Feasibility and Usability Test of a Developed Cognitive Training System Based on Smart Mirror: Targeting Community-Dwelling Patients with Chronic Stroke (Preprint)

Abstract

Cognitive impairment is a prevalent consequence among individuals following a stroke. Numerous stroke survivors reintegrating into the community experience cognitive challenges that restrict their engagement, subsequently contributing to additional cognitive decline and adversely affecting their quality of life. This study seeks to feasibility a cognitive training system based on smart mirror designed for chronic stroke patients residing in the community and usability test of the associated training equipment.

The cognitive training system based on smart mirror developed in this study caters specifically to older adults, incorporating training modules for orientation, memory, attention, visual perception, and high cognition. It also integrates kiosk-based activities relevant to daily life and dual-task training, creating a VR environment to stimulate cognitive functions in both community-dwelling older individuals and stroke patients. Thus, the primary objective of this study is to assess the feasibility and usability of the developed cognitive training system based on smart mirror, confirming its utility, acceptability, and consistency as a consumer-centric system leveraging ICT technology.

Ten chronic stroke patients aged 60 years or older, each with independent mobility in the community, were involved in this study. The validation process included a 30-minute cognitive training session administered twice a week for eight weeks. The training regimen encompassed a blend of targeted cognitive domain exercises and virtual reality training. The feasibility of cognitive function assessments employed the Korean version of the Montreal Cognitive Assessment (MoCA-K) and the Cognitive Assessment System for the Elderly (CoSAS). Pre- and post-test results were compared. Additionally, usability test was performed at the end of the experiment using the System Usability Scale (SUS) and the Adapted Intrinsic Motivation Inventory (IMI). Statistical analyses for cognitive function involved calculating mean and standard deviation values for all variables using the SPSS program. The Wilcoxon signed rank test was then employed to compare pre- and post-cognitive function results.

The feasibility of the implemented cognitive training system based on smart mirror revealed significant differences in the total score, delayed recall, and orientation items of the MoCA-K (P<.05). Additionally, a notable improvement was observed in the accuracy and response time of task performance in the CoSAS (P<.05). Usability test results indicated an SUS mean score of 73.5 (SD 17.25) and an Adapted IMI score of 5.63 (SD 1.55), surpassing suggested thresholds for usability tests.

The outcomes of the feasibility and usability test affirm the utility, safety, and motivational aspects of the developed cognitive training system based on smart mirror. Consequently, we advocate for further validation of the training system’s efficacy and usability through clinical trials, specifically targeting groups aiming to enhance cognitive function.

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