title: Modelling Ecological Cognitive Rehabilitation Therapies for Building Virtual Environments in Brain Injury.
abstract: BACKGROUND
  Brain Injury (BI) has become one of the most common causes of neurological disability in developed countries. Cognitive disorders result in a loss of independence and patients' quality of life. Cognitive rehabilitation aims to promote patients' skills to achieve their highest degree of personal autonomy. New technologies such as virtual reality or interactive video allow developing rehabilitation therapies based on reproducible Activities of Daily Living (ADLs), increasing the ecological validity of the therapy. However, the lack of frameworks to formalize and represent the definition of this kind of therapies can be a barrier for widespread use of interactive virtual environments in clinical routine.
  
  
  OBJECTIVE
  To provide neuropsychologists with a methodology and an instrument to design and evaluate cognitive rehabilitation therapeutic interventions strategies based on ADLs performed in interactive virtual environments.
  
  
  METHODS
  The proposed methodology is used to model therapeutic interventions during virtual ADLs considering cognitive deficit, expected abnormal interactions and therapeutic hypotheses. It allows identifying abnormal behavioural patterns and designing interventions strategies in order to achieve errorless-based rehabilitation.
  
  
  RESULTS
  An ADL case study ('buying bread') is defined according to the guidelines established by the ADL intervention model. This case study is developed, as a proof of principle, using interactive video technology and is used to assess the feasibility of the proposed methodology in the definition of therapeutic intervention procedures.
  
  
  CONCLUSIONS
  The proposed methodology provides neuropsychologists with an instrument to design and evaluate ADL-based therapeutic intervention strategies, attending to solve actual limitation of virtual scenarios, to be use for ecological rehabilitation of cognitive deficit in daily clinical practice. The developed case study proves the potential of the methodology to design therapeutic interventions strategies; however our current work is devoted to designing more experiments in order to present more evidence about its values.
authors.affiliation: José María Martínez-Moreno, Biomedical Engineering and Telemedicine Centre, ETSI Telecomunicación, Universidad Politécnica de Madrid, Avda. Complutense, 30, 28040. Madrid, Spain, E-mail: jmartinez@gbt.tfo.upm.es.
authors.forename: J M
authors.initials: JM
authors.lastname: Martínez-Moreno
authors.forename: P
authors.initials: P
authors.lastname: Sánchez-González
authors.forename: M
authors.initials: M
authors.lastname: Luna
authors.forename: T
authors.initials: T
authors.lastname: Roig
authors.forename: J M
authors.initials: JM
authors.lastname: Tormos
authors.forename: E J
authors.initials: EJ
authors.lastname: Gómez
mesh_terms: D000203:Activities of Daily Living; D001930:Brain Injuries / Q000534:rehabilitation*; D003071:Cognition; D003198:Computer Simulation; D004867:Equipment Design; D006801:Humans; D008962:Models, Theoretical; D000066530:Neurological Rehabilitation / Q000379:methods; D009484:Neuropsychology / Q000379:methods; D011594:Psychometrics / Q000379:methods; D011788:Quality of Life; D012984:Software; D013030:Spain; D017216:Telemedicine / Q000379:methods*; D013813:Therapy, Computer-Assisted; D014584:User-Computer Interface
keywords: Neurorehabilitation; activity of daily living; brain injury; cognitive rehabilitation; ecological rehabilitation; eye-tracking; interactive video; virtual rehabilitation