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GRADIORCognitive training component

Cognitive training component Gradior

The cognitive training component is a custom developed, stand alone application that will carry out the cognitive training of the elderly. Gradior is a program which offers a structured evaluation and neuropsychological rehabilitation system. This system permits cognitive training and the recovery of higher cognitive functions in people who show cognitive deficit / deterioration, with few technical requirements for the therapist or the professional that supervises the performance of the elderly individual.

The Gradior cognitive evaluation and rehabilitation program is aimed at people with dementia, brain trauma, neuropsychiatric disorders, brain damage, mental impairment, mental illness, and any other type of loss of cognitive skills.

Gradior works on a large number of areas of cognitive ability: attention, perception, memory, and executive functions. It is comprised of four modules: clinical management, treatment management, reports management and rehabilitation sessions. The clinical management module collects data on the patient's clinical history, sociodemographic details, diagnosis, medication and clinical evaluations. The treatment management module allows the therapist to establish an individual treatment regime for the patient using the reports management module, which presents the performance results data of the patient in the form of lists or graphs. The final module is that which provides the exercises in a specialised session for the patient.

With the aim of providing the final users with sessions of cognitive training suitable for the population being studied, activities will be developed which include exercises that increase in difficulty and help to improve retention, concentration and memory, fundamental pillars for maintaining constant activity.

Cognitive training component Gradior

Hardware specifications

In order to use Gradior, a standard, low-cost computer is required, which complies with the minimum requirements necessary for the correct functioning of the Gradior software. The PC should have a touch-screen by which the user can carry out the cognitive training activity.

Characteristics of the proposed equipment (EeeTop PC ET1602)Does it all at a TouchIntuitive and interactive touch screen PC Versatile mobility anywhere at home Connect to the Internet with ease, anytime, anywhere Near-silent operation at just 26 dB Exclusive touch-optimized software applications

Architecture

The GRADIOR programe has been developed according to a client-server architecture, and runs:

a)Local installations. The GRADIOR-client presents all the functionalities, enabling its functioning without internet connection

Patients managerTreatmentsActivities

b)Intranet installations/ intranet-internet installations Main GRADIOR. Gradior-Client with a local database and a Gradior-

Server, that expones to the net this database One or more GRADIOR-Client (Secondary GRADIOR)connected via

webservices to the main GRADIOR

Architecture

1st - 2nd October 2009 - Schwechat

Capability of integration with other management systems

GRADIOR is ready to communicate with other management systems remotely (web based). In the short term we are working on a central management system that integrates vertical services that are already developed (Psicoed platform, tele-health platform, other)

1st - 2nd October 2009 - Schwechat

Capability of integration with other management systems

Software specifications

Interface user therapist: It is comprised of four modules: clinical management, treatment management, reports management and rehabilitation sessions. The clinical management module collects data on the patients’ clinical history, sociodemographic details, diagnosis, medication and clinical evaluations. The treatment management module allows the therapist to establish an individual treatment regime for the patient, using the reports management module, which presents the performance results data of the patient in the form of lists or graphs. The final module is that which provides the exercises in a specialised session for the patient.

With the clinical specifications in mind, activities will be designed comprising of the following cognitive areas: Attention, Perception, Memory and Reasoning. As the level of difficulty increases, so too does the complexity of the exercises displayed. It is advisable to start at the lowest level of difficulty and when the exercises are completed without mistakes, change to a level of greater difficulty. Each group is comprised of a set of different exercises that are presented at random for a determined length of time.

Memory: An activity that contains exercises related to verbal, graphic and auditory memory. These are exercise related to retention and recognition, in this way allowing for the practice of memorization. There are 6 levels of difficulty.

Software specifications

Attention: Incorporates exercises for the practicing of visual and auditory attention. There are various models of exercises which favour concentration. There are 6 levels of difficulty.

Perception: Includes exercises of perception such as the recognition of colours, shapes, faces and movement that help to improve the sharpness of visual perception. There are 6 levels of difficulty.

Reasoning: Includes exercises with analogies, ordering (both graphic and verbal) and observation. All of which favour both inductive and deductive reasoning. There are 3 levels of difficulty.

User-Patient Interface: Through this interface the patient carries-out the cognitive training activities, the LLM system implements Gradior through web services

Software specifications

Scenario of a cognitive activity

VISOR DE PRUEBAS  Scene Title Implementation of the cognitive tests

Preconditions There should be a Gradior Version with the entire set of cognitive activities installed in the computer.

Who starts The user (initiates the installation process). Manager LLM

Who finishes The system

Post conditions The system compiles the results of the execution of the tests, and they are sent to the central Management system through web services.

Exceptions

Description (steps) Step Description of the step Comments

User 0 Start of the implementation process of a test or a set of tests

The implementation of the test consists of the following of a steps outlined in the design of the test. Firstly, a presentation is shown, later the exercise is shown and finally a response is given

System 1 The system implements the test

The system interprets the reactions and responses of the subject

The system stores the results of the test in a xml file

The system indicates to the user that the activity has finished

The system determines if it is just one test or a set of tests

The system carries-out the tests that make up the activity sequentially

The system compiles the results

System 2 The system sends the results of implementation to the central manager of the LLM by means of the corresponding web service.

Variable included by the system: correct response, error, error by omission, reaction times, total number of stimulus, number of critical stimulus, duration of exercise.

Diagram of a cognitive activity

The availability of the application in various languages will be achieved through the use of XML files located in the Languages subdirectory that should be found in the directory of the application.

If there is no file in this directory, it will be operated, by default, in the language in which the application was created; Spanish (Castellano)

The structure of the language files is the following: [Name].[ language code].idm

The code is comprised of an ISO-639-27 code in small case letters, followed by a hyphen and an ISO-3166-A28 code in capital letters.

Gradior Localization of Cognitive Training Component

User-therapist Interface: It is comprised of four modules: clinical management, treatment management, reports management and rehabilitation sessions. The clinical management module collects data on the patients’ clinical history, sociodemographic details, diagnosis, medication and clinical evaluations. It is implemented in Spanish and it is foreseen that it will be translated into English and French.

Gradior Localization of Cognitive Training Component

Gradior Localization of Cognitive Training Component

On one hand, in so far as the operational software for the cognitive training exercises (user interface) is concerned, the elements that appear on screen will be translated taking into account local linguistic customs and idioms. On the other hand, the multimedia contents (sounds that form the instructive phrases, implementation phrases, positive and negative reinforcement)

Gradior Localization of Cognitive Training Component

GRADIOR needs certain information to execute the activities, such as the ID of the elderly individual and the Username and Password that are required to interact with the Web Service. GRADIOR presumes that the latter values correspond to an elderly individual, although, it allows for other types of user as well, as it could be a specific user of Gradior. This information must be sent by means of a command line.

GRADIOR can also configure other types of information that does not change so frequently, such as the names of the activities, the name of the component, and even the URL where the Web Service is located. A part of this information can be sent through command line, however, GRADIOR also allows for configuration through the Windows Registry. If a value is not specified in the Windows registry, GRADIOR has per default values in the source code.

Once GRADIOR has this information, it executes the activities and sends back a value through Web Services API.

Development and Integration of GADIOR

Gradior allows the below mentioned parameters of the command line:

id: Identification of the elderly individual. This parameter is mandatory. usr: Username to be used to access the Web Service API Methods. pwd: Password to be used to access the Web Service API methods. actname: Name of the activity. Used by GRADIOR to obtain the identification of

the activity through the Webservices API (optional). comname: Name of the component. Used by GRADIOR to obtain the

identification of the component through the Web Services API (optional).

The parameters must be preceded by a hyphen (-) and followed by an equals sign (=), and the last value of the parameter in quotation marks (“). An example could be:

Gradior.exe –id=”55” –usr=”senior1” –pwd=”0987”

Development and Integration of GADIORConfiguration of GRADIOR by means of a command line

When GRADIOR is executed by means of parameters, it carries out the following functions:

It establishes the values founded in the registry in the corresponding variables.It establishes, in the corresponding variables, the values to be introduced by command line.If there is any variable needed, such as the Id, the Username or Password, the programme stops the execution and exits, sending back a 1 value to the command line.It creates a Web Service object, using for that purpose the default URL or the one that has been established in the Windows Registry. If the object cannot be created, the programme stops and sends back a 1 value by the command line.

Validation of GADIOR

The exsistence of the user is confirmed, by user_username_exists(). If the user does not exist, the programme stops the execution and sends back a 1 value to the command line.

The correct functioning of the password is checked, by find_username_and_password() through the API Web Service.

The component Identification, that must be used at the moment of saving the activity, is obtained by way of a method called GETCTCComponent(0, username, password), later confirming the name of the component that Gradior has in the list that this method sends back. If the identification cannot be found, the programme stops its execution sending back a 1 value to the command line.

The list of the activities is obtained by means of GetCTCActivity(0, UserName, Password). It identifies all the activities whose name coincides with the one which GRADIOR has. If it can not find any activity, the programme stops its execution sending back a 1 value to the command line.

Validation of GADIOR

The level to be shown to the elderly individual is calculated thus; the list of the activities carried out by the senior is obtained by way of getCTCSeniorActivity(0, IdSenior, 0, IdComponent, 0, Username, Password),

The level and the score of the last activity performed is checked, and the following verifications are made:

If Score is higher than 50, it is increased Level. If Score is between 50 and 25, it is maintained Level. If Score is lower than 25, it is diminished Level. Once the level is obtained, the activity is presented to the elderly

individual.

Validation of GADIOR

Once the activity is finished, the percentage of correct answers is calculated, an object CTCActivity is created, the data for this object is filled-out and it is saved by means of AddCTCSeniorActivity(NewActivity, Username, Password). After performing this action, the programme stops its execution and returns back an 0 value if the data has been correctly sent and a 2 value if the data has not been correctly sent.

Validation of GADIOR