This study was supported by research grants from the Ministry of Science and Technology (105-2314-B-002 -015 -MY3).

This study protocol was approved by a local institutional review board, and all patients gave informed consent.
1. Development of the CAT-FAS
<ol>
	<li>Retrieve the secondary and encrypted data from the FAS study14 to conduct simulations (Supplementary File 1: Appendix 2). 
	NOTE: In the study, a total of 301 patients were recruited froma rehabilitation ward of a medical center and assessed at 14 d after stroke onset. Among the 301 patients, 262 patients were repeatedly assessed at 30 d after stroke onset. The study recruited patients who had (1) a diagnosis of stroke, (2) first onset of stroke, (3) onset of stroke within 14 d before hospitalization, (4) the ability to follow commands, and (5) the ability to give informed consent personally or by proxy. Patients who had other major diseases were excluded. In each assessment session, patients were assessed with the FM, PASS, and BI by a well-trained occupational therapist (Supplementary File 1: Appendices 3-5).
	<ol>
		<li>Establish the item bank of the CAT-FAS by adopting the item bank of the FAS (Supplementary File 1: Appendix 2A). 
		NOTE: The item bank has sufficient items fit the Rasch partial credit model15,16 and covers a wide range of item difficulties. The item bank contains 58 items (Supplementary File 1: Appendix 3) selected from the FM-UE (26 items), FM-LE (11 items), PASS (12 items), and BI (nine items).</li>
		<li>Retrieve the item difficulties of all items in the item bank from the FAS study (Supplementary File 1: Appendix 2A - Item difficulty). 
		NOTE: Each item in the item bank has a set of parameters to depict the difficulty of the item (i.e., item difficulties), which are estimated by the Rasch partial credit model. The CAT-FAS uses the item difficulties to (1) select items with difficulties tailored to the examinee&#39;s level of function (step 1.3.3) and (2) estimate the examinee&#39;s level of function (step 1.3.5).</li>
		<li>Retrieve each patient&#39;s responses (e.g., 0, 1, or 2 points) to the items of the item bank of the FAS (Supplementary File 1: Appendix 2B). 
		NOTE: In previous studies14, all items of the item bank of the FAS were administered to the patients. In this simulation study, these responses of the patients were retrieved and used as the simulated responses (patients were not administered by the CAT-FAS) to the items of the CAT-FAS (step 1.3.4).</li>
		<li>Retrieve the ability distribution (i.e., the standard deviation [SD] of the scores) of the patients in the four functions (BADL, postural control, and UE/LE motor functions; Supplementary File 1: Appendix 2C). 
		NOTE: The abilities of the patients in the four functions are the final scores of the assessment of the item bank (Supplementary File 1: Appendix 2C). The scores (and SD of the scores) of the four functions are estimated in a previous study14 by the Rasch partial credit model, based on the patients&#39; responses to each item (step 1.1.3). In this study, the SD of the scores is retrieved and used as prior information to calculate the reliability of the CAT-FAS (step 1.3.6).</li>
	</ol>
	</li>
	<li>Determine the operational algorithms of the CAT-FAS (Supplementary File 1: Appendix 7).
	<ol>
		<li>Adopt the maximum a posteriori (MAP) method for estimating each patient&#39;s scores of the four functions with Newton-Raphson iteration17.</li>
		<li>Use the criterion of D-optimality for the item selection18. An item with the maximum determinant of the Fisher information matrix is selected from the item bank for administration.</li>
		<li>Adopt 10 candidate sets of stopping rules for exploring the properties of the CAT-FAS via simulation (Supplementary File 1: Appendix 8). 
		NOTE: The first five candidate sets are &#34;reaching limited reliability increase (LRI) criterion&#34; (i.e., an LRI &#60; 0.001, &#60; 0.005, &#60; 0.010, &#60; 0.015, or &#60; 0.020). The other five candidate sets are &#34;reaching either LRI criterion or threshold of reliability&#34; (i.e., a Rasch reliability &#8805; 0.90, paired with the aforementioned five LRI criteria). The LRI and threshold of reliability are frequently adopted stopping rules in CATs13,17.</li>
	</ol>
	</li>
	<li>Explore the measurement reliability and efficiency (number of items needed for administration) of the CAT-FAS via steps 1.3.1 to 1.3.11 of simulation (Figure 1). 
	NOTE: Supplementary File 1: Appendix 9 shows the screenshot of the software.
	<ol>
		<li>Use a specified set of stopping rules (i.e., from the first to the last candidate sets of stopping rules which are in step 1.2.3, successively) to explore the properties of the CAT-FAS (Figure 1A).</li>
		<li>Set the initial CAT-FAS scores of the four functions (BADL, postural control, UE motor function, and LE motor function) to 0 for specified patients (i.e., from the first to the last patient in the data, successively; Figure 1B,C).</li>
		<li>Adaptively select an item with the maximum determinant of the Fisher information matrix (i.e., the criterion of D-optimality) from the item bank for administration (Figure 1D). 
		NOTE: The information matrix of each item is calculated based on a patient&#39;s scores of the four functions and the item&#39;s difficulty (from step 1.1.2). To ensure that the CAT-FAS administers at least one item in each function/domain, the first four items of the CAT-FAS are selected from the four functions.</li>
		<li>Obtain the patient&#39;s response to the selected item from step 1.1.3 (Figure 1E).</li>
		<li>Simultaneously estimate the CAT-FAS scores (and standard errors [SEs] of the scores) of the four functions using the MAP method with an iterative Newton-Raphson process (Figure 1F).19 During the iterative Newton-Raphson process, renew the scores and SEs of the four functions in each iteration until the criterion of convergence is met. Convergence occurs when the differences in scores between two consecutive iterations are &#60;0.001.</li>
		<li>Count the number of items which are administered, save the latest renewed CAT-FAS scores (and SEs), and calculate the individual-level Rasch reliability of each function using the following formula: 
		1 - ([SE2 of step 1.3.5] / [SD2 of the scores of step 1.1.4]).</li>
		<li>Calculate the LRI using the last renewed individual-level Rasch reliability (step 1.3.6) minus that of the previous estimation (Figure 1G).</li>
		<li>Check whether the specified set (e.g., the first candidate set) of stopping rules is met (Figure 1H). If not, repeat steps 1.3.3 - 1.3.8 until the specified set of stopping rules is met. If so, save the latest renewed CAT-FAS scores (and SEs) as the final CAT-FAS scores (and SEs).</li>
		<li>Repeat steps 1.3.2 to 1.3.8 until all patients&#39; administrations are completed (Figure 1I).</li>
		<li>Finish the simulation of the CAT-FAS with the specific set of stopping rules and save the results of the simulation (Figure 1J). 
		NOTE: The results should include (1) the final CAT-FAS scores (and SEs) of the four functions, (2) the number of items needed to complete the CAT-FAS, (3) the Rasch reliability of each patient (i.e., individual-level Rasch reliability), and (4) the average Rasch reliability of all patients.</li>
		<li>Repeat steps 1.3.1 to 1.3.11 to explore the properties of the CAT-FAS with other candidate sets of stopping rules until all candidate sets of stopping rules are explored (Figure 1K).</li>
	</ol>
	</li>
	<li>Select the final set of stopping rules for the CAT-FAS according to the average Rasch reliability of &#8805;0.90 in at least three functions and the average items of administration of &#8804;10.0.</li>
	<li>Develop an online administration platform for the CAT-FAS by writing a computer program to establish a website (Supplementary File 1: Appendix 10).</li>
</ol>
2. Administration of the CAT-FAS
<ol>
	<li>Connect the examiner&#39;s electronic device (e.g., personal computer, tablet, or smartphone) to the online administration platform of the CAT-FAS using an internet browser.</li>
	<li>Log in to the administration system (Supplementary File 1: Appendix 11).</li>
	<li>Click Data management to access data from previous examinees (Supplementary File 1: Appendix 12).</li>
	<li>Click New examinee to create an account for a new examinee by entering the examinee&#39;s name and ID number.</li>
	<li>Select an examinee and click Start (Supplementary File 1: Appendix 13).</li>
	<li>Click New assessment to create a new assessment or click Results to review the results of the examinee&#39;s previous assessments.</li>
	<li>Administer the items shown on the screen to the examinee (Supplementary File 1: Appendix 14).</li>
	<li>Rate the examinee&#39;s performance or responses by clicking the rating scale shown at the bottom of the screen(Supplementary File 1: Appendix 14).</li>
	<li>Explain the results of the CAT-FAS to the examinee, including the T-scores with a 95% interval, the percentile ranks of the T-scores, and the reliabilities of the four functions of the CAT-FAS. These results are calculated and shown automatically by the CAT-FAS (Supplementary File 1: Appendix 15).</li>
	<li>Click OK and return to the Data management page.</li>
</ol>

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The authors have nothing to disclose.

The results presented here showed that the CAT-FAS administered about 10% of the items in the original tests (the average number of items used in the CAT-FAS: 8.5 items vs. the original tests: 72 items). These findings indicate that the CAT-FAS has good administrative efficiency. The results were in line with previous studies, which reported that a CAT administered only about 10 items or less to assess social function, balance, or activities of daily living in patients with stroke10,...

Dysfunctions of the upper and lower extremities (UE and LE), postural control, and basic activities of daily living (BADL) are major sequelae of stroke1,2,3. The assessment of these four functions in patients with stroke is fundamental for clinicians to evaluate patients' levels of dysfunctions, set treatment goals and plans, and monitor the longitudinal trajectories of these functions.
The Fugl-Meyer Assessment (FM),4 the Postural Assessment Scale for Stroke patients (PASS),5 and the Barthel Index (BI)6 have good psychometric properties to assess the UE/LE motor functions, postural control, and BADL, respectively, in patients with stroke7,8,9. However, the total of 72 items from these three measures impedes the feasibility of assessing all three measures within a time-limited therapeutic session. A more efficient testing method is warranted. Computerized adaptive testing (CAT) is a modern measurement method. Compared with conventional measurement methods, CAT provides a more reliable estimate of the examinee's level of function in much less time10,11,12. In conventional measurement methods, each examinee receives the same test form (or item sets), in which many items are too difficult or too easy for the examinee. These items provide limited information for estimating the examinee's level of function and are time-intensive for examinees. In contrast, in CAT, each examinee gets a tailored item set, in which the difficulty level of the selected items meets the function level of the examinee. Because these items are tailored for that particular examinee, CAT can provide a more reliable estimate of the examinee's level of function with fewer items and, thus, in much less time. The steps of CAT development are shown in Supplementary File 1: Appendix 1.
Because CAT promises reliable and efficient assessments, the CAT-FAS was developed to improve the administrative efficiency of the three measures previously used (FM, PASS, and BI)13. This paper describes the development and administration of the CAT-FAS. This protocol provides information for researchers to develop their CATs and for prospective users of the CAT-FAS to administer it. We also address the strengths and weaknesses of the CAT-FAS.

<table><tbody><tr><td>Computer</td><td>Any</td><td></td><td>Compatible with software listed below</td></tr><tr><td>MATLAB software</td><td>The MathWorks Inc.</td><td>http://www.mathworks.com/products/matlab/</td><td>Numerical computing software, which is used in the Protocol Section 1 (Step 1.3)</td></tr><tr><td>Java Development Kit</td><td>Oracle</td><td>https://www.oracle.com/java/</td><td>Programming language, which is used in the Protocol Section 1 (Step 1.5)</td></tr></tbody></table>

computerized adaptive testing system of functional assessment of stroke

The computerized adaptive testing system of the functional assessment of stroke (CAT-FAS) can simultaneously assess four functions (motor functions of the upper and lower extremities, postural control, and basic activities of daily living) with sufficient reliability and administrative efficiency. CAT, a modern measurement method, aims to provide a reliable estimate of the examinee's level of function rapidly. CAT administers only a few items whose item difficulties match an examinee's level of function and, thus, the administered items of CAT can provide sufficient information to reliably estimate the examinee's level of function in a short time. The CAT-FAS was developed through four steps: (1) determining the item bank, (2) determining the stopping rules, (3) validating the CAT-FAS, and (4) establishing a platform of online administration. The results of this study indicate that the CAT-FAS has sufficient administrative efficiency (average number of items = 8.5) and reliability (group-level Rasch reliability: 0.88 - 0.93; individual-level Rasch reliability: &#8805;70% of patients had Rasch reliability score &#8805;0.90) to simultaneously assess four functions in patients with stroke. In addition, because the CAT-FAS is a computer-based test, the CAT-FAS has three additional advantages: the automatic calculation of scores, the immediate storage of data, and the easy exporting of data. These advantages of the CAT-FAS will be beneficial to data management for clinicians and researchers.

The results of the simulation showed that the 10 candidate sets of stopping rules had sufficient average Rasch reliability (0.86 - 0.95) and varied administrative efficiency (the average number of items = 6.4 - 17.5). Considering the trade-off between reliability and administrative efficiency, the set of LRI &#60; 0.010 was selected as the optimal set of stopping rules for the CAT-FAS because of its sufficient average Rasch reliability (0.88 - 0.93, see Table 1</s...

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Computerized Adaptive Testing System of Functional Assessment of Stroke

Here, we present a protocol to develop the computerized adaptive testing system of the functional assessment of stroke (CAT-FAS). The CAT-FAS can simultaneously assess four functions (two motor functions [upper and lower extremities], postural control, and basic activities of daily living) with sufficient reliability and administrative efficiency.

The computerized adaptive testing system of the functional assessment of stroke (CAT-FAS) can simultaneously assess four functions (motor functions of the ...

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5.8K Views.  National Taiwan University. Het algemene doel van deze testontwikkelingsstudie is het ontwikkelen van een geautomatiseerd adaptief testsysteem om de functies van het bovenste uiteinde, het onderste uiteinde, evenwicht en activiteiten van het dagelijks leven bij beroertepatiënten te beoordelen. Geen andere tractive efficiëntie wordt gevonden bij de beoordeling van de functies van de bovenste extremiteit, onderste extremiteit, evenwicht, en activiteiten van het dagelijks leven met patiënten van een beroerte. De geautom...

Video: Computerized Adaptive Testing System of Functional Assessment of Stroke

Development of a Virtual Reality Assessment of Everyday Living Skills

Cognitive impairments affect the majority of patients with schizophrenia and these impairments predict poor long term psychosocial outcomes.&#160; Treatment studies aimed at cognitive impairment in patients with schizophrenia not only require demonstration of improvements on cognitive tests, but also evidence that any cognitive changes lead to clinically meaningful improvements.&#160; Measures of &#8220;functional capacity&#8221; index the extent to which individuals have the potential to perform skills required for real world functioning. &#160;Current data do not support the recommendation of any single instrument for measurement of functional capacity.&#160; The Virtual Reality Functional Capacity Assessment Tool (VRFCAT) is a novel, interactive gaming based measure of functional capacity that uses a realistic simulated environment to recreate routine activities of daily living. Studies are currently underway to evaluate and establish the VRFCAT&#8217;s sensitivity, reliability, validity, and practicality.&#160;This new measure of functional capacity is practical, relevant, easy to use, and has several features that improve validity and sensitivity of measurement of function in clinical trials of patients with CNS disorders.

A challenge for proving treatment efficacy for cognitive impairments in schizophrenia is finding the optimizing measurement of skills related to everyday functioning.&#160; The Virtual Reality Functional Capacity Assessment Tool (VRFCAT) is an interactive gaming based computerized measure aimed at skills associated with everyday functioning, including baseline impairments and treatment related changes.

Cognitive impairments affect the majority of patients with schizophrenia and these impairments predict poor long term psychosocial outcomes.&#160; ...

Eye-Tracking Control to Assess Cognitive Functions in Patients with Amyotrophic Lateral Sclerosis

Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disorder with pathological involvement of upper and lower motoneurons, subsequently leading to progressive loss of motor and speech abilities. In addition, cognitive functions are impaired in a subset of patients. To evaluate these potential deficits in severely physically impaired ALS patients, eye-tracking is a promising means to conduct cognitive tests. The present article focuses on how eye movements, an indirect means of communication for physically disabled patients, can be utilized to allow for detailed neuropsychological assessment. The requirements, in terms of oculomotor parameters that have to be met for sufficient eye-tracking in ALS patients are presented. The properties of stimuli, including type of neuropsychological tests and style of presentation, best suited to successfully assess cognitive functioning, are also described. Furthermore, recommendations regarding procedural requirements are provided. Overall, this methodology provides a reliable, easy to administer and fast approach for assessing cognitive deficits in patients who are unable to speak or write such as patients with severe ALS. The only confounding factor might be deficits in voluntary eye movement control in a subset of ALS patients.

Cognitive deficits are common in about one third of patients with amyotrophic lateral sclerosis, a neurological condition leading to progressive impairments in speech and movement abilities. To conduct cognitive tests in patients unable to speak or write a reliable and easy to administer eye-tracking paradigm was developed.

Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disorder with pathological involvement of upper and lower motoneurons, subsequently leading to ...

The Multiple Sclerosis Performance Test (MSPT): An iPad-Based Disability Assessment Tool

Precise measurement of neurological and neuropsychological impairment and disability in multiple sclerosis is challenging. We report a new test, the Multiple Sclerosis Performance Test (MSPT), which represents a new approach to quantifying MS related disability. The MSPT takes advantage of advances in computer technology, information technology, biomechanics, and clinical measurement science. The resulting MSPT represents a computer-based platform for precise, valid measurement of MS severity. Based on, but extending the Multiple Sclerosis Functional Composite (MSFC), the MSPT provides precise, quantitative data on walking speed, balance, manual dexterity, visual function, and cognitive processing speed. The MSPT was tested by 51 MS patients and 49 healthy controls (HC). MSPT scores were highly reproducible, correlated strongly with technician-administered test scores, discriminated MS from HC and severe from mild MS, and correlated with patient reported outcomes. Measures of reliability, sensitivity, and clinical meaning for MSPT scores were favorable compared with technician-based testing. The MSPT is a potentially transformative approach for collecting MS disability outcome data for patient care and research. Because the testing is computer-based, test performance can be analyzed in traditional or novel ways and data can be directly entered into research or clinical databases. The MSPT could be widely disseminated to clinicians in practice settings who are not connected to clinical trial performance sites or who are practicing in rural settings, drastically improving access to clinical trials for clinicians and patients. The MSPT could be adapted to out of clinic settings, like the patient&#8217;s home, thereby providing more meaningful real world data. The MSPT represents a new paradigm for neuroperformance testing. This method could have the same transformative effect on clinical care and research in MS as standardized computer-adapted testing has had in the education field, with clear potential to accelerate progress in clinical care and research.

The Multiple Sclerosis Performance Test MSPT: An iPad-Based Disability Assessment Tool

Precise measurement of neurological and neuropsychological impairment and disability in multiple sclerosis is challenging. We report methodologic details on a new test, the Multiple Sclerosis Performance Test (MSPT). This new approach to the objective of quantification of MS related disability provides a computer-based platform for precise, valid measurement of MS severity.

Precise measurement of neurological and neuropsychological impairment and disability in multiple sclerosis is challenging. We report a new test, the ...

Medicine

Quantitative Static and Dynamic Assessment of Balance Control in Stroke Patients

In patients with stroke, damage to the central nervous system (CNS) can affect the postural stability and increase the risk of falling. Therefore, accurately assessing the balance is important to understand the type, extent, and causes of balance deficit, and to identify individualized interventions. Clinical assessment methods for balance function can be broadly divided into observation, scale assessment, and balance instrument testing. Here, a clinical protocol is presented for static and dynamic balance assessment in stroke patients, which includes three semiquantitative balance function scale assessments (i.e., Berg Balance Scale, Timed Up and Go Test, and Fugl-Meyer Assessment) and three quantitative instrumental balance evaluation (i.e., Stability Assessment Module, Proprioceptive Assessment Module, and Limit of Stability Module). It is recommended that clinicians consider the use of both classic clinical balance scales and instrumental balance measurements when assessing stroke patients to improve the accuracy of assessments, leading to a better individualized treatment plan.

Presented here is a quantitative, clinical balance assessment method suitable for stroke patients with balance disorders.

In patients with stroke, damage to the central nervous system (CNS) can affect the postural stability and increase the risk of falling. Therefore, ...

Determining the Functional Status of the Corticospinal Tract Within One Week of Stroke

High interindividual variability in the recovery of upper limb (UL) function after stroke means it is difficult to predict an individual&#39;s potential for recovery based on clinical assessments alone. The functional integrity of the corticospinal tract is an important prognostic biomarker for recovery of UL function, particularly for those with severe initial UL impairment. This article presents a protocol for evaluating corticospinal tract function within 1 week of stroke. This protocol can be used to select and stratify patients in trials of interventions designed to improve UL motor recovery and outcomes after stroke. The protocol also forms part of the PREP2 algorithm, which predicts UL function for individual patients 3 months poststroke. The algorithm sequentially combines a UL strength assessment, age, transcranial magnetic stimulation, and stroke severity, within a few days of the stroke. The benefits of using PREP2 in clinical practice are described elsewhere. This article focuses on the use of a UL strength assessment and transcranial magnetic stimulation to evaluate corticospinal tract function.

This protocol is for evaluating corticospinal tract function within 1 week of stroke. It can be used to select and stratify patients in trials of interventions designed to improve upper limb motor recovery and outcomes and in clinical practice for predicting upper limb functional outcomes 3 months after stroke.

High interindividual variability in the recovery of upper limb (UL) function after stroke means it is difficult to predict an individual&#39;s potential ...

Neuroscience

A Computerized Functional Skills Assessment and Training Program Targeting Technology Based Everyday Functional Skills

Today, many functional skills are technology-based, so development of a technology-based training program has broad importance. Here we present a computerized functional skills training program that was paired in half of the participants with a commercially available cognitive training (CCT) program.
Non-impaired older individuals (NC) aged 60+ (n=45) and similarly aged individuals with mild cognitive impairment (MCI; n=50) were randomized to receive 12 weeks of twice-weekly computerized functional skills training (CFST) or 12 weeks of twice-weekly sessions split between CCT and CFST. Skills trained were use of an ATM; internet banking; ticket kiosk; telephone and internet prescription refill; medication management; and internet shopping. As with previous functional capacity assessments, we focus on completion time for each simulation.
51 participants completed the training program, either by mastering all 6 tasks (34) or completing 12 weeks of training. 44 more participants completed 4 or more training sessions so they were also analyzed for improvement up to their last training session. Completion time for all 6 tests significantly improved from the baseline assessment to the final training session in both groups of participants (all p&#60;0.001 with an average improvement in task completion time of 45%). Further, there was no differential improvement in MCI and NC in the 6 tests from baseline to end of training (all t&#60;1.66, all p&#62;0.12). Finally, combined CCT plus CFST did not differ from CSFT alone on any of the percent-change score measures (all t&#60;1.64, all p&#62;0.11).
Both NC and MCI groups evidenced substantial improvements in performance. CCT supplementation led to similar functional gains with half as many training sessions. The NC participants proceeded through the training fairly rapidly even without CCT supplementation; MCI participants required more training but learned equivalently. These findings suggest that even in cases with memory impairments, functional skills can be efficiently learned with training.

This training protocol uses computerized training to teach technology-related everyday functional skills. These skills include financial skills, travel and transit, as well as medication management.

Today, many functional skills are technology-based, so development of a technology-based training program has broad importance. Here we present a ...

Motor Dual-Tasks for Gait Analysis and Evaluation in Post-Stroke Patients

Eighteen stroke patients were recruited for this study involving the evaluation of cognition and walking ability and multitask gait analysis. Multitask gait analysis consisted of a single walking task (Task 0), a simple motor dual-task (water-holding, Task 1), and a complex motor dual-task (crossing obstacles, Task 2). The task of crossing obstacles was considered to be equivalent to the combination of a simple walking task and a complex motor task as it involved more nervous system, skeletal movement, and cognitive resources. To eliminate heterogeneity in the results of the gait analysis of the stroke patients, the dual-task gait cost values were calculated for various kinematic parameters. The major differences were observed in the proximal joint angles, especially in the angles of the trunk, pelvis, and hip joints, which were significantly larger in the dual motor tasks than in the single walking task. This research protocol aims to provide a basis for the clinical diagnosis of gait function and an in-depth study of motor control in stroke patients with motor control deficits through the analyses of dual-motor walking tasks.

This paper presents a protocol specifically for dual motor task gait analysis in stroke patients with motor control deficits.

Eighteen stroke patients were recruited for this study involving the evaluation of cognition and walking ability and multitask gait analysis. Multitask ...

Dual-Task Stroop Paradigm for Detecting Cognitive Deficits in High-Functioning Stroke Patients

General clinical cognitive assessment scales are not sensitive enough to cognitive impairment in high-functioning stroke patients. The dual-task assessment has advantages for identifying cognitive deficits in high-functioning stroke patients and has been gradually applied in clinical assessment and cognitive training. Moreover, the Stroop paradigm has higher sensitivity and specificity for attentional assessment than conventional clinical cognitive assessment scales. Therefore, this study presents the dual-task assessment based on the Stroop paradigm to identify cognitive deficits in high-functioning stroke patients. This study demonstrates a single- and dual-task evaluation based on the Stroop paradigm and confirms its feasibility through case experiments and synchronized functional near-infrared spectroscopy evaluation. The Stroop reaction time and correct rate are used as the main indicators to evaluate the cognitive level of the subjects. This study protocol aims to provide new ideas to figure out the ceiling effect in general clinical assessment failure for high-functioning stroke patients.

Clinical assessment scales are notsensitive enough to cognitive dysfunction in high-functioning stroke patients. The dual-task paradigm presents advantages and potential in the assessment and cognitive training of cognitive dysfunction. The study here proposes a dual-task Stroop paradigm to identify cognitive dysfunction in high-functioning stroke patients.

General clinical cognitive assessment scales are not sensitive enough to cognitive impairment in high-functioning stroke patients. The dual-task ...

Enhancing Stroke Rehabilitation with Virtual Reality-Based Occupational Training

Cognitive Function and Upper Limb Rehabilitation Training Post-Stroke Using a Digital Occupational Training System

Stroke rehabilitation often requires frequent and intensive therapy to improve functional recovery. Virtual reality (VR) technology has shown the potential to meet these demands by providing engaging and motivating therapy options. The digital occupational training system is a VR application that utilizes cutting-edge technologies, including multi-touch screens, virtual reality, and human-computer interaction, to offer diverse training techniques for advanced cognitive capacity and hand-eye coordination abilities. The objective of this study was to assess the effectiveness of this program in enhancing cognitive function and upper extremity rehabilitation in stroke patients. The training and assessment consist of five cognitive modules covering perception, attention, memory, logical reasoning, and calculation, along with hand-eye coordination training. This research indicates that after eight weeks of training, the digital occupational training system can significantly improve cognitive function, daily living skills, attention, and self-care abilities in stroke patients. This software can be employed as a time-saving and clinically effective rehabilitation aid to complement traditional one-on-one occupational therapy sessions. In summary, the digital occupational training system shows promise and offers potential financial benefits as a tool to support the functional recovery of stroke patients.

Author Spotlight: Rehabilitation of Stroke Patients With a Digital Occupational Training System

The current protocol outlines how the VR-based digital occupational training system enhances the rehabilitation of patients with cognitive impairment and upper limb dysfunction following a stroke.

Stroke rehabilitation often requires frequent and intensive therapy to improve functional recovery. Virtual reality (VR) technology has shown the ...

Transcranial Pulse Stimulation for Alzheimer's Patients

Transcranial pulse stimulation (TPS) is a noninvasive neuromodulation therapy with Conformit&#233; Europ&#233;enne (CE) marking for the treatment of Alzheimer's disease (AD). Initial pilot studies have demonstrated promising effects on cognitive function. This article focuses on the procedure for treating patients with AD using an MRI-guided, neuro-navigated TPS device. The protocol to be followed for this is described in detail, including the necessary procedures and device settings. A brief overview of the representative clinical results published to date is also provided. In addition to significant clinical improvements in cognition and affect, adverse events (AE) and possible adverse device events (ADE) are presented to provide safety data. Finally, the method is critically discussed. In the future, randomized controlled trials should be conducted to rule out any placebo effects. There is also currently a lack of long-term studies with a larger number of patients. Despite these unresolved questions, TPS has the potential as an adjunct treatment for Alzheimer's patients when used in a controlled, scientifically guided setting.

This article describes the procedure of transcranial pulse stimulation in patients with Alzheimer's disease. It discusses the indications, methodology, and future prospects in detail.

Transcranial pulse stimulation (TPS) is a noninvasive neuromodulation therapy with Conformit&#233; Europ&#233;enne (CE) marking for the treatment of ...

Computerized Adaptive Testing System of Functional Assessment of Stroke

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