Alertness training with RehaCom

This is one of a series of articles featuring specific training modules within the RehaCom software suite. This particular article will look at the "Alertness" training module.

Folloiwng a brain injury cognitive issues are common, but will vary significantly from person to person in their nature and extent. The "Alertness" module is suitable for moderate to severe cognitive deficits and is part of the Attention group of training modules.

It is often a good idea to begin with one of the Attention group of training modules as some abilitity to pay attention is required for progress to made in Memory or Executive Function training.

Alertness training is suitable for clients age 6 and over and was developed for use with patients who have neurological or psychiatric disorders related to attention activation. The module focuses on improving the phasic and the tonic aspects of alertness.

The patient is asked to press a button when a given stimulus appears. The program measures the responses of the patient and determines if he or she is able to work with other stimuli, scenarios, and/or interstimulus intervals.

Testing alertness functions

Alterness testing with cockpit display

The module uses realistic images to train the patient's alertness functions. The patient is
presented with a traffic situation. An object (e.g., an animal, vehicle, or person) suddenly pops up on the road and the patient has to press the OK button as soon as possible once the object appears.

There are 16 levels of difficulty available for the training. Twenty objects are presented for each
level.  Depending on the number of correct reactions, the patient will either reach the next higher level (if there is a timely reaction to 90% of all presented objects), stay at the current level (if there is a timely reaction between 75 and 90% of all objects), or step down a level. These default settings can be changed at any time by the therapist

Levels 1 to 6 are designed to improve phasic alertness. Before the stimulus appears, the patient is warned by a sound. The stimulus is presented on the screen in a stochastically calculated timeframe (1250–3750 ms; see Training parameters). The patient has up to 1250 milliseconds to react to each stimulus in the first level. The maximum reaction time decreases automatically as the level increases (see Levels of difficulty).

Starting with Level 7, the training tasks are designed to improve tonic alertness. At this level and higher, the patient does not hear a warning sound prior to the presentation of stimuli. For all levels, the interstimulus intervals vary by as much as 50% more or less than the set time between the objects.

A total of 32 scenarios and 48 different objects are available for the training.
An optional setting includes choosing a cockpit view within the parameter menu.

The patient receives feedback after the set number of stimuli have been presented. The number of stimuli can be adjusted in the parameter menu. The feedback contains thenumber of times the patient was able to react in time during the task.

The patient is informed whenever the level will increase ("Training will continue with a more difficult task."), stay the same ("Training will continue with the same level of difficulty.") or decrease ("Training will continue with a less difficult task."). Upon reaching the highest level, the patient is told about his/her success ("You have reached the highest level. Training will continue at this level to strengthen your abilities."). As long as the task is completed accurately ( 90% accuracy [see Training parameters]), the patient will continue to repeat the highest level until the consultation time expires.

You can review the PDF of the Alertness training module manual with this link.