The efficacy of a task model approach to ADL rehabilitation in stroke apraxia and action disorganisation syndrome: A randomised controlled trial

Abstract

Background Apraxia and action disorganization syndrome (AADS) after stroke can disrupt activities of daily living (ADL). Occupational therapy has been effective in improving ADL performance, however, inclusion of multiple tasks means it is unclear which therapy elements contribute to improvement. We evaluated the efficacy of a task model approach to ADL rehabilitation, comparing training in making a cup of tea with a stepping training control condition. Methods Of the 29 stroke survivors with AADS who participated in this cross-over randomized controlled feasibility trial, 25 were included in analysis [44% females; mean(SD) age = 71.1(7.8) years; years post-stroke = 4.6(3.3)]. Participants attended five 1-hour weekly tea making training sessions in which progress was monitored and feedback given using a computer-based system which implemented a Markov Decision Process (MDP) task model. In a control condition, participants received five 1-hour weekly stepping sessions. Results Compared to stepping training, tea making training reduced errors across 4 different tea types. The time taken to make a cup of tea was reduced so the improvement in accuracy was not due to a speed-accuracy trade-off. No improvement linked to tea making training was evident in a complex tea preparation task (making two different cups of tea simultaneously), indicating a lack of generalisation in the training. Conclusions The clearly specified but flexible training protocol, together with information on the distribution of errors, provide pointers for further refinement of task model approaches to ADL rehabilitation. It is recommended that the approach be tested under errorless learning conditions with more impaired patients in future research. Trial registration Retrospectively registered at ClinicalTrials.gov on 5th August 2019 [NCT04044911] https://clinicaltrials.gov/ct2/show/NCT04044911?term=Cogwatch&rank=1

Development and usability of a hospital standardized ADL ratio (HSAR) for elderly patients with cerebral infarction: a retrospective observational study using administrative claim data from 2012 to 2019 in Japan

“…The results of this study indicated the need for research on the care system for the maintenance of ADL. To improve care during hospitalization, the findings from a good care system of hospitals with HSAR over 100 should be used to evaluate the care in hospitals with HSAR less than 100, and hospitals and policymakers should evaluate the quality of hospital care management, including rehabilitation [ 43 ]. In a super-aged society, HSAR based on DPC/PDPS data can be considered a useful indicator for hospital managers and policymakers in healthcare.…”

Gender Influence on Students Attitude Towards the Use of Scramble Game for Learning in Secondary School English Language Concepts in Ilorin Metropolis

“…The elements that make games fun along with the nature of games are intrinsically motivating, so applying game elements to the classroom may increase students' intrinsic motivation to learn (Fauziddin & Mufarizuddin, 2018;Pérez-Juárez et al, 2022). Other reasons supporting gamification include improvement of students' engagement and learning outcomes, and to tailor difficulty progression that facilitates instruction based on each individual student's needs (Palaniappan et al, 2022); the immediate and frequent feedback that games provide (Tsividis et al, 2021); the capacity to give students the freedom to fail without fear when learning and a display of progress and rewards which is essential for reinforcement (Conroy et al, 2021); and a trial-and-error learning process which makes mistakes recoverable (Howe et al, 2022). Board games are highly enriching activities that provide creative learning and playful exploration (Prastyo et al, 2021;Ratminingsih, 2017).…”

A task-model based approach for detecting ADL-related anomalies

“…However, the system does not provide adequate or indepth knowledge about the elderly inhabitant daily routine, in order to detect punctual anomalies related to abnormal ADL patterns. An approach, based on intelligence compliant objects, was studied in [21]. It is able to classify the making-tea ADL, by evaluating the efficacy of a task model approach to ADL rehabilitation for stroke apraxia and action disorganisation syndrome, comparing training in making a cup of tea with a trial-and-error learning process; and to monitor progress and feedback given implementing a Markov Decision Process task model.…”