Buele, Jorge
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Buele, Jorge
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Ambato
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jorgebuele@uti.edu.ec
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57200380202

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Virtual reality applications based on instrumental activities of daily living (iADLs) for cognitive intervention in older adults: a systematic review

2023 , Buele, Jorge , Varela-Aldás J.L. , Palacios-Navarro G.

Background: In recent years, the use of virtual reality (VR) as a complementary intervention in treating cognitive impairment has significantly increased. VR applications based on instrumental activities of daily living (iADL-VR) could offer a promising approach with greater ecological validity for intervention in groups with cognitive impairments. However, the effectiveness of this approach is still debated. Objective: This systematic review aims to synthesize the effects of iADL-VR interventions to rehabilitate, train, or stimulate cognitive functions in healthy adults and people with mild cognitive impairment (MCI) and different types of dementia. Methods: A systematic search was performed in the Scopus, PubMed, IEEE Xplore, Web of Science, and APA PsycNet databases until September 2022 and repeated in April 2023. The selected studies met the search terms, were peer-reviewed, included an iADL-VR intervention, and were written in English. Descriptive, qualitative studies, reviews, cognitive assessment, non-intervention studies, those unrelated to VR or iADL, those focused on motor aspects, and non-degenerative disorders were excluded. The PEDro scale was used to assess the methodological quality of the controlled studies. To present and synthesize the results, we organized the extracted data into three tables, including PEDro scores, participant characteristics, and study characteristics. Results: Nineteen studies that met the inclusion and exclusion criteria were included. The total sample reached 590 participants, mostly women (72.67%). Approximately 30% were diagnosed with Alzheimer’s disease or dementia, and 20% had mild cognitive impairment. Variables such as authors and year of publication, study design, type of intervention and VR applied, duration of the intervention, main findings, and conclusions were extracted. Regarding demographic characteristics, the sample size, age, sex, years of education, neurological diagnosis, dropouts, and the city and country where the intervention took place were recorded. Almost all studies showed improvements in some or all the outcomes after the intervention, generally greater in the iADL-VR group than in the control group. Conclusion: iADL-VR interventions could be beneficial in improving the performance of cognitive functions in older adults and people with MCI and different types of dementia. The ecological component of these tasks makes them very suitable for transferring what has been learned to the real world. However, such transfer needs to be confirmed by further studies with larger and more homogeneous samples and longer follow-up periods. This review had no primary funding source and was registered with PROSPERO under registration ID: 375166. © 2023, The Author(s).

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Cognitive Decline Detection for Alzheimer's Disease Patients Through an Activity of Daily Living (ADL)

2022 , Palacios-Navarro G. , Buele, Jorge , Gimeno Jarque S. , Bronchal Garcia A.

There are conventional screening instruments for the detection of cognitive impairment, but they have a reduced ecological validity and the information they present could be biased. This study aimed at evaluating the effectiveness and usefulness of a task based on an activity of daily living (ADL) for the detection of cognitive impairment for an Alzheimer's disease (AD) population. Twenty-four participants were included in the study. The AD group (ADG) included twelve older adults (12 female) with AD (81.75±7.8 years). The Healthy group (HG) included twelve older adults (5 males, 77.7 ± 6.4 years). Both groups received a ADL-based intervention at two time frames separated 3 weeks. Cognitive functions were assessed before the interventions by using the MEC-35. The test-retest method was used to evaluate the reliability of the task, as well as the Intraclass Correlation Coefficient (ICC). The analysis of the test-retest reliability of the scores in the task indicated an excellent clinical relevance for both groups. The hypothesis of equality of the means of the scores in the two applications of the task was accepted for both the ADG and HG, respectively. The task also showed a significant high degree of association with the MEC-35 test (rho = 0.710, p = 0.010) for the ADG. Our results showed that it is possible to use an ADL-based task to assess everyday memory intended for cognitive impairments detection. In the same way, the task could be used to promote cognitive function and prevent dementia. © 2001-2011 IEEE.

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A virtual reality-based cognitive telerehabilitation system for use in the covid-19 pandemic

2021 , Varela Aldas, José , Buele, Jorge , Lorente P.R. , García-Magariño I. , Palacios-Navarro G.

The COVID-19 pandemic has changed people’s lives and the way in which certain services are provided. Such changes are not uncommon in healthcare services and they will have to adapt to the new situation by increasing the number of services remotely offered. Limited mobility has resulted in interruption of treatments that traditionally have been administered through face-to-face modalities, especially those related to cognitive impairments. In this telerehabilitation approach, both the patient and the specialist physician enter a virtual reality (VR) environment where they can interact in real time through avatars. A spaced retrieval (SR) task is implemented in the system to analyze cognitive performance. An experimental group (n = 20) performed the SR task in telerehabilitation mode, whereas a control group (n = 20) performed the SR task through a traditional face-to-face mode. The obtained results showed that it is possible to carry out cognitive rehabilitation processes through a telerehabilitation modality in conjunction with VR. The costeffectiveness of the system will also contribute to making healthcare systems more efficient, overcoming both geographical and temporal limitations. © 2021 by the authors. Licensee MDPI, Basel, Switzerland.

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Virtual Reality applications based on activities of daily living (ADL) for cognitive diagnosis and rehabilitation

2022 , Buele, Jorge , Varela Aldas, José , Palacios-Navarro G.

Traditionally, screening tools are available to help diagnose a person's cognitive problem. Therefore, rehabilitation techniques are lab exercises that lack adequate ecological validity. In this paper, we propose to establish the projection of a methodology for the development of serious games based on activities of daily living (ADL). Both for real and immersive environments, to assess what provides better results when applied in healthy patients at first, but with a focus on those suffering from Alzheimer's disease. It is expected that when this research is completed, precedents will be established for the development of new proposals based on virtual environments. © 2022 IEEE.

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Cognitive-motor interventions based on virtual reality and instrumental activities of daily living (iADL): an overview

2023 , Buele, Jorge , Palacios-Navarro G.

Non-invasive, non-pharmacological interventions utilizing virtual reality (VR) represent a promising approach to enhancing cognitive function in patients with degenerative cognitive disorders. Traditional “pen and paper” therapies often lack the practical engagement in everyday activities that older individuals encounter in their environment. These activities pose both cognitive and motor challenges, underscoring the necessity of understanding the outcomes of such combined interventions. This review aimed to assess the advantages of VR applications that integrate cognitive-motor tasks, simulating instrumental activities of daily living (iADLs). We systematically searched five databases–Scopus, Web of Science, Springer Link, IEEE Xplore, and PubMed, from their inception until January 31, 2023. Our review revealed that motor movements, coupled with VR-based cognitive-motor interventions, activate specific brain areas and foster improvements in general cognition, executive function, attention, and memory. VR applications that meld cognitive-motor tasks and simulate iADLs can offer significant benefits to older adults. Enhanced cognitive and motor performance can promote increased independence in daily activities, thereby contributing to improved quality of life. Copyright © 2023 Buele and Palacios-Navarro.

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Influence of Hand Tracking in Immersive Virtual Reality for Memory Assessment

2023 , Varela Aldas, José , Buele, Jorge , López I. , Palacios-Navarro G.

Few works analyze the parameters inherent to immersive virtual reality (IVR) in applications for memory evaluation. Specifically, hand tracking adds to the immersion of the system, placing the user in the first person with full awareness of the position of their hands. Thus, this work addresses the influence of hand tracking in memory assessment with IVR systems. For this, an application based on activities of daily living was developed, where the user must remember the location of the elements. The data collected by the application are the accuracy of the answers and the response time; the participants are 20 healthy subjects who pass the MoCA test with an age range between 18 to 60 years of age; the application was evaluated with classic controllers and with the hand tracking of the Oculus Quest 2. After the experimentation, the participants carried out presence (PQ), usability (UMUX), and satisfaction (USEQ) tests. The results indicate no difference with statistical significance between both experiments; controller experiments have 7.08% higher accuracy and 0.27 ys. faster response time. Contrary to expectations, presence was 1.3% lower for hand tracking, and usability (0.18%) and satisfaction (1.43%) had similar results. The findings indicate no evidence to determine better conditions in the evaluation of memory in this case of IVR with hand tracking. © 2023 by the authors.

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Gamification in Inclusive Education for Children with Disabilities: Global Trends and Approaches - A Bibliometric Review

2023 , Jadán Guerrero, Janio , Avilés-Castillo, Fátima , Buele, Jorge , Palacios-Navarro G.

Given the growing attention to the intersection between technology and education, gamification has emerged as a strategy with great benefits. This bibliometric review addresses gamification’s current and future relevance in the educational field, focusing on its use as a pedagogical strategy to improve the learning and engagement of children with disabilities. Sixty-six studies published between 2001 and 2023 were analyzed, evaluating the most influential articles, main keywords, prominent authors, collaborating institutions, and funding sources. The literature suggests that gamification offers inclusive and personalized learning opportunities covering various disabilities. Methodologies and approaches to implement gamification were identified, including game elements, user-centered design techniques, and emerging technologies such as virtual reality, artificial intelligence, and educational robotics. However, challenges and areas for improvement were also found, such as the need for more long-term empirical evidence and the importance of considering individual differences and specific needs when designing gamification strategies. The review highlights the importance of strengthening collaborative networks between researchers and education professionals to disseminate best practices and promote more effective gamification approaches adapted to the needs of children with disabilities. Collaboration between educators, game developers, researchers, and parents are crucial to ensure that gamification efforts are inclusive and meet the diverse needs of students. © 2023, The Author(s), under exclusive license to Springer Nature Switzerland AG.

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Electric Monitoring System for Residential Customers Using Wireless Technology

2022 , Buele, Jorge , Morales-Sánchez J.C. , Varela Aldas, José , Palacios-Navarro G. , Ayala-Chauvin, Manuel Ignacio

Power grids continue to develop and it is increasingly difficult to guarantee the quality of service offered to the user. In several developing countries, consumption is calculated on the basis of visual inspection, which is prone to errors. Consequently, this document outlines the construction of electrical consumption telemetering equipment. This is designed to reduce human error through manual measures and have a web backup that can be accessed from anywhere. To develop the prototype voltage and current sensors are used, and the signal is conditioned for the control stage. The processing unit is the Arduino Mega embedded board, which incorporates a GPRS Shield (General Packet Radio Services) that handles communication with a LAMP server (Linux, Apache, MySQL, PHP) connected to the Internet. It also incorporates a block of connection and disconnection of the electrical service that would leave the whole house without service. Two functionalities are used to present the data, one is local on the LCD display of the equipment installed in the home (user) and the second is remote access to a website (server). The results show that in comparison with a standard voltage device it presents an error of 0.28% and 4.12% in current. In this way, the use of this prototype for real-time monitoring of electricity consumption is validated, since it works similarly to a conventional one. © 2022, The Author(s), under exclusive license to Springer Nature Switzerland AG.

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Development of a WBGT Index Meter Based on M5Stack Core2

2022 , Varela Aldas, José , Buele, Jorge , Mosquera H. , Palacios-Navarro G.

Environmental working conditions are of crucial importance for job performance. Thus, thermal comfort helps the human body to withstand long working hours without stress. There are several indicators of heat stress, but one of the most complete is the WBGT (Wet Bulb Globe Temperature) index, which considers 3 temperatures to determine the heat stress index, the dry bulb temperature, the wet-bulb temperature, and the temperature of radiation. For this reason, this document describes the process of building a low-cost heat stress meter. Two DHT22 sensors and M5Stack Core2 controller are used that includes a screen for the presentation of the information. The user interface includes buttons for changing the view type to show indoor or outdoor results, as well as the battery level. In addition, all this information is sent to the IoT platform of ThingSpeak through internet access using WiFi communication, this information can be displayed graphically from a web browser and from anywhere in the world. The data are compared with a commercial meter to validate this prototype, obtaining an error of less than 5% and no significant differences were found. In this way, it is possible to offer equipment for industrial solutions, but at a fraction of its cost. © 2022, Springer Nature Switzerland AG.

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