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There are eight software packages that make up the PSSCogRehab cognitve rehabilitation therapy system. All of the packages and programs within each package run from the same operational framework so that when you learn to maneuver within one, you basically have learned to maneuver within them all. The system is designed to be administered by a therapist who will most likely be using the system with a number of different patients. Therefore, the system software resides on the computer's hard drive and is not modified in any way when a task's parameters are changed. However, since each patient will be working at different levels on the various tasks assigned we wanted to be able to easily maintain each and every patient's exact prescription for each clinic session and for every practice period between. To accomplish this, we set up the system to look at the patient's personalized data diskette (see Fig.1) prior to running a task and to extract that patient's parameters from the diskette. The personalized data diskette is made by selection from the Menu (see Fig.2) during the very first session and the parameters are set and stored on the diskette during each clinic session thereafter. At the completion of each task a patient's scores and performance levels are stored on that same personalized data diskette. Practice work done by the patient between formal therapy sessions can be saved by the patient and later viewed and graphed by the therapist. Each package starts up with the display of a Menu showing all the exercises included. Upon selection of a program, the personalized data diskette is examined and the patient's name and ID number are loaded and displayed for verification (Fig.3). When okayed to continue, the program displays the Instruction screen (Fig.4) for the current task. At the bottom of this screen, there are four buttons allowing one to:
The Modify Parameter screen (Fig.5) is available for most of the programs on the eight packages. By using these modifiable parameters, the therapist can mold the task to match the level at which the patient would be challenged but not overwhelmed by the demands of the task. Then as the patient progesses the parameters can be adjusted to more difficult levels. When parameters are adjusted the levels are stored on the Patient's data diskette only. Our patients are seen by the therapist once per week at the center. Between the formal clinical visits they practice the tasks with the software on their own computers at home for up to three 1 hour sessions each and every day. Since we set the parameters on their diskette while they were in the clinic, we know that they are practicing precisely what we want them to be practicing. We refer to this as our Therapy Prescription and we even have a Therapy Prescription pad on which we write the current week's assignments. The Run button runs the tasks, of course, and as the tasks are detailed within other sections of this presentation please refer back to the home page for clickable icons to those sections. Following the completion of each task, the Task Performance Results screen appears (Fig.6). This screen identifies the patient, shows the date, lists the parameter settings and reports the scores on the tasks. Most tasks provide several measures of performance. Even the most simple of tasks, such as Simple Visual Reaction, shows the reaction time on each trial, the overall average reaction time, the variance (which is used here as a measure of response consistency) and the number of commission error responses. Our therapy goal on such a task is not simply to get the patient to respond faster, but to get maximum accuracy, consistency and speed all together. Each results screen for every task shows the same six buttons across the bottom of the screen (Fig.6) that allow one to:
The results and the graphs can be printed for a hardcopy record of the patient's progress. We use the Window's Print Manager to handle printing matters, so any graphics capable printer you have properly set up for use with Microsoft Windows should work perfectly. |
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