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iMedicalApps and JMIR Publications have partnered to help disseminate interesting & innovative digital health research being done worldwide. Each article in this series will feature summaries of interesting studies to help you keep up to date on the latest in digital health research. We invite you to share your thoughts on the study in the comments section.

A new app for at-home cognitive training: description and pilot study on people with multiple sclerosis

  1. What was the motivation behind your study?

Cognitive impairment is common in people with neurological diseases with a consequent deleterious impact on their occupational profile, social participation and quality of life. It has been shown that intensive and personalized cognitive rehabilitation (CR) based on working memory (WM) exercises produces positive effects on the cognitive status improvement of healthy and cognitively impaired subjects. In this frame, new technologies would help to promote accessible, at-home and self-managed CR interventions. However, the disposability-to-use (usability, motivation to use, compliance to treatment) of new technologies is not always evaluated before their use, although it is well-known that increases the risk of their disuse.

  1. Describe your study.

The study describes the design of Cognitive Training Kit (COGNI-TRAcK), an app to self-administer at-home intensive and personalized CR intervention based on WM exercises. COGNI-TRAcK includes routines automatically implementing adaptive working load algorithms and allowing data processing and analysis. COGNI-TRAcK was developed for Android and up to now implements three exercises shown to improve WM performances in healthy people. However, its modularity will easily consent to update the app with new exercises. To assess the disposability-to-use we recruited 16 cognitive impaired PwMS (age=49.06±9.10 years; moderate disability) who submitted to an 8-week at-home intervention self-administered by the app, 5 sessions/week, 30 minutes/session.

  1. What were the results of the study?

Disposability-to-use COGNI-TRAcK was investigated by means of a questionnaire administered to patients at the end of the training. Results showed that:

  • PwMS adherence to treatment was 84%
  • 93.75% of PwMS understood the instructions given
  • 100% felt independent to use COGNI-TRAcK at-home
  • 75% found the exercises interesting
  • 81.25% found the exercises useful and were motivated to use the App again

Moreover, during the exercises execution, PwMS felt high level of motivation to well perform (3.19/4) and rather low levels of stress (2.19/4), boredom (1.81/4) and amusement (2.25/4).

  1. What was the most surprising finding from your study?

The high level of adherence and motivation to perform well are the most surprising findings of our study.

  1. What are the next steps? How do you envision this work ultimately translating into clinical practice or affecting future research?

We are now ready for large-scale deployment of COGNI-TRAcK, with particular interest in validating both neurological aspects, such as therapeutic effectiveness and effect on brain structure and function, and technological features, such as internet communication procedures for the data transfer to a central server. If these aspects also, as expected, show effective results we believe that CR interventions could be rethought improving administration, management and adherence to treatment and also allowing (although it is necessary to test it on large scale) the Public Health System to economize.