Authors (including presenting author) :
Lau WYS (1), Cheng KL (1)
Affiliation :
(1) Occupational Therapy Department, Castle Peak Hospital
Introduction :
Technology-assisted rehabilitation such as virtual reality and mixed reality are nowadays utilised among psychogeriatric patients' rehabilitations, focusing on domains of cognition, life skills, functional mobility and sensation. However, most of the research investigated cognitive or physical improvement, but limited of them evaluated on psychosocial effects. Also, local studies were mainly conducted at community settings, instead of hospitalised in-patient wards.
Objectives :
This study was aimed to compare the effect of technology-assisted rehabilitation with conventional rehabilitation among psychogeriatric in-patients. It was hypothesized that technology-assisted rehabilitation showed a better effect on improving patients’ communication, motivation and mental well-being.
Methodology :
A Randomized Controlled Trial study design with two intervention arms was employed. Subjects were (1)in-patients from psychogeriatric ward at Castle Peak Hospital, (2) diagnosed with mental illness including schizophrenia, dementia and mood disorders, (3) hospitalised for at least one month and (4) mental state fit for Ward OT program. Subjects were excluded if they had severe communication deficits, visual, hearing or any physical impairments hindering participation. Recruited subjects were randomised into two groups: technology-assisted rehabilitation group, which received cognitive rehabilitation, life skills training, functional mobility exercises and sensory stimulation using advanced technology devices; and conventional group, which received rehabilitation using tangible tools or paper-pencil tasks. Outcome measures were catergorised as: (1) Holden Communication Scale, a proxy-based scale assessing a patient's communication ability rated by clinician , (2) Apathy Evaluation Scale-Clinician Version, assessing emotional, behavioural and cognitive aspects of apathy, (3) The Short Warwick-Edinburgh Mental Well-being Scale, assessing subjective mental well-being and rated by patients.
Result & Outcome :
A total of 24 patients were recruited and received treatment for three weeks. The majority (43.5%) of patients was diagnosed with schizophrenia, the remaining were mood disorders (34.8%) and dementia (21.7%). One patient from the technology-assisted rehabilitation group dropped out during the study due to early discharge. The remaining 23 patients completed three weeks of treatment. Compared to the conventional group, subjects from the technology-assisted rehabilitation group showed significantly greater decline on Holden Communication Scale (F=6.80, p=0.016), and Apathy Evaluation Scale-Clinician Version (F=12.50, p=0.002) , which indicated better communication ability and less apathy. For the Short Warwick-Edinburgh Mental Well-being Scale, subjects from the technology-assisted rehabilitation group showed greater increase than the conventional group, but no statistical difference between two groups was found (F=1.64, p=0.215).
These findings suggested technology-assisted rehabilitation yields clinical benefits to elderly, particularly on communication with others and motivation when compared to conventional rehabilitation. This result might be explained by various benefits of advanced technology. For example, gamification of routine training with instant sensory feedback not only made therapy more enjoyable but also boosted patients’ motivation. Besides, advanced technology, especially virtual reality, allows the elderly to connect and socialise easier by providing a shared experience while learning new tasks. On the other hand, despite no significant differences of subjective well-being between two groups were found, it might be limited by short treatment time and small sample size. Further studies with larger sample size and longer treatment time are warranted.
