Telerehabilitation, cognition and user-accessibility

Survivors of traumatic brain injury (TBI) often experience cognitive and physical impairments. The aims of this study were to: 1) build an internet-based, "Virtual Rehabilitation Center" (VRC) that provides rehabilitation, education and support services to individuals with TBI; and 2) to determine the relationships between the nature and severity of the participants' cognitive impairments and their ability to use the VRC. Eight individuals with brain injuries (Age: M=43, SD=15.4; Years of Education: M=13.8, SD=3.15) participated. The Neurobehavioral Cognitive Status Exam (NBCSE) was used to assess intellectual functioning. The VRC modules consisted of reaction time, functional modules, and communication capabilities. All participants learned how to use the VRC. However, those requiring more "trials to acquisition" showed greater cognitive impairment than those requiring fewer trials in: Construction (p=0.02), Reasoning-Similarities (p=0.01) and in calculation and language repetition.(i.e., a non-significant trend). Importantly, all participants learned how to use the system although learning rates varied. Moreover, one case-study demonstrated that learning on the VRC generalized to the community. Overall, impairments on the NBCSE in visual-constructional integration and executive-type functions, as well as language processing appeared to be related to how effectively participants learned how to use the VRC.