Photo-Realistic Interactive Virtual Environments for Neurorehabilitation in Mild Cognitive Impairment (NeuroVRehab.PT): A Participatory Design and Proof-of-Concept Study.

Filipa Ferreira-Brito,Tiago Guerreiro,Sérgio Alves,Cátia Caneiras,Ana Verdelho,Luís Carriço,Osvaldo Santos

doi:10.3390/jcm9123821

Filipa Ferreira-Brito, Tiago Guerreiro + Show 5 more

Open Access

https://doi.org/10.3390/jcm9123821

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Abstract

Mild cognitive impairment (MCI) is characterized by cognitive, psychological, and functional impairments. Digital interventions typically focus on cognitive deficits, neglecting the difficulties that patients experience in instrumental activities of daily living (IADL). The global conjecture created by COVID-19 has highlighted the seminal importance of digital interventions for the provision of healthcare services. Here, we investigated the feasibility and rehabilitation potential of a new design approach for creating highly realistic interactive virtual environments for MCI patients’ neurorehabilitation. Through a participatory design protocol, a neurorehabilitation digital platform was developed using images captured from a Portuguese supermarket (NeuroVRehab.PT). NeuroVRehab.PT’s main features (e.g., medium-sized supermarket, the use of shopping lists) were established according to a shopping behavior questionnaire filled in by 110 older adults. Seven health professionals used the platform and assessed its rehabilitation potential, clinical applicability, and user experience. Interviews were conducted using the think-aloud method and semi-structured scripts, and four main themes were derived from an inductive semantic thematic analysis. Our findings support NeuroVRehab.PT as an ecologically valid instrument with clinical applicability in MCI neurorehabilitation. Our design approach, together with a comprehensive analysis of the patients’ past experiences with IADL, is a promising technique to develop effective digital interventions to promote real-world functioning.

Highlights

Mild cognitive impairment (MCI) was initially conceptualized as a clinical entity affecting the cognitive functioning exclusively [1]
Studies conducted in Vascular mild cognitive impairment (VaMCI) patients are scarce, with even fewer studies focused on the development of rehabilitation instruments which target cognitive and functional impairments simultaneously
Sixty-one participants (58.1%) claimed that they have an estimation of how much they will spend before going to the checkout counter, and 33 (35.9%) stated that, after being informed of the value of the bill, they know precisely how much they should receive in return

Summary

Introduction

Mild cognitive impairment (MCI) was initially conceptualized as a clinical entity affecting the cognitive functioning exclusively (i.e., memory capacity) [1]. Empirical evidence has shown that cognitive and functional impairments co-exist from very early stages of the disease [2], and difficulties in instrumental activities of daily living (IADL) are prevalent among MCI patients [3]. Vascular mild cognitive impairment (VaMCI) is a clinical condition of vascular etiology, in which executive deficits are a prominent feature [4,5] and a strong predictor of functional decline and dementia [6]. Studies conducted in VaMCI patients are scarce, with even fewer studies focused on the development of rehabilitation instruments which target cognitive and functional impairments simultaneously. Several virtual environments (VEs) have been developed targeting IADL, such as preparing meals [13,14], moving within the community [15,16], and cleaning and maintaining the house [17,18,19,20]

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