SLB: Systemic Lisbon Battery

SLB: Systemic Lisbon Battery
Pedro Gamito and Jorge Oliveira
CTIP, COPELABS, University Lusófona
{pedro.gamito, Jorge.oliveira}@ulusofona.pt
Abstract—The
Systemic
Lisbon
Battery
aims
at
complementing existing paper-and-pencil assessment outlets with
3D ecological IADL exercises from which behavioral indicators
are unobtrusively recorded.
Keywords—cognitive
serious games; IADL
impairments;
cogntive
several buildings arranged in eight square blocks, a 2-room
apartment, and a mini-market in its vicinity, in both of which
participants are able to move freely around and to grab objects
(Figure 1).
assessment;
I. INTRODUCTION
Currently, the most common measures used to assess
cognitive decline due to ageing, to acquired brain injuries or to
substance abuse, are based on traditional neuropsychological
tests that consist mainly in paper-and-pencil exercises. The
neuropsychological examination can be considered as an
extension of neurological examination and based on a
standardized assessment of cognitive function [1]. The
development of standardized assessment techniques is mainly
due to the theories of Alfred Binet in his assessment of
intelligence. However, the neuropsychological procedures,
most of them developed during the middle of the Twentieth
Century, do not take advantage of what new technologies have
to offer. In fact, there is a growing body of research suggesting
that paper-and-pencil neuropsychological tests may lack in
ecological validity, suggesting that these outcomes may not
reflect the cognitive demands form a real-life situation [2, 3].
We argue that neuropsychological methods should be
complemented with approaches that capture patients’ ability to
perform real life tasks (i.e., shopping, dressing or preparing
breakfast), rather than only performance in pencil-and-paper
exercises. The use of virtual setups where patients could
perform daily-life activities requiring different cognitive
abilities could be a viable solution for this problem [4].
Another advantage of computer-based neuropsychological
assessments is the ability of the system to record behavioural
measures, which would increase standardization, but also the
ease of administration and data collection. Improvements on
behavioural measures of overcoming these real life tasks (e.g.
less errors, lower execution times, less indecisions and shorter
trajectories) may reflect an increase in the cognitive abilities
required to perform a given task [5]. We have developed and
tested a set of cognitive exercises, according to these
principles, and complied them into a Systemic Lisbon Battery –
SLB. SLB 1.0 is a virtual reality online platform
(http://labpsicom.ulusofona.pt) that consists of a small town
populated with digital robots. This virtual town includes
Fig. 1. SLB 1.0. Two examples of the SLB platform. On the left, the
apartment, and on the right, the market.
The platform was developed using Unity 2.5. The SLB 1.0
has now evolved into SLB 2.0 (Figure 2), in which several
bugs have been fixed and a new system of recording
performance data is used. This is a new city, and new tasks
have been introduced that address different activities of daily
living. Moreover, a Casino was also incorporated in the city.
The associated task – gambling on a slot machine – has the aim
of training and assessing the role of inhibitory
control/impulsivity in decision-making.
Fig. 2. SLB 2.0. Two examples of the SLB 2.0 platform. On the left the new
city, and on the right the Casino.
The SLB served as the cradle for the following
publications:
1. Gamito, P., Oliveira, J., Lopes, P., Brito, R., Morais,
D., Silva, D., Silva, A., Rebelo, S., Bastos, A. & Deus, A (in
press) Cognitive stimulation through mHealth-based program
for patients with Alcohol Dependence Syndrome. A
randomized controlled study. International Journal on
Disability and Human Development. DeGruyter
2. Gamito, P., Oliveira, J., Caires, C., Morais, D., Lopes
,P., Saraiva, T., Soares, F., Sottomayor, C., Barata, A., Picareli,
F. (2015) Virtual Kitchen Test: Assessing Frontal Lobe
Functions in Patients with Alcohol Dependence Syndrome.
Methods of Information in Medicine, 54(2), 122-126.
Schauttauer. ISSN 0026-1270 [IF = 1.6];
3. Gamito P., Oliveira J., Coelho C., Morais D., Lopes
P., Pacheco J., Brito R., Soares F., Santos N., Barata F. (2015)
Cognitive training on stroke patients via virtual reality-based
serious games. Disabilities and Rehabilitation, 1-4 [IF = 1.5];
4. Gamito P., Oliveira J., Pinto L., Rodelo, L., Morais
D., Lopes P., Brito R. (in press). Normative data for a cognitive
VR rehab serious games-based approach. Methods of
Information in Medicine [IF = 1.6].
5. Gamito, P., Oliveira, J., Pinto, L., Rodelo, L., Lopes,
P., Brito, R. & Morais, D. 2014. Normative data for a cognitive
VR rehab serious games-based approach. PervasiveHealth '14:
Proceedings of the 8th International Conference on Pervasive
Computing Technologies for Healthcare, 443-446. ICST
6. Gamito, P., Oliveira, J., Brito, R., Santos, N.,
Pacheco, J., Morais, D., Saraiva. T., Soares, F., SottoMayor,
C., & Barata, A. (2014). Virtual exercises to promote cognitive
recovery in stroke patients. In Sharkey PM & Merrick J, eds.
Virtual reality: Rehabilitation in motor, cognitive and sensorial
disorders- New York: Nova Science, 57-68. ISBN: 978-6332177-7.
7. Oliveira J., Gamito P., Morais D., Brito R., Lopes P,
Norberto, L. (2014). Cognitive assessment of stroke patients
with mobile apps: a controlled study. In B. Wiederhold & G.
Riva (eds). Studies in Health Technology and Informatics. 199,
103-107. ISBN 978-1-61499-400-8
8. Gamito, P., Oliveira, J., Lopes, P., Brito, R., Morais,
D., Silva, D., Silva, A., Rebelo, S., Bastos, A. & Deus, A.
(2014). Executive Functioning in Alcoholics Following a
Mobile Health Cognitive Stimulation Approach: a Randomized
Controlled Trial. Journal of Medical Internet Research.
16(4):e102 [IF = 4.7]; doi:10.2196/jmir.2923
9. Gamito, P.; Oliveira, J.; Lopes, P.; Brito, R.; Morais,
D.; Cristovao, S.; Cacoete, C.; Henriques, C.; Silva, D.; Silva,
A.; Rebelo, S.; Bastos, M.; Deus, A. (2013). Executive
functioning in addicts following health mobile cognitive
stimulation. Evidence from alcohol and heroin patients. IEEE
7th International Conference on Pervasive Computing
Technologies for Healthcare (PervasiveHealth). pp.385,388, 58 May, Venice, Italy.
10. Gamito P, Oliveira J, Lopes P, Morais D, Brito R,
Saraiva T, Bastos M, Cristóvão S, Caçôete C, & Picareli F., A.
(2013). Assessment of frontal brain functions in alcoholics
following a health mobile cognitive stimulation approach. In B.
Wiederhold & G. Riva (eds). Studies in Health Technology and
Informatics, 191, 110-115.
11. Gamito, P., Oliveira, J., Pacheco, J., Morais, D.,
Saraiva. T., Lacerda. R., Baptista, A., Santos, N., Soares, F.,
Gamito, L. Rosa, P. (2011). Traumatic Brain Injury memory
training: a Virtual Reality online solution. International Journal
on Disability and Human Development. DeGruyter, 10 (2),
309-315.
ACKNOWLEDGMENT
SLB is the result of the effort of many. Tomaz Saraiva
Nuno Santos, André Baptista, Ruben Macedo, Felipe Picareli,
Marcelo Matias are the top contributors on the development
phases of SLB.
REFERENCES
[1] Parsons TD. (2011). Neuropsychological assessment using
[2] [3] [4] [5] virtual environments: enhanced assessment technology for
improved ecological validity. In S. Brahnam (Ed.), Advanced
Computational Intelligence Paradigms in Healthcare: Virtual
Reality in Psychotherapy, Rehabilitation, and Assessment (pp.
271- 289). Germany: Springer-Verlag.
Chaytor N, Schmitter-Edgecombe M. (2003). The ecological
validity of neuropsychological tests: A review of the literature
on everyday cognitive skills. Neuropsychol Rev, 13(4):181-197.
Spooner D, Pachana N. (2006). Ecological validity in
neuropsychological assessment: A case for greater consideration
in research with neurologically intact populations. Archives of
Clinical Neuropsychology, 21:327–337.
Gamito, P., Oliveira, J., Caires, C., Morais, D., Lopes ,P.,
Saraiva, T., Soares, F., Sottomayor, C., Barata, A., Picareli, F.
(2015) Virtual Kitchen Test: Assessing Frontal Lobe Functions
in Patients with Alcohol Dependence Syndrome. Methods of
Information in Medicine, 54(2), 122-126. Schauttauer. ISSN
0026-1270 [IF = 1.6];
Gamito P, Oliveira J, Pinto L, Rodelo L, Lopes P, Brito R,
Morais D. (2014). Normative data for a cognitive VR rehab
serious
games-based
approach.
PervasiveHealth
'14:
Proceedings of the 8th International Conference on Pervasive
Computing Technologies for Healthcare, pp. 443-446.