Improving the Rehabilitation Process

Summary

A major challenge in care of persons with dementia is that illness and hospitalizations can lead to significant decreases in functional abilities. Maintaining functional abilities as high as possible is a key goal in dementia care, because persons are able to function optimally despite cognitive problems and engage in more preferred and enjoyable activities. Functional decline can be ameliorated through rehabilitation, building strength, balance and functional competencies. People with dementia, however, may not able to engage fully in rehabilitation due to their cognitive problems. They may not understand the therapist's instructions and may be fearful of what the therapist is trying to do.

The proposed study will test the efficacy of a multifunctional interactive computer system, the IN2L, that uses video and audio to engage people more fully in rehabilitation. Music and videos elicit and sustain responses that contribute to rehabilitation goals such as increasing balance or strength. With the IN2L, audio and video material that matches the preferences and past experience of the person in rehabilitation can be selected. While this approach shows promise with rehabilitation patients generally, it has particular potential for application with persons with dementia. Specifically, when Physical or Occupational Therapists (PT and OT) are not able to engage a person with dementia in rehabilitation tasks using verbal instructions and explanations, they may be able to involve the person using audio and video stimuli that draw upon abilities that have remained intact despite the disease.

To determine the efficacy of IN2L, the study will use a quasi-experimental design that compares rehabilitation patients with dementia seen at two comparable facilities operated by Presbyterian Senior Care Network. In one facility, the Willows, OT and PT currently use IN2L. In the comparison facility, (Southmont), OT and PT do not currently have access to IN2L. This type of design is optimal, because it prevents contamination effects that could occur with random assignment within the same facility. In that case, therapists in the control condition who were working side-by-side with therapists using IN2L would be likely to incorporate IN2L techniques in their therapy sessions if they perceived it to be useful.

The study will use observational and self-report by patients and their therapists measures to determine if persons with dementia in rehabilitation show greater participation in rehabilitation activities, better attainment of rehabilitation goals and functional improvement when therapists use the IN2L compared to usual therapy approaches.

Conditions

• Dementia

Interventions

DEVICE

IN2L computer system

Therapists will use the IN2L computer system to choose videos, music, games and exercise specific to the rehabilitation needs and personal preferences of patients.

Sponsors & Collaborators

• Presbyterian SeniorCare Network

  collaborator UNKNOWN

• Penn State University

  lead OTHER

Study Design

Allocation

NON_RANDOMIZED

Purpose

TREATMENT

Masking

NONE

Model

PARALLEL

Eligibility

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2018-03-31

Primary Completion

2019-05-31

Completion

2019-06-30

Countries

• United States

Study Locations