The Efficiency and Efficacy of On-Line Vs. Off-Line Cognitive Rehabilitation Therapies: Can a Wireless Interactive Cognitive Rehabilitation System on Dementia Patients Replace Rehabilitation Therapists?

Abstract

There have been increasing attempts to control memory, attention and naming difficulties of the elderly by using game applications on a tablet device. It is necessary to take into account several factors for such attempts to be realized effectively. This study applied the group rehabilitation therapy programs of a wireless interactive cognitive rehabilitation system and of paper-pencil methods to patients with dementia and the elderly with mild cognitive impairment, respectively, and sought to present the factors to be considered in order to achieve both efficiency and efficacy of cognitive rehabilitation therapies. The mild cognitive impairment group had few difficulties in participating in games connected with multi-users, understanding training directions and adjusting a training level of difficulty and speed, whereas the mild AD group, whose cognition fell below -2SD in normative data, had difficulties while a group rehabilitation program was being carried out with only one therapist and a device, and were continually directed one to one on how to use the device. In the therapy program of a paper & pencil method, while the mild cognitive impairment group understood clearly every task, the dementia group could complete the task only under assistant's repeated directions and explanation. The reason why engineering techniques have been applied in cognitive rehabilitation training programs for the elderly with dementia is the advantages of such programs like immediate feedback depending on user's performance and a decreased burden of labor force. It is cognitive functions of the device user that serve as a highly significant variable to predict efficiency and effectiveness of such engineering techniques.