de cada indivíduo, têm levantado várias questões no que diz respeito à saúde no envelhecimento, pois a esperança média de vida aumentou, e com isso surgiu a necessidade de melhorar os cuidados nesta faixa etária. Com o avanço da tecnologia e com o aumento da literacia digital junto das pessoas mais velhas, vão surgindo novos métodos para manter ou melhorar a saúde mental nesta população. Este trabalho pretende refletir sobre o idoso e a sua saúde mental, sendo que esta temática será abordada num contexto universal e, de forma sintetizada, também no contexto da Região Autónoma da Madeira. Iremos debruçar-nos sobre o envelhecimento, em contexto social, na promoção de saúde, qualidade de vida e alterações psicológicas e neurológicas no idoso, como por exemplo aquelas provocadas pelos quadros demenciais.Nowadays, self-care, health prevention, and improving the quality of life of each individual have raised several issues concerning health in ageing, as the average life expectancy has increased, and with this arose the need to improve care in this age group. With the advancement of technology and the increase in digital literacy among older people, new methods are emerging to maintain or improve mental health in said population. This work aims to reflect on the elderly and their mental health, and this theme will be addressed in a general context and in the context of the Autonomous Region of Madeira (Região Autónoma da Madeira (RAM)). We will focus on ageing, in a social context, in health promotion, quality of life, and psychological and neurological changes in the elderly, such as those caused by dementia.info:eu-repo/semantics/publishedVersio

Building music with lego bricks and Raspberry Pi

In this paper, a system to build music in an intuitive and accessible way, with Lego bricks, is presented. The system makes use of the new powerful and cheap possibilities that technology ofers for making old things in a new way. The Raspberry Pi is used to control the system and run the necessary algorithms, customized Lego bricks are used for building melodies, custom electronic designs, software pieces and 3D printed parts complete the items employed. The system designed is modular, it allows creating melodies with chords and percussion or just melodies or perform as a beatbox or a melody box. The main interaction with the system is made using Lego-type building blocks. Tests have demonstrated its versatility and ease of use, as well as its usefulness in music learning for both children and adults.Funding for open access publishing: Universidad Málaga/CBUA This publication is part of the project PDC2021-120997-C33 funded by MCIN/AEI/10.13039/501100011033, and European Union “NextGenerationEU/PRTR”. This publication is part of the project PID2021-123207NB-I00 funded by MCIN/AEI/10.13039/501100011033/FEDER, UE. This work was done at Universidad de Málaga, Campus de Excelencia Internacional Andalucia Tech. Funding for open access charge: Universidad de Málaga/CBUA

NeuroAIreh@b: an artificial intelligence-based methodology for personalized and adaptive neurorehabilitation

Cognitive impairments are a prevalent consequence of acquired brain injury, dementia, and age-related cognitive decline, hampering individuals' daily functioning and independence, with significant societal and economic implications. While neurorehabilitation represents a promising avenue for addressing these deficits, traditional rehabilitation approaches face notable limitations. First, they lack adaptability, offering one-size-fits-all solutions that may not effectively meet each patient's unique needs. Furthermore, the resource-intensive nature of these interventions, often confined to clinical settings, poses barriers to widespread, cost-effective, and sustained implementation, resulting in suboptimal outcomes in terms of intervention adaptability, intensity, and duration. In response to these challenges, this paper introduces NeuroAIreh@b, an innovative cognitive profiling and training methodology that uses an AI-driven framework to optimize neurorehabilitation prescription. NeuroAIreh@b effectively bridges the gap between neuropsychological assessment and computational modeling, thereby affording highly personalized and adaptive neurorehabilitation sessions. This approach also leverages virtual reality-based simulations of daily living activities to enhance ecological validity and efficacy. The feasibility of NeuroAIreh@b has already been demonstrated through a clinical study with stroke patients employing a tablet-based intervention. The NeuroAIreh@b methodology holds the potential for efficacy studies in large randomized controlled trials in the future

Reh@Store: an ecosystem for the management, deployment and update of serious games and virtual environments for health

Os processos tradicionais de distribuição de software geralmente envolvem o uso de um dispositivo físico que contém o código máquina desse software a ser distribuído. Após o aparecimento da Internet, este processo de distribuição lentamente transitou para o uso de plataformas centralizadas de distribuição de software que permitem não a distribuição do software como também as suas atualizações. Neste documento é implementado um sistema de distribuição de software para o NeuroReha bLab de modo a permitir a distribuição dos seus jogos sérios e ferramentas de investigação recor rendo a uma plataforma centralizada de distribuição que também permite o controlo do acesso às versões de um determinado software distribuído. Além de que, este sistema permite o auxílio cen tralizado dos utilizadores nais e a colheita dos dados provenientes dos softwares distribuídos. De modo a melhorar e validar o sistema implementado efetuou-se testes de usabilidade, desempenho e stress ao servidor, e, um caso de estudo. Os resultados demonstram que esse sistema encontra-se preparado para ambiente de produção e para o seu uso pelo NeuroRehabLab e as suas instituições parceiras.Traditional software distribution systems, in general, involve the use of a physical device contai ning the distributed software's code. After the surge of the Internet, this distribution process is transitioning to the use of centralized platforms that allow the distribution of the software and its updates. In this document, it is implemented a software distribution system for NeuroRehabLab that allows the centralized distribution of their serious games and research tools and the control of the users that are allowed to use each version of those games and tools. Also, this system allows the centralized help of the end-users and the collection of the data of the used software that is distributed. To validate the implemented system, it was conducted user testing, performance test, server stress test, and case of study. The results show that this system is ready to be used in production by the NeuroRehabLab

Musiquence Toolset: um conjunto de ferramentas de IA para Musiquence

As terapias, especialmente as de estimulação cognitiva e as de reminiscência, têm como objetivo melhorar a qualidade de vida de um indivíduo, assim como melhorar as funções cognitivas e sociais, através do uso de diversas ferramentas. Devido ao progresso tecnológico, incluindo a inteligência artificial, houve uma revolução na aplicação destas ferramentas. Esta evolução influenciou vários setores, incluindo a medicina e as artes, podendo até fazer diagnósticos com maior precisão e gerar conteúdos de forma personalizada. Com o Toolset, a integração da inteligência artificial na ferramenta Musiquence vai permitir aos utilizadores uma experiência mais facilitada no processo de estimulação cognitiva e de inserção e utilização de conteúdos como recordações para estimular a memória dos indivíduos com demência. Assim, este documento aborda o state-of-the-art, assim como as características e as funcionalidades mais relevantes. Adicionalmente, também apresenta protótipos preliminares desenvolvidos, a implementação e execução dos testes de usabilidade e, consequentemente, a análise dos resultados obtidos, e uma retrospetiva geral na implementação de um conjunto de sistemas para a Musiquence com recurso a inteligência artificial.Therapies, especially cognitive stimulation and reminiscence therapies, aim to improve an indivi dual’s quality of life, as well as improve cognitive and social functions, through the use of various tools. Due to technological progress, including artificial intelligence, there has been a revolution in the application of these tools. This evolution has influenced several sectors, including medi cine and the arts, and can even make diagnoses with greater precision and generate personalized content. With Toolset, the integration of artificial intelligence into the Musiquence tool will allow users to have an easier experience in the process of cognitive stimulation and the insertion and use of content as memories to stimulate the memory of individuals with dementia. Therefore, this document addresses the state-of-the-art, as well as the most relevant features and functionalities. Additionally, it also presents preliminary prototypes developed, implementation and execution of usability tests and, consequently, analysis of obtained results, and a general retrospective on the implementation of a set of systems for Musiquence using artificial intelligence