Intervención con personas sin deterioro cognitivo o deterioro cognitivo leve

Intervention for people with mild cognitive impairment and without cognitive impairment


Justification

The intervention will be conducted in a group of people with mild cognitive impairment (MCI) and without cognitive impairment.

The NeuronUP  platform has been used to design the session and the activities chosen from the platform are the most appropriate for clients to achieve the desired outcomes.

NeuronUP is a great tool for cognitive rehabilitation and stimulation. It is based on neuroplasticity, the ability of the brain to change and adapt in response to experience, chemical substances, hormones and/or injuries; neuroplasticity is key to recovery (1).

Short-term memory is one of the first capacities to go in people with MCI, therefore, it is important and necessary to train it. Other functions such as attention and memory will be trained as well.

Objetives

General

To impove and/or maintain short-term memory in people over 65 with mild cognitive impairment and without cognitive impairment.

Specific

To improve implicit and explicit memory as well as semantic memory, to strengthen selective and sustained attention, and to improve visual agnosia.

Methodology

The intervention is based on the Occupational Therapy Practice Framework (AOTA) since performance skills will be impaired, especially cognitive skills that will have an effect on the different areas of occupation and therefore in the clients’ daily life (2).

The dynamics of the session is previously arranged by taking into account the client’s different skills, although it is flexible upon client’s requests or the environment itself. Also, the session lasted 45 minutes and covered various activities, all of which are about 10 minutes long, although they can be modified upon client’s request.

While all activities have both written and auditory information regarding instructions as well as correct and incorrect answers, the occupational therapist will be responsible for explaining them, in addition to ensuring that everyone has understood the activity.

To carry out the intervention it is necessary to have a NeuronUP account and set up a room with a projector, a computer with Internet access, tables and chairs. It is also necessary to have good lighting, no distracting elements (noise), an adequate temperature and a comfortable environment.

Activities

Below is a selection of activities as well as their descriptions and the personalized mode chosen. It is important to bear in mind that it is not necessary to go through all the levels: the participants will simply move up until completing the 10 minutes given per activity.

Memorize the order (open-time period)

This activity involves memorizing the order of the images displayed (they will vary according to difficulty level) and afterwards arranging them in the same manner. I chose the personalized mode and call it “ARRANGE IMAGES.”

General aspects and parameters

  • Operation: correction and maximum number of errors (Level 0=4; Level 1=5; Lvel 2=6; Level 3=6)
  • Maximum time: 4 minutes (per each level)
  • Inactivity warning
  • Show timer
  • Number of items (Level 0=7; Level 1=8; Lvel 2=9; Level 3=10)
  • Category: random
  • Number of exercises: 2

Click on “generate” until you find a suitable worksheet and click on continue and then start.

Solution

A) In the case of exhausting all lives or allowed errors

The solution is automatically given in a gray bar displaying the following:

  • On the left side, the number of correct images out of the total.
  • In the middle, the number of errors made.
  • On the right side, the time taken to complete the activity.

Intervention for people with mild cognitive impairment and without cognitive impairment

Intervention for people with mild cognitive impairment and without cognitive impairment

B) Once the worksheet has been completed correctly

Below the images, a green bar appears displaying the following:

  • On the left side, the number of correct images out of the total.
  • In the middle, the number of errors made.
  • On the right side, the time taken to complete the activity.

Intervention for people with mild cognitive impairment and without cognitive impairment

Intervention for people with mild cognitive impairment and without cognitive impairment

Color Lottery 

Intervention for people with mild cognitive impairment and without cognitive impairment

In this activity, balls of various colors fall from a pipe into a lottery cage. Once the balls are in the cage, it will begin to spin. Clients must memorize the colors of all the balls because one of them will vanish and clients must determine the color of the ball that has vanished. Once clients move up levels, the difficulty increases. In the lower levels, the balls only have one color, but in the more difficult levels, the clients will have to memorize not only the color of the ball itself but also one or two colored stripes that are on the ball.

We choose the personalized mode and call it “COLORFUL BINGO BALLS.”

General aspects and parameters

  • 4 levels (level 0 = 4 balls with no stripes; level 1= 2 balls with one stripe; lvel 2 = 3 balls with one stripe; level 3= 2 balls with two stripes). There are 5 screens on each level.
  • The maximum time for each slide is two minutes for levels 0 and 1, and four minutes for levels 2 and 3.
  • A timer counting down will be displayed.

Once level 0 is completed, clients will move up to the other levels. Click save and then start.

Solution

When the ball vanishes, on the side of the screen, clients will be asked “What ball has vanished?” Clients must then determine the correct color of that ball.

  • In levels 0 and 1, clients must determine the color of the ball itself.
  • In levels 2 and 3, clients must determine the color of the ball and the color of the stripe/s on the ball.

Once all clients reach an agreement regarding the final answer, they can click on the “correct” button. If the answer is correct, they will move on to the next slide. But if it is incorrect, the solution will appear on the screen.

At the bottom of the screen, the total number of slides is displayed, and they turn blue as clients progress.

Home delivery

Intervention for people with mild cognitive impairment and without cognitive impairment

This activity consists of memorizing the order in which buildings light up and reproducing it in reverse.

We choose the personalized mode and call it “THE CITY LIGHTS UP”

General aspects and parameters

  • Operation: correction and maximum number of errors (Level 0=4; Level 1=5; Level 2=6; Lvel 3=6)
  • Maximum time: 4 minutes (per each level)
  • Inactivity warning
  • Show timer
  • Number of exercises/level: 2. When clients complete them, they can move up levels. The level has been determined before the start, based on the level of clients.

There is a countdown from 3 to 1 and the sequence of buildings lighting up starts.

At the top left is the time available for each screen (1 minute); if the time runs out without completion, it will count as an error and the screen will restart.

At the top right is the number of trials starting as 1/4, that is, first trial out of a total of four.

Also, at the bottom of the screen, the total number of slides is displayed, and they turn blue as clients move from screen to screen, completing the different levels.

At the bottom, there is also a pause button and an information button with the explanation of the exercise both in written and auditory form.

If clients answer correctly, they will move up levels (this occurs automatically). However, if they answer incorrectly, the activity will resume at the level they were at up to a maximum of 4 times (maximum number of errors allowed).

Conclusions

In future sessions, the objectives will be modified and activities will be chosen based on the interests, tastes and suggestions of the clients, without diverting from the objectives set for the session.

Bibliography

 

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