Acquired brain injury, whether due to traumatic brain injury (TBI), cerebral vascular accident (CVA), tumor, etc., is a major health problem in our society today.
Every year in Spain there are 80,000 new cases of TBI, 923 of which result in severe disability, and the number of cerebral vascular accidents is around 122,000 new cases, 1,300 of which will result in severe disability.
Advances in the field of medicine and technology have made it possible for people with brain injury to survive longer. These people, however, may present a series of physical, cognitive and behavioral deficits that will have a significant impact on the individual and his or her family, social and work environment.
Among the consequences of brain damage, neuropsychological alterations, which include cognitive (attention, language, memory, executive functions) and emotional behavioral aspects, are highly disabling.
The need for neuropsychological rehabilitation arises when considering these long-term sequelae and their impact on functional adaptation, independence and quality of life, not only for the affected person but also for his or her family.
Within neuropsychological rehabilitation, cognitive rehabilitation is defined as the intervention strategy that helps patients and their families to live with and cope with or reduce the cognitive deficits resulting from the neurological injury and is essential, as another element of the neurorehabilitation process, to improve activities of daily living and promote reintegration.
In order to respond to this rehabilitation need, the Institut Guttmann initiated in 2004 the development of the PREVIRNEC® Rehabilitation Platform, with the help of the Department of Universities, Research and Information Society (DURSI) of the Generalitat de Catalunya. It is a collaborative project that, led by the Institut Guttmann, has continued its development and implementation, with the participation of several universities, technology centers and professionals who have contributed their knowledge.
PREVIRNEC® is a computerized telemedicine platform that enables intensive, personalized and supervised cognitive rehabilitation. It is based on the development of a clinical telerehabilitation program which, based on the care models developed to date, allows the neuropsychologist, starting from the neuropsychological evaluation, to design personalized therapeutic programs proposing specific tasks for the rehabilitation of attention, language, memory and executive functions. In this way, the cognitive aspects that limit the patient’s functionality and, consequently, their daily activities are worked on.
It is a tool with great potential in the field of cognitive rehabilitation and an opportunity offered by the technologies of the information and communication society, since it makes it possible to intensify rehabilitation, continuously monitor the patient’s performance and personalize it.
Since 2006, when the Platform was installed at the Institut Guttmann, more than 500 patients with acquired brain damage have received cognitive treatment: TBI, CVA, post-surgical patients, cerebral anoxias, etc. At the end of 2008, the clinical extension phase began in several hospitals and day centers: Francolí Day Center in Tarragona, Sant Josep Social and Health Center in Igualada, Aspid Day Center in Lleida, Sant Jaume and Santa Magdalena Social and Health Center in Mataró, Santa Creu Social and Health Center in Vic, Barcelona Multipurpose Center and brain injury associations.
Since a few months ago, and in order to expand the possibilities of rehabilitation and to be able to continue the treatment at a distance, eliminating geographical barriers to access the system to people who do not have access to hospital rehabilitation but with clinical improvement criteria, more than 30 patients have benefited from the advantages of telerehabilitation and have benefited from the service offered by the PREVIRNEC® Platform, receiving for three months the daily therapeutic program that a neuropsychologist schedules from the hospital and, via Internet, the patient receives and executes at home.
PREVIRNEC® is an innovative product that offers the opportunity to intensify the benefits of cognitive rehabilitation, making it accessible to a greater number of people, and is a particular and useful tool in the context of the rehabilitation of patients with brain damage.
Based on our experience in the population with acquired brain damage, we are working with different entities to adapt and transfer the current contents to the field of dementia, mental health and child neurodevelopment.