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The evaluation of the efficacy of technology in the assessment and rehabilitation of brain-damaged patients

Objective

The general objective of the concerted action was to harmonize the developments of assessment and long-term training programmes in the countries of the ECs in order to arrive at a scientifically founded and clinically justified pool of primarily computer-based rehabilitation programmes that the participating centres can make use of, adapt to their needs and evaluate. We thereby concentrated on those pathologies that occur most frequently and for which interdisciplinary approaches have been developed.
A pool of primarily computer based assessment and rehabilitation programmes for the treatment of brain damaged patients has been established to harmonize developments in European Community (EC) countries. This pool contains the following assessment procedures: batteries for the diagnosis of attention disorders, visual hemineglect, disorders of short term visual memory and procedural learning aphasia type and severity, naming disorders and acalculia. Normative data have been collected for all test batteries and standardization has been achieved for the attention and aphasia test batteries. The following rehabilitation programmes were developed, adapted for the respective languages and partially evaluated in multicentric studies: training programmes for attention disorders, visual hemineglect, everyday memory disorders (imagery as a therapeutic mnemonic), several aphasia therapy programmes and a self adapting training programme (expert system) for the treatment of acalculia. This pool of programmes provides the basis for the commercial development of a European standardized computerized assessment procedure for the evaluation and rehabilitation of brian damaged patients. This will assist patients in regaining lost functions or in learning strategies to help cope with everyday life situations in spite of their handicaps, thereby taking into consideration the social, emotional and motivational factors of the individuals treated.

The results have been partially used to create the basis for a data collection which can be used for further scientific evaluation and which lay the foundation for a targeted neurophysiological control of behavioural change in rehabilitation. The measurement of therapy progress with standardized tests such as those developed in the project can be correlated with or paralleled by studies which investigate changes in the brain during the course of rehabilitation and during spontaneous recovery, using computerised tomography (CT), positron emiss ion tomography (PET), magnetic resonance imaging (MRI) and the latest developments in biomagnetic imaging techniques.
The collective project was subdivided into eight workgroups forming a close network within the total programme. An exchange among the centres enabled the gathering of the appropriate patient data, especially in the carrying-out of clinical single case and group studies.

Study Design and Methodology

The study design consisted in the following step by step procedure, which applied to the eight workgroups mentioned above:

-Exchange and transfer of assessment and treatment materials and programmes
-Integration and adaptation of materials and programmes as well as constructing new batteries; use of authoring software
-Preparation and harmonization of research protocols for international multicentric studies
-Clinical applications (Single Case and Group Studies)
-Collecting data and transferring them to evaluation centres, feedback to study centres
-Interpretation and publication of results
-Planning the continuation of the cooperative research after the end the concerted action.

Funding Scheme

CON - Coordination of research actions

Coordinator

Rheinische Landesklinik Bonn
Address
Kaiser-karl-ring 20
5300 Bonn
Germany