Educación social y discapacidadAplicación del programa GRADIOR4.0 para la mejora cognitiva en personas con daño cerebral adquirido

Abstract

INTRODUCTION Cognitive sequelae in people who have suffered an Acquired Brain Injury (ABI) are increasingly common in society and especially in the younger population. To deal with this, systematized and individualized resources and tools must be sought to counteract these consequences with the primary objective of improving their wellbeing and quality of life, normalizing, as far as possible, the inclusion of people in the community. who have suffered. There is no doubt that people who suffer from some degree of neuronal dysfunction will lead to a disability that will affect basic activities of daily living (ABVD). This entails a great joint effort between the patient, the professionals who care for him and, of course, continuous contact with family members, without forgetting the external resources necessary for the development of rehabilitation with the ultimate goal of normalizing the patient's life as much as possible. OBJECTIVE The general objective of this thesis is to verify the effectiveness of a program based on new technologies (ICT) called "GRADIOR4.0", which performs an initial evaluation of the cognitive state that the person presents, to later apply a treatment through different sessions of cognitive training carried out by computer. This tool allows training and continuous stimulation of higher cognitive abilities that have been altered, with the aim of recovering, maintaining or increasing their function. PARTICIPANTS For this, we have worked with 21 selected participants in a Residence for Seriously Physically Affected Persons and People with Brain Damage. Said residence is located in Almería, being managed by the Almería Federation of Associations of Persons with Disabilities, FAAM. The Experimental Group, GE, made up of 13 participants, carried out the cognitive training carried out by the Social Educator and the Control Group, CG, made up of 8 participants, carried out traditional training. INSTRUMENTS AND METHODOLOGY To develop this research, several instruments were used, the Barthel Index to evaluate the Basic Activities of Daily Living (reliability of ⍺ = .98). The Lawton and Brody scale to assess Instrumental Activities of Daily Living (reliability of ⍺=.94). The Katz Index that determines the level of functionality (reliability of ⍺=.90). The Pfeiffer test for screening for cognitive impairment (reliability of ⍺=.90). SF36 questionnaire to measure quality of life, being the most used and prestigious questionnaire at the health level (reliability of ⍺ = .90). Mini Cognitive test to assess the user's mental state, and finally the Clock Drawing test, which assesses the user's cognitive state (reliability of ⍺ = 87). User satisfaction questionnaire when using the Gradior4.0 tool. Gradior4.0 cognitive evaluation and rehabilitation program whose purpose is the rehabilitation of cognitive deterioration through the interaction of the patient with the touch screen, carrying out training in Attention, Memory, Calculation, Perception, Executive Function and Reasoning. To carry out this research we used a multimedia computer and a touch screen in which the participants carried out their sessions interactively with the series of exercises proposed by the tool. At the same time, the aforementioned standardized scales were supplied in Pre-test and Post-test. The application of this cognitive training program through new technologies is an extremely useful tool, scientifically validated for its application in different pathologies and disorders. Many authors consider ICTs relevant in the development and application of rehabilitation programs, a large part of which are effective. RESULTS Different results have been obtained, which provide clarity in terms of carrying out cognitive training based on ICTs. People who underwent cognitive training in the Gradior4.0 program have been shown to significantly increase their capacity for autonomy, compared to both basic and instrumental activities of daily living, and therefore their quality of life has improved. In the same line and at a cognitive level, the results obtained indicate a decrease in cognitive deterioration, increasing its capacity in all higher functions. Regarding the reaction time and the percentage of failures, both by omission and by commission decreased significantly. In this sense, the users were, in a very high percentage, satisfied with their participation in the Gradior4.0 program. CONCLUSIONS The cognitive training carried out by the Social Educator guarantees additional motivation for people with DCA, since it delves into issues that go beyond brain injury, effectively, we refer to emotions, social and labor inclusion, mediation , the involvement of families and a long etcetera that have a real impact on the user and their environment. Cognitive recovery and improvement entails the union of the group of therapeutic professionals (Physiotherapists, Speech Therapists, Occupational Therapists, Psychologists, Leisure and Free Time Monitors, etc. For all these reasons, it can be concluded that the maintenance and rehabilitation of brain injury can be achieve through the use of ICTs, producing changes in the users who carry it out compared to those who do not, motivated by their recovery and by the team that accompanies them in this work.