• Title/Summary/Keyword: cognitive assessment

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Targeting motor and cognitive networks with multichannel transcranial direct current stimulation along with peripheral stimulation in a subacute stroke survivor: single case study

  • Midha, Divya;Arumugam, Narkeesh
    • Physical Therapy Rehabilitation Science
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    • v.9 no.4
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    • pp.318-323
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    • 2020
  • Objective: Reacquisition of motor functions following stroke depends on interhemispheric neural connections. The intervention highlighted in the present case is an insight for augmenting motor recovery by stimulating the lesioned area and adjacent areas governing the motor behaviour of an individual. The purpose of this study was to determine the changes in the motor and cognitive outcomes through multi target stimulation of cortical areas by application of multichannel transcranial direct current stimulation (M-tDCS) in a stroke survivor. Design: A case report. Methods: The patient was a participant of a trial registered with the clinical trial registry of India (CTRI/2020/01/022998). The patient was intervened with M-tDCS over the left primary motor cortex i.e. C3 point and left dorsolateral prefrontal cortex i.e. F3 point with 0.5-2 mA intensity for the period of 20 minutes. SaeboFlex-assisted task-oriented training, functional electrical stimulation over the lower extremity (LE) to elicit dorsiflexion at the ankle and eversion of the foot, and conventional physiotherapy rehabilitation including a tailored exercise program were performed. Outcome assessment was done using the Fugl-Meyer assessment scale (FMA) for the upper and lower extremity (UE and LE), Montreal Cognitive Assessment (MOCA), Wisconsin Gait Scale (WGS) and the Stroke Specific Quality of Life (SSQOL) measures. Assessment was taken at Day 0, 15 and 30 post intervention. Results: Improvement was observed in all the outcome measures i.e FMA (UE and LE), MOCA, SSQOL and WGS across the span of 4 weeks. Conclusions: M-tDCS induced improvement in motor functions of the UE and LE, gait parameters and cognitive functions of the patient.

Cognitive Function Affecting Self-reported Driving Test of Mild Cognitive Impaired Elderly Driver in The Community (지역사회 거주 경도인지장애 노인 운전자의 자가-보고식 평가 수행에 영향을 미치는 인지기능)

  • Choi, Seong-Youl
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.19 no.12
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    • pp.178-185
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    • 2018
  • A self-report evaluation is used to prevent driving accidents by elderly drivers. The majority of normal older adults may have mild cognitive impairment with reduced cognitive function. These depressed cognitive functions may be variables that affect the performance of elderly drivers. This study confirmed the cognitive functions that affect the self-reported evaluation for elderly drivers with mild cognitive impairment. Based on the results of the Korean Version of the Montreal Cognitive Assessment, 103 elderly drivers were classified into mild cognitive impairment and normal groups of elderly drivers. The Korean-Drivers 65 plus scores used in the self-reported evaluation of the two groups were compared, and the cognitive functions affecting the evaluation were analyzed. Results found the mild cognitive impairment group showed a significantly lower evaluation performance compared to the normal group, and the self-reported evaluation results of the elderly driver with mild cognitive impairment showed a significant correlation between visuoconstructional skills and delayed recall. As a result of regression analysis, the visuoconstructional skill was identified as the cognitive function with the strongest influence on the self-reported evaluation performance. Delayed recall was also found to have a partial effect but not at the level of altering the self-reported evaluation results of the elderly driver with mild cognitive impairment.

Analysis of Correlation between Students' Cognitive Level and Cognitive Demand of Activities in 'Mirror and Shadow' Unit ('거울과 그림자' 단원 수업 활동의 인지요구도와 학생의 인지수준과의 관계 분석)

  • Lee, Doyi;Jhun, Youngseok
    • Journal of Korean Elementary Science Education
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    • v.37 no.3
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    • pp.285-295
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    • 2018
  • The purpose of this study is comparing cognitive development of elementary $4^{th}$ graders and cognitive demand of activities in lesson 'The mirror and the shadow.' Also, the researchers tried to reveal how cognitive development of elementary $4^{th}$ graders and cognitive demand of textbook activities affects the achievement of students. To study students' cognitive development, the researchers use GALT(Group Assessment of Logical Thinking). Piaget's scientific thinking is used to evaluate cognitive demand of textbook activities. With several experts in science education the researchers discussed which scientific thinking is contained in each activities. The results were followed as : (1) The third of activities are significantly affected by students' cognitive development. (2) The another third of activities are influenced by not only students' cognitive development but also other factors experimental instrument. (3) The environmental factors had meaningful impact on the other third of activities.

A Systematic Review of the Application Nonpharmacological Cognitive Interventions in Patients With Dementia (치매 환자에게 적용된 비약물적 인지중재방법에 대한 체계적 고찰)

  • Kwak, Ho-Soung;Park, Ji-Hyuk
    • Korean Journal of Occupational Therapy
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    • v.26 no.4
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    • pp.13-26
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    • 2018
  • Objective : The aim of the study was to investigate the application of nonpharmacological cognitive interventions in patients with dementia. Methods : We searched published studies in KISS, PubMed, and Sciencedirect databases from January 2013 to December 2017. The main keywords used were "Dementia" AND "Cognitive stimulation OR Cognitive rehabilitation OR Cognitive training" and a total of ten studies were selected for analysis from 753 searched articles. Results : Seven of the ten selected studies showed significant improvements in cognitive function after intervention, whereas three studies showed no improvement in cognitive function; however, activation of brain waves, improvement in the relationship between care givers and patients, improvement in the quality of life of care givers, and improvements in visual motor skills were shown. Mini-Mental State Examination(MMSE) was used as the assessment tool for identifying the effects of the cognitive function improvement, and in four studies the quality of life of dementia patients was measured as an intervention effect. The main subject of the cognitive intervention is patients with mild to moderate dementia. Conclusion : The results of this study can be used as a basis for the selection of intervention methods, as well as their duration and assessment, according to the characteristics of dementia patients.

High School Students' Perceptions on Descriptive Assessment Activity Experiences by Teacher or by Peer (서술형 평가에서의 교사평가와 동료평가 활동 경험에 따른 고등학생들의 인식)

  • Paik, Seoung Hye;Ryu, Hye Jung
    • Journal of The Korean Association For Science Education
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    • v.34 no.6
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    • pp.593-599
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    • 2014
  • The purpose of this study is to figure out the influence on the students' achievement of the cognitive and the affective domains by descriptive items assessment of teacher or peer and to obtain implications by analyzing the students' satisfaction and the reliability of the assessment. For this purpose, two classes of 11th grade students located in a small city were selected and took an exam related to the cognitive and the affective domains before and after the assessment. The assessment activities were carried out during 10 lessons and the teacher gave feedback to the students of the teacher assessment class in the lessons. In the peer assessment class, a small-size student group discussion and feedback were given to the students after the exam. The results show that higher level achievement group students represented relatively positive satisfaction on teacher assessment, and lower level achievement group students represented positive satisfaction on peer assessment. In spite of the same marker list, higher level achievement group students represent relatively high reliability than lower level achievement group students. The lower level achievement group students in the peer assessment class got statistically meaningful improvement of achievement than the students of teacher assessment class. The peer assessment activity was positively influenced on the affective domain of the lower level achievement group students, especially signigicant meaning of statistics was found on the students' perception about science.

Cognition and Upper-extremity Function Influence on Performance of Activities of Daily Living in Patients with Chronic Stroke (인지능력과 상지기능이 만성 뇌졸중 환자의 일상생활동작에 미치는 영향)

  • Roh, Hyo-Lyun;Kim, Chan-Woo
    • Journal of the Korean Society of Physical Medicine
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    • v.14 no.4
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    • pp.115-123
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    • 2019
  • PURPOSE: This study compared the scores of the Mini-Mental State Examination-Korean version (MMSE-K) and Korean version Montreal Cognitive Assessment (K-MOCA), which assess cognitive function, the Fugl- Meyer Upper-Extremity Assessment (FMA), which assess the upper extremity function; and Modified Barthel Index (MBI), which that assesses activities of daily living among patients receiving inpatient treatment following a diagnosis of stroke to determine the correlations among MMSE-K, K-MOCA, FMA, and MBI. METHODS: The study assessed the cognitive function using the MMSE-K and K-MOCA, upper extremity function using FMA, and activities of daily living using MBI. The data were analyzed using Pearson's correlation analysis and multiple regression analysis. RESULTS: An analysis of the differences in the MMSE-K, K-MOCA, MBI, and FMA scores according to the affected side, revealed differences in the, K-MOCA scores according to the affected side, where patients with right hemiplegia showed better cognitive function (p <.05). Correlation analysis among MMSE-K, K-MOCA, FMA, and MBI Showed significant correlations (p <.05). The results indicate that those with higher cognitive and upper extremity functions had higher performance of activities of daily living. CONCLUSION: The cognitive and upper extremity functions were correlated with the activities of daily living in stroke patients. Accordingly, applying physical therapy with a focus on improving the cognitive function and training activities of daily living could assist in the functional recovery of stroke patients significantly.

Validation of MoCA-MMSE Conversion Scales in Korean Patients with Cognitive Impairments

  • Jung, Young Ik;Jeong, Eun Hye;Lee, Heejin;Seo, Junghee;Yu, Hyun-Jeong;Hong, Jin Y.;Sunwoo, Mun Kyung
    • Dementia and Neurocognitive Disorders
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    • v.17 no.4
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    • pp.148-155
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    • 2018
  • Background and Purpose: Two conversion scales between the Mini-Mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA) have been validated for Korean patients with Parkinson's disease. The aim of the present study was to validate these conversion scales for all patients with cognitive impairments regardless of dementia subtype. Methods: Medical records of 323 subjects who completed both MMSE and MoCA on the same day were retrospectively reviewed. Mean, median, and root mean squared error (RMSE) of the difference between true and equivalent MMSE scores were calculated. Intraclass correlation coefficients (ICCs) between true and equivalent MMSE scores were also calculated. The validity of MoCA-MMSE conversion scales was evaluated according to educational level (low educated: ${\leq}6$ years; high educated: ${\geq}7$ years) and subtypes of cognitive impairment. Results: The difference between true and equivalent MMSE scores had a median value of 0, a mean value of 0.19 according to the van Steenoven scale, a mean value of 0.57 according to the Lawton scale, RMSE value of 2.2 according to the van Steenoven scale, and RMSE value of 0.42 according to the Lawton scale. Additionally, ICCs between true and equivalent MMSE scores were 0.92 and 0.90 on van Steenovan and Lawton conversion scales, respectively. These results were maintained in subgroup analyses. Conclusions: Findings of the present study suggest that both van Steenovan and Lawton MoCA-MMSE conversion scales are applicable to transforming MoCA scores into MMSE scores in patients with cognitive impairments regardless of dementia subtype or educational level.

Effects of a Group Computerization Cognitive Rehabilitation Program on Cognitive Function in Patients with Cognitive Impairment (그룹 전산화 인지 재활 프로그램이 인지 손상 환자의 인지 기능에 미치는 효과)

  • Shin, Jae-Wook;Han, Hye-Kyung;Shin, Sang-Hwa;Park, Jae-Sung;Park, Chan-Hyo;Kim, Hye-Jin;Kim, Dong-In
    • PNF and Movement
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    • v.17 no.1
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    • pp.69-79
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    • 2019
  • Purpose: This study aims to investigate the effects of a group computerization cognitive rehabilitation program on cognitive function in patients with cognitive impairment. Methods: The subjects of this study comprised 34 patients with cognitive impairment (15 males and 19 females) who were randomized into two groups. The experimental group (n = 17) were trained with the group computerization cognitive rehabilitation program, while the control group (n=17) received traditional cognitive therapy. The interventions for both groups were performed for 1 hour per day, once a week for 12 weeks. The cognitive functions of the subjects before and after the experiment were measured using the Korean mini-mental state examination (K-MMSE), global deterioration scale (GDS), clinical dementia rating (CDR), and Lowenstein occupational therapy cognitive assessment (LOTCA). A paired t-test was conducted to examine the intragroup differences before and after the experiment, and ANCOVA was performed to check intergroup differences. Results: The intragroup comparison results showed that the cognitive function of the group that were trained with the group computerization cognitive rehabilitation program improved after the experiment more than for the group that received traditional cognitive therapy. The intergroup comparison results showed significant differences in orientation, visual perception, and visuomotor organization between the two groups. Conclusion: The results of this study confirmed that the group computerization cognitive rehabilitation program was more effective in improving cognitive function than the traditional cognitive therapy in patients with cognitive impairment. Based on the results of this study, the group computerization cognitive rehabilitation program can be used as an effective intervention method for patients with cognitive impairment.

Risk Factors for Cognitive Impairment in Intensive Care Unit Survivors (중환자실 퇴원환자의 인지장애 위험요인)

  • Kang, Ji Yeon;Yi, Bo Kyung
    • Journal of Korean Critical Care Nursing
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    • v.13 no.3
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    • pp.75-85
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    • 2020
  • Purpose : This study aimed to identify the prevalence and risk factors of cognitive impairment in survivors discharged from the intensive care unit (ICU). Methods : This secondary analysis study utilized data from a multicenter prospective cohort of post-ICU patients. We analyzed the data of 175 patients enrolled in the primary cohort who completed the cognitive function evaluation three months after ICU discharge. Cognitive function was assessed using the Montreal Cognitive Assessment (MoCA) scale. The cut-off points for cognitive impairment were < 23 for face-to-face evaluation and < 18 for telephone evaluation. Results : The prevalence of cognitive impairment three months after ICU discharge was 32.6%. Significant risk factors for cognitive impairment were age ≥ 60 years (OR=10.52, 95% CI=3.65~30.33, p<.001), education < high school graduation (OR=2.53, 95% CI=1.07~6.01, p=.035), unplanned ICU admission (OR=4.01, 95% CI=1.45-11.14, p=.008), and delirium in the ICU (OR=4.33, 95% CI=1.08-17.23, p=.038). Conclusion : ICU nurses should use preemptive strategies to reduce post-ICU cognitive impairment of patients with risk factors. It is necessary to frequently assess and detect early delirium in critically ill patients, while attempting various non-pharmacological interventions.