RehaCom Catalogue

RehaComcomputer assisted cognitive rehabilitation

HASOMED

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hard- and software for medicine

RehaCom systems are used successfirlly throughout Europe in:

Stroke unitsRehabilitation centresHospitalsGeriatric centfesUniversity clinicsOut-patient treatrnent unitsPsychological practicesNeuropsychological establishmentsOccupationilthetapyVocational training institutes for the disabledNeuropaediatryRetirement homesand by patients and sufferers at home

RehaComCognitive Therapy

computer assisted cognit ive rehabil i tat ion

I ntrod uction into the system RehaCom...........................o4

Training of attentionAlertness

Acoustic reactivity (AKRE)................... .....................09Reaction behavior (REVE)... ..................O9Ability to respond (REA1)................ ........1O

Vigi lanceVigilance (Vtct)...... ......................1 1

Visual spat ial at tent ionSpatial operations (RAUM)............... .......12Two d i me ns iona I ope rat ions (V ROt )..........................................13Three dimensional operations (RO3D).. .............14Visuo constructive abil it ies (KONS)............... ......15

Selective attentionAttention and Concentration (AUFM).. ...............15

Divided attentionDivided attention (GEAU).. .......................17Divided attention 2 (GEAZ)................... ......................1g

Training of memoryTopolocial memory (MEMO)............... ..................19Physiognomic memory (GESI)..... ......................2OMemory of words (WORT) ................21Figural memory (BILD)..... ...................22Verbal memory (VERB).. ....................23

Executive functionsShopping (EINK) ................24Plan a day (PLAN).. 25Logical reasoninq (LODE)................... ................26Caf culations (CALC).........-. .................27

Training of visual f ield

CompensatingSaccadig training (SAKA).. ...................28Exploration (EXPL)....-.-.-.... .....................29Overviewandreading(ZtFll-)................... ...............3O

RestoringVisual training to restore (VIST) ......31

Visuo-motoric coordinationVisuomotoric coordination (WISO).....--...... ....................32

Overview of procedures....... .....33Effectiveness studies .......................34Team of development ..................3eTechnical requirements........... ........................41

I -;1ffi,'


Cognitive defects are the frequent consequencesof brain damage, and the need for anappropriatetherapy instfument is enormous. progress incomputer technology enables the application ofcomputer-as sisted therapy programs in cognitiverehabilitation. Disturbances in attention andconcentration, in learning, in memory, in reactivityand in many other brain functions are treatable.Cognitive rehabilitation aims first of all. at areduction of the restrictions caused by braindamages. The aim of computeraided trainingprocedures is thepositive change of the cognitiveabilities of the patients. The main success criterionis the patient's own estimation of how his qualityof living changes. This training is executedin stroke units, in neurological rehabilitationcentres, in psychological and occupationalpractices and also at home. In conjunction withclassical therapy forms such as client-cenreredtherapy, play therapy, logopaedics, physiotherapyor occupational therapy, the computer-assistedtherapy gains ever more significance.If certain brtrn areas are injured by stroke, trafficaccident, tumour operation or other diseases,the possibiJity exists that healthy brain areascan take over the functions of the incapacitatedareas. Computer-assisted neuropsychologicalrehabilitation realtzes highty individual andintensive training of the effected brain areas.Wilson (1989) differentiates berween 3 kinds ofrehabilitation:t Restitution of functions+ Compensation of functions and+ Substitution through intact functions.Resource orientated therapy approaches (Matthes,von Cramon & von Cramon) suggest those skillsthe patient has maintained and which can be usedto reduce the patient's restriction. Howeveq thisfunction transfer must be trained and stimulated,and this is done through the following therapyapproaches:t Exercise procedures

-t Giving over of internal strategies+ Supportingmetacognition+ Using external help.Computer-assisted training mainly consists ofrepetitive exercise and needs the therapist to giveover strategies linking to daily routine. RehaComprocedures are structured in a way allowing thetransfer to daily routine easily.In the last years it was shown that the applicationof computers as a constituent of different rhet:lpyforms contributes to therapy success considerably.The computer supports the patient as ̂ n untiringand never despairing teacher, even if the patient.spfogress is slow: New exercises are constantlygenerated, as long as the patient achieves therequired therapy t^rget. By editing own conrenrs,the therapisr can even w-iden the offer of tasksand adapt the tasks to local traditions.

Basic elements and featuresFor more than two decades computer-assistedtraining of cognitive functions has been a basicconstituent of neurological therapy. Many of thecomputer-aided training procedures uses conceptsof psychological tests, others afe ,,copies.. ofcomputer games, and a third group developed foreducational assumptions.RehaCom was developed to suit the needs ofeffective neuropsychological rehabilitation ofcognitive functions. The theoretical concept isthe result of intensive cowork of psychologists,neurologists, biomedical engineers andprogrammers. The following points describeRehaCom's theoretical concept:t Modular structure of the training procedures:

ttaining of basic functions up to complexdemand

-t Best possible interaction between the thera-pist, patient and computer as basic elementof the training

t Adaptation of the training level to thepatient's capacitres

(a

â

++

Powerfirl feedback for motivating the patientEffective process recording for finding de-ficits and caoacities.

Modular i tyRehaCom trains different cognitiveareas according to the procedue. Startingwith simple procedures, more and more complexdemands are set up for the client. As there is awide spectrum of cognitive deficits, an effectivetraining package should be able to train all aspectsof cognitive functions, both basic and complex,using a common interface.

Modular i ty enablest Selecting a procedure according to

the cognitive deficitt Selecting a combination of procedures

according to the profile of cognitive deficits+ Variation of the training structure (number

of tasks per session, changes in the level ofdifficulty etc.)

I nteraction between therapist,pat ient and computer

In the therapist-, patient- and computer relation-ship the dominant element should be the therz-pist-patient axis. The computer is part of a totaltherapy concept which allows individual treat-ment for every patient. This individual adjustmentshould help the patient to develop strategies fotsolving the training tasks. The computer providesinstruction on the training tasks, information onthe progress of performance and positive feed-back.

Patient adjusted panel

A special keyboard $ehaCom panel) helps thepatient to communicate with the computer. Aconventional keyboard is mosdy unsuitable fortherapies since it is too confusing and requireshigh dexterity. The RehaCom panel is reduced tothe minimum necessiry.

vJ_.]Q t-1-?- itl

RehaCom panel:

Large, robust reaction buttons which are also

for patients with motor disturbances

Automatic adaptat ionto current performance

An effective training procedure works adaptivelyand adjusts to the current capabilities of the clientautomatically. The stress balance of the client ismaintained in order to increase the motivation forthe therapy.

Individual t rainingand feedback

Individual training is necessary for maximummotivation. Adapted instructions and helpmenus are used to achieve optimal instructioncomptehension ("learning by doing"). The clientreceives continuous performance feedback viapleasant sounds and images. Every trainingprocedure is equipped vrith a large item poolto avoid habiruation and boredom in the client.Procedures which ate highly tealistic proved to beof growing importance.

After solving a task, the clients receive informationon the quality of performance as well asinstructions fot the next tasks.


Continuity, patient progressand process recording

Specific progress data zre recorded for everytraining procedure. They are the basis for a chzngeof level and the feedback. Saved in every session,the patient's progress can be traced back to thevery first session on the grounds of these data.During training evaluation the data provide thetherapist with details on patient progress. A newsession starts at the same level at which the lastsession finished.

Efficiency and economyThe procedures generally allow the client to trainon his own, instructed and verbally motivatedby the PC. At the beginning of each ttainingsession, though, the therapist's presence is neededin order to define the dayt training aim togetherand to estimate the emotional, motivational andperformance state of the client. The same appliesto the end of each session when therapist andclient evaluate the petformance together andspeak about difficulties that occurred.

The computer caflnot and should not replace thepsychologist or therapist. Every patient needs socialfeedback and allowance and has a right to receive it.The computer is only a part of the therapyconcept, offering new possibilities, providesrepeating divercifi ed training.

Language avai labi l i ty anddistr ibut ion

The procedures which operate under the systemname RehaCom, which now number 29 e1. ofthemtranslated into English, have been on themarket stnce 1992. Cognitive training with Re-haCom is used in thousands of leading neuro-logical tehabilitation clinics and out-patient de-partrnents and by practice therapists in Germanyand eisewhere. Improvements to the RehaComsystem ^te, to a large extent, based on theirexperiences and on the results of a series of effec-tiveness studies at clinics and universities.

In recent years, the method of treating brain func-tion disorders with RehaCom has become firmlyestablished in a number of countries. RehaComis now the market leader in Europe and beyond.The leading treatment programmes have beentranslated into more *tan 14 languages. RehaComcustomers who wish to train their patients in theirnative tongue can benefit from this multilingualprovision.

Continuing RehaCom treatmentin cl in ical pract ices and athome after leaving hospital

Itis often advisable to continue brain performancetraining with RehaCom in a clinical pracace or athome aftet a hospital stay. For financial reasons,patients often spend too litde time in hospital toachieve sustainable success in the long term. Thatis why an increasing number of neurological andoccupational practices are offering their patientsRehaCom training.

RehaCom enables customers to exportpatient datafrom the clinic (for instance, using a memory stick)and import it into the system used at the practice.

This enables one to continue brain performancetraining without interruption after the patientleaves hospital, and to update patient fi.les andthe results of treatrnent seamlessly, either in thepractice or at home. $7ith its dialogue-orientedstfuctufe, integrated instruction cycle for patientsand auto-adaptive mode of operation, users afeable, once instructed accordingly, to work withRehaCom independendy for prolonged periods.Litde time must be committed to observing thepatient. The latest studies at the NeurologicalRehabilitation Centre in Magdeburg, Germany,have shown that RehaCom is the most suitabletool for carrying out brain performance trainingat home.

Prescribing treatment and theinternet

A modern therapeutic system such as RehaCommust engage with the new challenges presentedby global networking and communication. As aresult, RehaCom has integral modules which al-low data to be exchanged through the internetbetween the therapist in a hospital or practice andthe patient at home in a simple, unproblematicway. Needless to say, we comply with the strictestdata protection guidelines. The therapist is thusable to set the patient precise tasks from the con-venience of his workplace. He prescdbes: whenthe patient should use which method of trainingand under what circumstances and can leave pre-cise instructions for the patient to follow.The informaion can be retrieved either from aserver on the internal hospital network (intranet)or from a HASOMED RehaCom server (inter-net).

The patient logs into the RehaCom system withhis name and password or with a smaft card, andreceives only the prescription which the therapisthas left for him. If the patient has workedwithout supervision, the data charting the pro-gress of training is automatically left on the server.

The therapist can access it from the RehaComsefvef, evaluate training and set flew targets.

Future perspectivesThe development of new procedures isdetermined byt the experiences with existing procedures,t the results of studies for effectiveness,

and validity and new computer techno-logy'

Training procedures will utilise multimediacomputer technology which make them evenmore realistic to situations and requirementsof evetyday routine. Clients should clearlysee that a progress in the training leads to aprogress in activities of daily living.

He lp deskIn case you want to share your experienceswith us, look for other people who want toshare experiences, need more information orliterature about "Computer assisted trainingof brain functions", ot have a question onRehaCom, the staff of HASOMED, RehaCom-team is aiways there for you.

The RehaCom smarr card


Acoustic reactivity(AKRE)

Brief descriptionThe aim of the procedure'Acoustic teactivity" isto improve precision and speed of acoustic reac-tions. The sounds zre fzmihar to the patient fromhis everyday environment.

Indicat ionsThe procedure is recommended in adults with adiagnosed deficit of reaction speed and reactionprecision but also in impairments of acousticdifferentiation abiJity. Furthermore the trainingmakes a strong request to mental flexibility andfocused attention. In clients liable to interferencesthe therapist should make sure they arc not over-strained. Fot training with children from 8 yearson child-odented instructions are provided.

Basic requirementsof the patient

The ability to petceive sounds and to differentiatebetween them are precondition. For an indepen-dent training the client needs to be able to handlethe RehaCom panel.

TaskDuring the preparation phase the client leatnsto associate the sounds with the buttons of theRehaCom panel. If desired, a practising phasefollows. Finally the actual training starts. Now a rangeof sounds (a barking dog, a.irgmg telephone etc.)ate heard and the corresponding buttons on theRehaCom panel have to be pushed as quicklyas possible.

Training materialAt the moment about 60 different sounds withtheir typical background sounds (..g. waveson the beach) are provided. Pictures on thescfeen and cetain acoustic stimuli cte te a p^r-ticular environment or situation (e.g. at home,

on a fzrm etc.). The RehaCom panel is requiredto use this programme. The computer must beequipped with a DirectX-compatible Soundcardand suitable loudspeakers or headphones!

Levels of diff icultyThe difficulty is modified through the number ofsounds to be differentiated, the use of irrelevantstimuli and the use of background sounds (e.g.quiet music).

EffectivenessAt the moment the procedure is tested scienti-fi.ily.Because of the high closeness to real lifea good transfer of the skills trained to everydaysituations can be expected.

Reaction behaviour(REVE)

Brief descriptionRespondent behaviour of single and multiplechoice reactions (speed and accuracy) towardsoptical signals is trained. On the edge of thescfeen lraffr,c signs can be seen. Next to each akey of the RehaCom panel is displayed which hasto be pressed when the taffic sign appears in themiddle of the monitor. Thus, attention and me-mory are joindy trained.

Ind icat ionsThe raining is indicated for all patients withreduced response speed induced by the centralnervous system. Such a reduction of responsespeed almost always occurs in diffuse brain dam-ages as well as in frontal and prefrontal lesions (e.g.dementia, brain trauma, insult, formation of atumour, ischemia, etc.).


The client needs to be able to understand andcomply independendy with easy instruction texts.

TaskVeryrealistic stimuli (taffrc signs) were chosen forthis training. The task is to press the correspond-ing reaction key as quickly as possible whenever atxget stimulus (i.". z traffic sign) appearson the monitor.

Training materialThe training material consist of realistic ttaffi,csigns. In the learning phase the pictures of thet^rget stimuli (uaffi,c signs) and the corespond-ing reaction keys are presented. By pressing theOK-button the learning phase is tetminated.Then the target taffrc signs (towards which theclient must react within a certa:tn time interval),

and in higher levels of difficulty also irrelevanttaffi,c signs (which requke no reaction), ate dis-played. The RehaCom panel is required to use this

Pfogfamme.

Levels of difficultyThtee types of tasks with 4 or 6levels of difficultyeach have been constructed:

+ The next traffic sign appears only after theresponse of the previous (6levels of difficulry).

+ Fixed interval between the items (4levels).+ The interval changes adaptively. After a correct

fesponse a shorter interval is chosen, and viceversa (6 levels).

EffectivenessInvestigation results fot this training piogrammare not yet available. However, good rehabilitati-on results afe expected for the above mentionedindications because a specific disorder is trained.

Cognitive TherapyRehaCom

Ability to respond(REAl)

dudng z pncilce session. Training then proceedswith a selectable number of stimuli. The speedand accutacy of the patient's reactions ^re mea-sued and evaluated.

Training materialTraining incoqporates more than 200 visual stimuliand 6 acoustic stimuli 1n 3 vaiaions each. Thetherapist can add his own visual and acousticstimuli (any pictutes and sounds he chooses).There is an integrated editor to create individuali-sed training programmes.

Levels of difficultyThe programme offets 20 levels of difficulty with5 tasks per level. Each task comprises several com-binations of stimuli. The various combinations arerandomly selected by computer, ensuring thateachpatient expedences an extremely varied trainingprogralnme. The programme works adaptivelytkough rhe 2}levels of difficulty. The higher thelevel of difficulty, the greater the number of sti-muli to be determined and the more vaded thetemporal sequence of stimuli.

EffectivenessThe effectiveness of alertness training has beendemonstrated in many scientific studies.

Brief descriptionThe objective of reactivity training is to improvethe speed and accutacy of reactions to visual andacoustic stimuli. Simple, simple choice and mul-tiple choice reaction tasks are designed to trainthe patient to react as quickly and differentially aspossible to signals.

Ind icationsThe objective of reactivity training is to improvethe speed of rcactions and the speed and accrxaciJof reactions following cerebral lesions. It is fecom-mended in the case of disorders of selective atten-tion performance, and in the case of disorders ofvisual or acoustic discrimination, cognitionandf orbehavioural performance.


The training programme is less suitable for pa-tients with serious ametropia or poor hearing(acoustic stimulation). The patient must be capableof pressing the large reaction buttons of theRehaCom panel accurately. Serious memoryimpairment (forgetting srategies) and disordetsaffecting attention and concentration may impairthe success of training.

TaskReactivity is trained using simple, simple choiceand multiple choice reactions, and involves visualzndf or acoustic stimuli. After a predefined visualstimulus appeafs and/or after an acoustic stimulusis played, the patient must press a particular but-ton on the RehaCom panel as quickly as possible.During an acquisition phase, the patient famili-arises himself with the practicalities of the task.He learns to associate the stimuli with the relevantbuttons on the panel. The assignment of stimulusto reaction which is learned can be consolidated

Vigi lance(vtGr)

Training materialObjects are displayed on a conveyor belt andhave to be compated to one or several fault-free

,,sample objects". The client should find thoseobjects thztzre not identical to the sample objects(= faulty objects).

Levels of diff icultyAccording to the parameter settings concfeteobjects (e.9.

" washing machine, z refigerator,

etc.) or abstract figures are displayed. Child-friendly instructions are provided to assist inits use by children.15 levels of difficulty zre avaifable. Ifith increa-sing degtee of difficulty the following parametersgrow:t the number of diffedng (,faulty') objects,t the numbet of differing elements,t the number of objects displayed as well ast the complexity of the pictures.

EffectivenessFor detailed information please refer to thesection,,Effectiveness Studies", especially tothe studies of BECKERS, HOSCHEL, PREETZand FRIEDL-FRANCESCONI. PHUR. PFLE-GER. GUNTHER.

Brief descriptionThe ability to maintain one's attention over alonger period of time is trained in a design withlimited response time towards the items. The taskof the patient is to monitor a conveyor belt andto select those objects that differ from a sampleobject in one or several details.

Ind icat ionsThe training is indicated for all disorders orimpaitments of the long-term (continuous)attention of different etiology and genesis. TheVigilance' training programme is particularlysuitable where there are disorders affectingtonic attention. In the case of patients withvascular brain damage, craniocerebral in-juries and dementia, improvements c 17. beexpected in cognitive petformance as well as,to some extent, age-related transfer effects.


The task of this taining is very simple. Thepatient has simple visual differentiationsto solve. Children c fl be trained also toappropriate instructions.

TaskThe task of this training is designed to be veryeasy. Basic visual differentiation tasks are requkedin the client. Objects move past on a conveyorand must be compared continuously with one ormore permanently visible specimen objects. Thepatient must identify which objects are not iden-tical to the specimens, and femove these from theconveyor at the point indicated.


Spatial operations(RAUM)

Brief descriptionThe ability to imagine something spatially is focusof the procedure "spatial operations". It is trainedin 5 categories: estimating positions, estimatingangles, estimating relations (fillirg of vessels) andestimating sizes one- and two-dimensionally.

Ind icat ionsThe procedure is recommended especially fortraining basic cognitive functions of spatial per-ception. Through using non-verbal material it isalso suitable for patients with impaired abiJity tounderstand words or language.


Visual basic skills belong to the complex cognitiveskills. For that, on the one hand, performancesin attention are ptecondition, on the other hand,there proved to be significant correlations to theability of abstract thinking. In highly impafued in-tellectual skills or disturbances of attention thisprocedure is less suitable.

Task and training mater ia lWhen estimating positions, two fields with struc-tured backgrounds are displayed on the screen.One of them shows an object (e.g. a cat) ata fixed position. In the second field the sameobject is displayed at a dtffercnt position. Thetask is to move the second picture to the sameposition in its field as the first picture by meansof the cursor buttoris on the RehaCom panel.Photographs and drawings are used. Whenestimating angles, 2 angles have to be made equi-angulat When estimating relations, vessels haveto be filled with "liquid" (half full, 1/3 etc.)$[hen estimating sizes, the fields display ob-jects - drawings or photographs - of differentsizes which have to be brought ro equal size by

means of the cursor buttons. This task is avatla-ble in a one- and in a two-dimensional version.The shot-term memory for spatial perception istained in higher levels when the original objectvanishes with the first adjustment of the ,.copy,,.Reconstructing the odginal position then has tobe carried out from memory.

Levels of diff icultyThe procedure works adapttvely, for each catego-ry ^ sepête serial of levels from 1 to 9 has beenvalidated, in total 42levels. The tasks of each ca-tegory are explained in an insttuction phase via"learning by doing".

EffectivenessStudies for this ptocedure are not yet available.However, good rehabilitation success can beexpected in the indications described abovesince the client trains disturbance specifically.

Two-dimensional operations(vRol)

Brief descriptionThe ptocedure "Tlwo-dimensional operations"trains the positioned relationship with two-dimensional presentation. The task is to find thepicture of a matitx which exactly correspondsto a ,,comparison picture". The correspondingpicture is t'wisted towards the ,,comparisonpictute".

Indicat ionsA decline in the performance in visual-constructivetasks, items of the position-in-space-explorationas well as in spatial orientation ate observedfor dght hemisphedc temporal and parietaland damages of the frontal lobe. The trainingis indicated for patients with lesions in thislocation, diffu se brain damage or mefital defectives.


TVo-dimensional and spatial operations, inwhich the position-in-space-relation must beperceived and the object turned or tiltedin order to find out the correspondingpicture, belong to the more complexcognitive abilities. Therefore basal attentioncapabilities ^re ^ precondition. On the otherhand considerable correlation with the abilityto solve absffact ,,bfain-teasers" andintelligence in general have been found invarious investigations. For clients with extremeintellectual impairments or a pronouncedattention disturbance the ttaining is lesssuitable.

TaskOn the screen various pictures (objects) atedisplayed that should be compared to ^n

object ^t the edge of the screen. Thecorresponding picture, which has to be foundout, is nvisted towards the compadson picture.

Training materialGeometric figues, e.g. squares, arroua, hexagons,are used as objects. At higher levels of difficulty,the training mateid, increases in complexity - up toconcfete objects and street-maps.

Levels of diff icultyWith increasing difficulty the number of picturesin the matrix grows. Additionally more and moresimilar objects are displayed. So the differentiationcapacity needed to find the cortesponding pictureincreases. S(hilst at lower levels of difficulty thetasks can be solved by estimating sizes and lengths,at higher levels the patient must visualise the rota-tion of objects.

EffectivenessFor detailed infotmation please refer to the section

,,Effectiveness Studies", especially to the study ofFRIEDL-FRANCESCONI.


Three dimensional operat ions(RO3D)

Brief descriptionSpatial sense and attention performanc e ^retrained. This is achieved by showing several three-dimensional bodies on the screen which mustbe compared with a reference body. All of thebodies on the screen can be rotated freely, makinga three-dimensional view possible. Stereo glassesfot a genuine 3D represenration ̂ re ̂ n additionaloption.

Indicat ionsThe programme is suitable for treating cognitivedisorders, particulady of spatial perception func-tions. The programme can also be used as a high-level continuation of attention training. By usingnon-verbal matedals, it is possible to work withthe programme even if language is restricted orthere are problems understanding words.


A spatial sense is one of the more complexcognitive activities. It requires a basic level ofattention, and many studies have found notinconsiderable correlations with the capacityfor abstract reasoning. The training is lesssuited in the case of profound inteilectual im-paitment or for those suffering from seriousattention disorders. Intact vision is required, par-ticulady at higher levels of difficultywhere detailshave to be recognised. Initial findings indicatethat the training can be used from the age of 10years. The patient needs to be able to move themouse of the computer.

Task and training materialA three-dimensional object is shown on the upperhalf of the screen. Below are 3 to 6 objects, whose

degtee of similarity varies with the level of diffi-culty. The patient must identify th. object whichmatches the object at the top of the screen exact-ly.All of the objects on the screen can be rotatedin three dimensions, and can therefore be viewedfrom every side. A total of 432 3D bodies in 67groups arc available as training material.

Levels of diff icultyThe programme works adaptively. TVenty-fourlevels have been validated altogether. Trainingcommences with simple bodies and shapes,laterprogressing to compound objects with and wi-thout an indication of dits6tisn. At the highestlevels of difficulty, the compleity of the bodiesincteases considerably; differentiation becomesincreasingly challenging. The level of difficulty isalso varied by using 3, 4, 5 or 6 objects of com-parison.

EffectivenessStudies on this training programme zre at ^ pte-p^t^toty stage. With the indications descdbedabove, however, good rehabilitation results canbe anticipated, because the training the patientteceives is specific to his disorder. Theexperiences and results obtained using the 'Tlwo-dimensional Operations' RehaCom programme^ppe r to be ransferable.

Visuo-constructive Abil it ies(KONS)

Brief descript ionThe procedure'Visuo-constructive abilities"trains visual reconstruction of concfete pictures.The client memorizes a picture in every detail.Afterwards the picture is displayed divided intoseveral pieces as in a puzzle. Then th epazzle has tobe reconsttucted correcdy.

Ind icat ionsSpecialists litetature claims that partetal lesionscause constructional apraiz. For managing tasksas in this procedute, however, not only abilitiesto solve visual reconstruction tasks are neededbut also memory and attention. The training isindicated for patients with a light or mediumdecline in the czpacity of the visuo-constructivefield as well as in other generalized functionaldisordets. Often such a general decline in theperformance can be observed in organic btaindamages (e.g. through intoxication, alcohol abuseetc.). Since only pictorial rr'aterial is used, thetraining is also suitable for children from about8 years on.


For clients with serious apraxia, amnesia, andconcentration disturbances the training is rathetunsuitable.

TaskThe trainingis constructed analogue to traditional

,,puzzle" games. In the beginning of a task apicture is displayedwhich has to be memorized asdetailed as possible. When the client presses theOK-button, or after a defined time, the pictureis divided into a certain amount of puzzle piecesand has to be reconsttucted.

Training materialThe pictures appear in very high resolutton Q56color mode) on the screen. Pictures of houses,faces, paintings, landscapes etc. are used.

Levels of diff icultyAltogethet lS levels of difficulty are provided. Themain ctiteita for the change in the level isthe number of ptzzle pieces the picture is divi-ded into (ranging from 4 to 36 pieces).

EffectivenessEffectiveness studies are not yet available. How-ever, many investigations of neuropsychologicalrehabilitation report good training effects afterregular puzzle pl"yrng (often also in combinationwith other programms and exetcises). One can as-sume that the results of these investigations arealso true for this RehaCom procedure since it isconstructed in analogy.

Cognitive Therapy

Attention and concentration(AUFM)

RehaCom

Brief descriptionThe RehaCom procedure 'Attention & concen-tration" is based on the pattern-compadson-method. The patient has to find the picture fromamati'tx which cotresponds exacdy to the,,com-parison picture".

Indicat ionsFunctionally and organically caused attentiondistwbances represent the most widespreadneuropsychological petformance deficit afteran acquired brain damage. They are found in80 % of the patients after stroke (apoplexy),brain tauma, diffuse organic btain impairments(e.g. caused by chronic alcohol abuse or intoxi-cation), as well as in other diseases of the centralnervous system. The training is suitable foradult clients and for children vzith attention andconcentration disturbances from 6 yeats on.


Besides the comprehension of easy instructiontexts, the abilities to perform visual differentia-tion tasks and to handle the big buttons of thepatient partel ate necessary.

TaskA pictute presented separately on the screenis compared to a matrix of pictures. The onepicture exacdy corresponding to it has to be found.

Training materialA total of 49 picture pools - each containing 16pictures - has been set up. Because of the use ofVGA-gaphics with high resolution, the pic-tures appearing on the screen are of goodquality. They represent different qrpes of ob-jects according to the parameter settings: either

concrete objects (fruits, animals, faces, etc), ge-ometrical objects (citcles, rectangles, tdangles indifferent sizes and orders), or letters and numbers.

Levels of difficultyThe adaptive change in the difficulty of the tasksguarantees that the client will be confronted withneither too difficult nor too easy tasks. Altogethet24Ievels of difficulty arc available. With increa-sing capability, three,later six, and finally 9 similarpictures are displayed on a matrix. Only one ofthese is identical with the comparison picture.

EffectivenessFor detailed information please refer to thesection ,,Effectiveness Studies", especiallyto the studies of GUNTHNER" BECKERS,HOSCHEL, POLMIN, PREETZ, FRTEDL-FRANCESCONI, PUHR and PFLEGER.

Divided Attention(GEAU)

Brief descript ionIn this attention training - like in every daylife - several circumstances must be observedsimultaneously. Like an engine driver the patientmonitors the driver's cab, regulates the speedand teacts towards different signals ,,during thejourney".

Ind icat ionsProblems in focusing attention towards sevetaldiffetent ob jects simultaneously occut with almostall diffuse brain damages (e.g. intoxication otalcohol abuse) as well as with local damages of theright hemisphere, especially of the parietal partsof the brain. Effected patients have difficultiesto focus their attention to different objects at thesame time. Because of the animated presentationthe training is very motivating and suitable alsofor children from 11 years on.


The client should be able to understand andcomply with easy insttuctions independendy.

TaskOn the lower part of the monitor a driver's cabinis represented. Above, one can observe the track(ike through the wind shield of the engine). Theclient has to react simultaneously towards theelements in the cab and towards certain signalson the track.

Training materialThe driverb panel contains a speedometer, a socalled,, deadman l amp" and the "emergency breaklamp". On the speedometer ̂ tmget speed is setthe client should comply with. On the flashingof one of the lamps the client must press the

correspondingbutton on the RehaCom- panel (e.g.the stop-button). If an important sign appears onthe track the client also has to react (e.g. stoppingzt a red block slgnal).

Levels of diff icultyThe training contains 14 levels of difficulty. In thebegrnning the client needs to regulate the train'sspeed only. From level two onwatd new tasks areadded step by step. This implies reactions towardsdifferent train signals, the deadman lamp andemergency break signals.

EffectivenessFot detailed information please tefer to the section"Effectiveness Studies", especially to the study ofPUHR.


Divided attention 2(GEA2)

Brief descriptionDriving z car the patient has to pay attentionpatallel on several issues: observing attentivelythe landscape and car dashboard as well asreacting differentiated on acoustic information.In the beginning there is only the speed to keep.L^ter on, with growing level of difficulty, thereare further tasks, which wait for certain reactionsof the training person in other area of attention.

Indicat ionsPatients with disturbances in focussing on certainaspects of a task, in fast reacting on relevantimpulses and at the same time ignodng irrelevantimpulses. These disturbances occur in 80o/oof patients after stroke, craniocerebral injury,diffuse brain organic impairment (e.g. as a resultof chronic alcohol abuse or intoxication) as wellas othet diseases of the central nervous svstem.

Basic reeuirementsof the patient

There are simple texts of instruction to compre-hend. The patient has to push the buttons on thepanel or keybord by himself. Supported byinstruc-tions appropriate for children also children upftom age 10 zre able to train with this procedure.

TaskOn your monitor you will have simulated a lookthrough a frontalwindow of a car as well as lookat the car's dashboard. Through the window yousee the street in front of the car, which trailsaway 'tn the distance of a landscape. Left hand isshown the speed-indicator. Within the tachome-ter there is a green area which marks the speedyou should ddve. Below the green atea thereis a ted ztrow, which shows you the currentspeed. The red arrow must always be located in

the green arca. The car moves on the stfeet on afixed track, also in curves, so that the patient hasnot to pay attention to keep the car on the stfeet.

Training materialTo speed up the car you have to push the arrowkey up, to slow down the arrow key down. Thereis a display for the way to go and the expfuedtime. The aim is to drive a ceftain distance in alimited time. It is to pay anention that the dis-play for the way is always in front of the displayfor the time. A level is finished when the time isover or the way is done. \X4rile the car is set inmotion through pushing the arrow keys on theRehaCom panel, relevant as well as irrelevant ob-jects are moving perspectively towards the user.Only the relevant objects and acoustic stimuli arecounting as results for the training of the patients.

Levels of diff icultyThe procedure works adaptive. In total there are22levels validated. l7ithin the training the difficultiesvary by adding more and more levels of attentionand by modi$ring the interval of the stimuli.

EffectivenessGood results of tehabilitation can be estimatedbecause the client is trained specifically to his di-sturbances. Studies are in process.

Topological memory(MEMO)

Brief descriptionThis procedure trains topological memory.Uke in a memory-game the position of cardswith pictures (e.g. a lion, a flowet, a house, a caf,etc.) ot geometric figures should be memorized.Once the cards ate turned "upside down", theitposition has to be remembered.

IndicationsThe indication for this training is given fot allmemory disorders or impairments regardingverbal and non-verbal contents. Amnesiacsyndtomes can be observed for all diffu se cerebro-organic diseases (dementia, intoxication, chtonicalcohol abuse etc.) as well as for all left or bothsided lesions of the medial or basolateral limbiclemniscus. Mote over vascular diseases, brainttuvrrra, or btain tumorts in ptefrontal, tempotalup to parietal cotical ate s c n lead to memorydeficits.


Beside basic task comprehension the handlingof the big buttons of the RehaCom panel is aprecondition.

TaskIn the so called ,,memorizing phase" a numberof cards (depending on the level of difficutry)with concrete pictures or geometric figwes aredisplayed. The client memorizes the position ofthe pictures. After a preset time - or manuallyby pressing the OK-button - the pictures of thematrix are hidden (turned ,,upside down'). Atthe edge of the screen a pictue udll be displayedand the client indicates which of the hiddenpictures corresponds to it.

Training materialIn total 464 picnxes (pictures of concrete objects,geometric figutes and lettets) arc available. Thenumbet of simultaneously displayed pictures variesfrom 3 to a maximum of 76.

Levels of difficultyThere arc 20 degrees of difficulty defined by anumbet of cards and complexity.

EffectivenessFor detailed information please refer to the section

,,Effectiveness Studies", especially to the studiesOf GUNTHNE& BECKERS, HOSCHEL,PREETZ, FRIEDL-FRANCESCONI, PUHRand PFLEGER.


Physiognomic memory(GESI)

Br ief descr ipt ion$7ith this training the recognition of faces andthe pairing of faces to a flame and a professionis practiced very realistically. Faces are displayedftom different sides. The client decides whetherthe picture of a person has been shown befote.In highet levels of difficulty additional verbal in-formation regarding the person (name, professi-on) has to be memorized.

Indicat ionsWith ptosopagnosia the ability to recognize facesand establish meaningful associations with themis impaired or lost. The problem can also be rela-ted to memofy components that are tesponsiblefor remembering faces. This disorder is causedby lesion of the tempotal lobe (more often lefthemispheric). The training is therefore indicatedfor all clients with right-sided or bilateral tempo-ral lobe damage of different pathogenesis if theabove mentioned impairments are observed.


It is necessary that the client is able to performeasy tecognition tasks and handle the patientpanel.

TaskFaces are memorized during a ,,leaning phase".Afterwards these faces are picked out from anumber of different faces pictured ftom differentsides. In higher levels of difficulty a name and aprofession ^re to be memorized additionally. It isthe client's task then to find out the face cone-sponding to the name or the profession.

Training materialAltogether 47 persons have been photographedfrom four different views. The pictures almostreach photo quality (16,7 million colours in theSVGA mode; 24 BPP). To adapt the training tolocal speciaiities or the familiar sutrounding of thepatient there is an editor to embed own pictures.

Levels of diff icultyThree levels have been designed:t Memorizing faces (1-6 pictures: level 1 to 6)+ Connecting face with a n me (2-6 pictures:

level 7 to 11)t Memorizing faces with the corresponding

name and ptofession Q-6 pictares: Ievel 12to 16)

t Memorizing faces with the correspondingname and phone number (2-6 pictutes: Ievels17 to21)

EffectivenessIfith this ttaining ptocedure exacdy those abilitiesarc tarned that arc impaired in clients with theabove mentioned lesions. Therefore a high effec-tiveness of the training can be expected.

Memorof words(WORT

Brief descriptionThis RehaCom procedure trains the recognitioncapability for individual words. In the so-called

,,learning phase" a cettun number of words isshown. Afterwards ^ vznety of words ,,roll bf'like on a conveyor belt. The client's task is torccogrttze and pick out the words shown in theIearning phase.

Indicat ionsThe taining is especially suitable for clients withan impairment of the word span or reduced te-cognition capability - especially for clients witha beginning amnesic syn&ome. This syndromeoccurs of patients with diffuse cerebro - organicdamage and left hemisphedc or bilateral lesion(especially of the limbic lemniscus with damageof the thalamic parts). The training is also sui-table fot clients with functionally caused i-pît-ments and for childten from 1.1. years on.


Beside the ability to read words, it is a pre-condition that the client is able to master easyrecognition tasks and to press the OK-button onthe RehaCom panel.

TaskIn the learning phase a list of words is memodzed(from 1 up to 10 words). The highet the degreeof difficulty, the higher are the number and thedifficulty of the words to be memorized. Thewords presented in the leatning phase should beselected afterwards from a number of other 6r-relevant) words.

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Training materialThe wotds ^ppex big and pl"inly visible on thescreefl. The moving of the words on the scteen iscarried out continuously and without jerking. Thespeed of the words ,,rolling by" can be adapted.

Levels of diff icultyThe displayed words are divided into three groupsof 200 words each. These groups include: easy andshort, easy compound, and complex compoundwords.

EffectivenessFor detailed information please refet to the section

,,Effectiveness Sudies", especially to the studiesOf HOSCHEL, POLMIN, PREETZ, FRIEDL-FRANCESCONI and PUHR.


memory

Brief descriptionThis procedure trains the medium-term nofl-ver-bal and verbal memory (working memory). Thepatient memorizes pictures with concrete (de-scribable) objects or terms. After the ,,learningphase" according terms or objects roll by like ona conveyor belt. The patient presses the OK-but-ton whenever a term or picture of an object ofthe ,,learning phase" rolls by.

Ind icat ionsThis training is indicated for all memory distur-bances (especially for the working memory) forverbal and non-verbal contents. The procedurecan also be used in clients with an - organicallyor functionally caused - impaired ability to nameobjects and difficulties in conceptual pairing.Average vocabulary assumed, Figural Memory issuitable fot children from 11 years on.


It is required that the client is able to nameconcrete objects and rcad easy wotds. Forindependent training the client must be able,regatding his motor skills, to ptess the bigbuttons on panel.

TaskPictures or terms of concrete objects are displa-yed. All terms or pictures of these objects haveto be memorized now. The ,,learning phase"is terminated by pressing the OK-button.Afterwards according to the displayed termvarious pictures or according to the displayedpicture various tefms ,,roll by" on the scfeenfrom the left to the dght like on a conveyor belt.Whenever a term or picture of an object of thelearning phase appears - terms or pictures that

had to be memorized - the client pushes the OK-button.

Training materialBecause of VGA-graphics with high resolutionthe pictures appearing on the screerr are of goodquality. Regarding the terms, a big and easy to readtypeface has been selected. The moving of thewords thtough the screen is carried out continuo-usly and without jetking. The speed of the words,,rolling by" can be adapted to teading speed.

Levels of diff icultyThe number of displayed objects in the,,learningphase" corresponds exacdy to the nine levels ofdifficulty provided. In the lowest level the clientshould memoize one object - in the highest levelnine objects - and later recognize the correspon-ding term(s).

EffectivenessFor detailed information please refer to the section,,Effectiveness Studies", especially to the studiesof HOSCHEL and FRIEDL-FRANCESCONI.

F igural(BILD)

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Verbal memory(VERB)

Brief descript ionAim of the procedure 'Verbal memory" is toimprove the short-time memory for verbal in-formation. Short stories displayed on the screencontain ^ r^nge of details the client is asked tomemorize and later reproduce when questionedby the PC.

Indicat ionsThe ptocedure is recommended for clients with adisturbance or an impairment of their short-timeor medium-term memofy. These might be con-sequences of almost any diffuse brain damage(dementia, alcohol abuse etc.) as well as of full orleft-hemisphedc lesion. The training can also beused to improve memory skills in childten from11 yeats on.


The client must be able to read and understandsimple language. For independent :r:urung he/she should be able to use the RehaCom panel.

TaskA short story is displayed on the screen. Theclient is required to memorize ^s m^ny detailsof the story as possible (dates, numbers, events,objects). The "memoizing phase" can be deter-mined through pressing the OK-button. Finallyquestions about the content of the story afeasked.

Training materialMore than 80 short stories arc avulable. Depen-ding on the setting, either the computer or thetherapist selects a story fot training. The pool ofstories available can be extended by virtue of anintegrated editor.

Levels of diff icultyThere zre lllevels of difficulty. The higher thelevel of difficulty, the greatet the length and in-formation content of the story. The number ofnames, numbers, events and objects to be recalledalso increases.

EffectivenessFor detailed information please refer to the section"Effectiveness Studies", especially the studies byREGEI-6. FRITSCH.


Shopping(E INK)

Brief descriptionThis procedure realistically trains an everyday

situation: shopping in a supermarket. All steps

necessary are just like in reality. Planning and

cootdinating an action are trained as well as the

short-time memory (interval between looking

into the trolley and looking at the shopping list)'

lndicat ionsThis procedure is recommended fot clients with

defi cits in working memory, concept attainment or

planning an action sequence. Trainingwith children

from 11 years on is possible, and with eldedy

persons in order to maintain their mental abilities.


Clients should be able to read and understand a

shopping list. To work on his own the client needs

the dexterity to handle a mouse or the OK button

on the panel. Training is not recommended for

clients with attention deficits.

TaskThe client gets a shopping list with a range of

goods. Then he/she moves through a symbolic

supermarket with shelves displaytng grouPs

of goods (e.g. ftuits, dairy products, stationery).

In order to pick out a particular item (e.g. a

bucket) he needs to "entef" the goods department

(in this case household articles) by clicking

on the shelf. The shelves content with ^

variety of products is displayed then and

goods ^re "pnt into the trolley'' by

clicking at them. Checking the ttolleys content,

taking items out agatn as well as - if adjusted- having a look at the shopping list is possible.

After the client has collected all the goods he thinks

he was supposed to buy he finishes shopping by

moving to the check out. Here the goods in the

trolley are compared to those on the shopping list.

At a higher level the client "receives" an amount

of shopping money. The goods then are marked

with prices. The task is to check whethet there is

enough money.

Training materialThe programme currendy uses some 100

articles illustrated photo-realistically (foodstuffs,

household objects, etc.) These articles ̂ pPe^r otr

shelves, from which they must be selected by the

patient. The training programme features a voice

fesponse; in other words, all of the articles are

named when selected.

Levels of diff icultyThe procedure provides 18 levels of difficulty

with 2 modes. In the first mode the goods on

the shopping list have to be bought only.

In the second mode a ceftatn amount of

shopping money is available and the client has

to check whether there is enough money.

In both modes with increasing difficulty the

shopping list gtows.

EffectivenessAt the moment studies are conducted. A ttansfet

to activities of daily living is expected.

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P lan a day(PLAN)

Brief descriptionThis procedure is very closely related to thedaily routine in which the patient has to orgarizea day following time schedules. It aims at impro-ving the executive functions or rather at establi-shing strategies how to plan. It practices basicand - in higher levels of difficulty - complexcognitive skills.

Indicat ionsUsing this training is recommended to adult cli-ents with disturbances of the executive functions,especially of the ability to plan. This ability toplan and to orgatize everyday life belongs to themost complex human skills. This skill can be im-paired as a result of any brun damage, especial-ly of damages of frontal structures or in diffusecerebral damages. The procedure Plan a day mayalso be used for training memory skills. However,it is not recommended in cases of verv heawsedous distutbances.


The client needs to be able to understand thetask and move hands according to the task. Thetherapist's presence is strongly recommended forseriously effected clients.

TaskThe training requkes the client to realtze a set oftasks in optimal ordet. On the screen a "town"ftom birds-eye-view is displayed, it shows buil-dings which the client needs to go to accordingto his time schedule. There are three kinds oftasks:t Realize pdoritiest Minimize path lengths (and thus the

time needed)

t Maximize the number of tasks carriedout successfrrlly

The levels of difficulty are characterrzedby v^fla-tion of different parameters.

Training materialThe procedure can generate an almost infinitenumber of different tasks through ever new com-binations of rasks, thus providing change andvaiety.

Levels of diff icultyThe procedure works adaptively following a va-lidated structure of 55 difficulties. Additionaladjustment to the client's capacities is possible viathe parameter window

EffectivenessPlan a day is a follow-up development of a proce-dure set up in cooperation with Prof. Dr. JoachimFunke pniversity of Heidelberg). Prof. Funkeproved an improvement of clients' planning skillswith a DOS-Vetsion of the procedure. Evaluationstudies for the procedure are in progress.


reaso n ing

Brief descriptionThis training aims at improving logical thinking(reasoning). The client picks out the symbolcorrecdy completing a row of symbols which isconstructed following aloglcal rule, or a combi-nation of logical rules.

Indicat ionsMost authors relate the frontal lobes above allvrith abstract reasoning. However, isolated lesionsof the frontal lobe seldom ^ppear separately. Forthat reason there is a high degree of disagreementabout which cortical parts are responsible forsolving reasoning tasks with non-verbal mateiil.The training is indicated for patients with acquiredcerebro-organic (frontal lobe) damage, when animpairment in logical thinking can be observed.Those declines in performance occur e.g. quitefrequendy as a cause of chronic alcohol abuse,dementia and insult, but also schizophrenia.

Basic reeuirementsof the patient

The precondition for using the raining is the abi-[ty itr the client to focus attention over a longerperiod of time. He/she should be able to draweasy absftactJogical conclusions. In order toperform the training independendy, the com-prehension of easy instruction texts and basicmotor skills to handle the RehaCom-panel arepreconditions. The training can also be used bychildren from 12 years on if they arc capableof performing abstractJogical conclusions.

TaskFrom various symbols (,response pool') theclient is asked to select the one which correctlycontinues a given sequence.

Training materialA sequence of s).nnbols (citcles, triangles, squares,etc.) of different shape, colour, and size, intercon-nected by a de, are displayed on the screen. For afalse tespond specific hints concerning the type oferror (shape, colour, andf or size) zre given.

Levels of diff iculty23 levels of difficulty are available. With increasingdifficulty the client must observe various levels ofabstraction in order to find the solution. In theeasier levels the symbols maintain e.g. size andcolour. Only the shape of the symbol changes.In higher levels all three components - shape,color and size - change according to sophisticatedrhlthms.

EffectivenessFor detailed information please refer to thesection,,Effectiveness Studies", especially tothe study of PUHR.

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Ca lcu lat ions(cALC)

Brief descriptionMathematical training enables patients to

improve their arithmetic skills. Such skills are

essential in many ateas of daily life. The pro-

blems to be solved ̂ revery vaned in natute. Thus,

depending on the type of disorder concetned,

training can be given in basic mathematical

operations or more complex tasks. The basic

mathematical problems include size comparisons,

quantitative comparis on s, atranging acco rding to

quantity and basic mathematical operations at

various levels of difficulty. Tasks telating to

money handling and written addition and

subtraction are included to train patients to solve

complex mathematical ptoblems.

lnd icat ionsThe treatment programme was developed for

patients with impaired arithmetical cognitive

skills. These disorders of cognitive function can

vary grearJy in nature. They range from restricted

basal disorders, such as the inabiJity to estimate

sizes and quantities, to problems in applying

basic areas of mathematics and difficulties

solving complex mathematical problems.


The patient should be capable of understan-

ding the task and have the necessary motor skills

to complete it. The presence of a therapist is

strongly recommended in the case of severely

affected patients.

TaskThe training involves a wide varrety of tasks.

The patient begins with simple comparisons of

size and quantity, and with sorting tasks. Then

the basic mathematical operations of adding and

subtracting are ptactised, both mentally and in

writing. At more advanced levels, the patient is

trained in very rcal-hfe situations to handle money;

he must be able to show that he can count, give

change or check his own change to the appropri-

ate standard. Finally there are multiplication and

division tasks.

Training materialSize and quantity tasks are practised using pictures

of simple objects, until the patient progresses to

counting with numbers. During written addition

and subtraction, the numbers carried over afe

shown in a smaller font. Money handling is prac-

tised using pictutes of genuine bank notes and

coins.

Levels of diff icultyThe programme comprises 42 levels of difficultyand works adaptively

EffectivenessAs the training was developed in accordance

with precise pedagogic principles, a high level of

validity can be assumed. Studies ate currendy being

conducted into mathematical taining.


Saccadic Training(SAKA)

Brief descr ipt ionThis procedure is devoloped for patients withreduced visual capacities and visual neglectphenomena (neglect, hemianopsis, hemiam-blyopis e.g.).The patients are instructed to push the left orright reaction button, when left or dght from thecentre a f,gxe (e.g. animal, vehicle, person ...)aPPeafs.

Indicat ionsThis procedure is designed for patients withcontra-lateral visual neglect phenomena onone-side and reptesentation disorders. A lowervisual exploration on one-side of the sight occursoften with visual neglect or extended cerebralinfarcts in the area of the Arteria cerebri orposterior. Also other hear-organic disorderscould be the cause of these lower functions.


This procedure is less suitable for patients withstrong defective vision organic based. Patientsmust be able to push the large reaction button.

TaskThe patientlooks at the horizon of a simple (2-di-mensional) landscape. A big sun is placed in themiddle of the screen. A figure appears left or rightof the sun with irregular distances. Everytimethe patient spots a figure, he/she must push theappropriate reaction button on the panel.

Training mater ia lOn the scfeen you can see a horizon. In the simp-ler levels a sun is in the middle of the pricrure.A figure appears on this horizon left or rightof the sun with irregular distances, different

figures ot symbols, i.e. animals, cars, bikes. Thesymbols get smaller at the higher levels, thehorizon vanishes and additional diversions appear.It is advisable to use the chin rest.

Levels of diff icultyThree levels of difficulry arc avatTable with threesizes of the objects ftig, middle, small). Theyare variable defined by the background contrast(black or grey) and the moving position (fixed ormoving) of the object. All together there arc 28levels of difficulties.

EffectivenessWith this RehaCom procedure the visual explo-ration is trained ,,symptom-orientated". There isa priori expected that with this computer assistedprocedure at least the same good training effectsare being accomplished as with conventionaltraining with patients who suffer from visualneglect phenomena on one-side.

Explorat ion(EXPL)

Brief descr ipt ionThe procedure deals with problems in visualexploration. The procedure uses a slow serialsearch for objects which must undergo a preciseinterpretion or analysis.

lndicat ionsThe training is recommended for patients with ahomonymous restriction in their field of vision,and fot patients who have problems with theirvisual exploration due to failure in their field ofvision, visual neglect. It is also recommended topatients who suffer from Balintsyndrome ot acombination of several of these types of distur-bances as a result of some type brain damage.The procedure can also be used to help pati-ents who suffer from linguistic resrictions andrestdctions in their ability to understand words,by combining the use of none vetbal materialwith the procedure.

Basic requirementsof the cl ient

The training programm is less suitable for patientswith strong defective vision. The patient mustbe able to press the large reaction keys on theRehaCom panel Serious disturbances in mem-ory (inabiJity to remember strategies) limits thesuccess of the training. It appears that childrenof 8 years and oldet could use this trainingprocedure. However, practice is encouraged sothat experience can be gained.

Task and training mater ia lThe objects are in lines and columns and aredivided up in a pre-arcanged manner. Thepatient searches over the given field with acircular cursor which is the size of a single ma-trix unit. In this way, the exploration movementof the patient is kept under control. The relevant

objects are not always distributed unifotmly but arefrequendy to be found in an unusual area of thefield of vision. It is advisable to use the chin rest.

Levels of diff icultyThe exploration training procedure can be adap-ted to suit up to 30 different levels of difficulty.In order to adapt certain strategies, the follow-ing modifications of difficulty ate included: thenumbet and the distance between the number oflines which have to be, the width of the explora-tion field (number and distance between columns),the recognisability of the different symbols, thedistance between the symbols which have to berecognised and therefore, the size and clarity ofthe cursor (atger distance t less symbols i largercursor), the variation of the symbols. An additionalmodification in the levels of difficulty is the speedof the cursor @,xplorations-speed). Its speed canbe set up by the therapist to suit each individualpatient.

Eff ect ive nessAs with all of the RehaCom-procedures the train-ing is ,,symptom orientated". ft can be assumedthat with this computer-assisted system, positivetraining effects can be achieved which are zt Iezstas good as those achieved during conventionaltraining with patients who suffer from a visualneglect-phenomena, in hatf of their field of vision.Conttolled tests have to be carrierd out.


Overview and reading(ztHL)

Brief descriptionBoth programmes are used to treat non-aphasicteadingdisorders (e.g. in the case of homonymousvisual field defects near the fovea) and overviewandf or visual search dysfunctions in patients withhomonymous visual field defects, visual neglector Balint's syndrome. They were developed andclinically tested by Prof. Zlkl, Prcfessor of Neu-ropsychology at the University of Munich.

Indicat ionsThe programmes are not suitable for patients withserious ametropia (visual acuity < 20o/o) or withalexj,z. Serious memory disorders (forgetting in-structions and strategies) as well as attention dis-orders will adversely affect the success of train-ing. Training appears to be possible for childrenaged 8 and over.

TaskReading: \X/ords or numbers of different lengthsappezr on the screen, and ate read aloud by thepatient. The display time is resfficted, so thatthe whole word or number must be registered.Responses are given to the therapist, who alsomonitors the progress of the new reading strategy.Visual search: Combinations of stimuli appear onthe scteen, with a predefined stimulus serving asthe target stimulus, and the other stimuli as dis-tractions. The patient must search the screenquickly and carefully and indicate the presenceor absence of the target stimuius by pressing abutton. Responses are given to the thetapist, whoalso monitors the progress of the compensationstfategy.

Training materialWords of different lengths (3-16 letters), shortsentences (2-4 words) and numbers (3-6 digits) are

used fot reading training; their length and the timethey are displayed can be tailored to the individualpatient. Different-coloured letters and shapes canbe used for visual seatches. It is advisable to usethe chin rest.

Levels of diff icultyReading training and visual search training in-crease in difficulry through several levels depen-ding on the patient's progress until predefinedperformance crtteria are achieved. The followingparameters which influence the level of difficultyare incorporated in the adaptation strategy:

- the length and display time of the wordsand numbers,

- the difference between target and distrac-tion stimuli and the density of stimuli.

EffectivenessScientific results arc avallable on the level ofeffectiveness of both training programmes.

Visual training to restore(vrsr)Brief descr ipt ion

Vision Restoration Training (InVISTAT) isa computer based pfogramm to initiate restora-tive processes in patients with visual impairmentsdue to neurological lesions. The self-adaptingprogramm presents kinetic supra-thresholdstimuli on a dark background. The patient is as-ked to respond to these stimuli by pressing a key.The therapy progress can be monitored by meansof CentraVIEWrM (computer based visual fields creening with static supra-thre shold stimuli) .

lnd icat ionsIn\{STATM was specifically designed for patientsexperiencing vision lo s s such as hemianopia follow-ing neurological lesions. Functional improvementshave been observed in patients with visual neglect,impaitments of visual perception and processing,and problems with reading and attention. Patientswith long existing impairments have been shownto also benefit from the taining. It is applicable forpatients with aphasia too.


To perform InMSTATM the patient should bemotivated, compliant, and be able to concen-tr"te for at least 10 to 1 5 minutes. There is no agelimit to the training. The patient should alwayswear prescribed visual correction. A head rest forhead stabilizatlon and keeping correct distance tothe monitor is highly recommended. The patientshould be able to press the space button of thekevboard or the buttons of the RehaCom panel.

TaskPatients sit in front of the computer monitorand put their chin and forehead in a chin rest toensure their eyes focus on the center of the screen.

Each time the fixation point changes color pati-ents are asked to respond by pressing a button.A bright stimulus is ptesented on the monitor,moving from the lnta.ct into the defect visual field.Patients are instructed to tespond to the movingstimulus by pressing a key as long as they stillperceive it. \X/hen the stimulus is no longer respon-ded to, it v/ill change direction and move from de-fect to intact visual field until the patient sees thestimulus agun and responds.

Training materialIn\IISTATM comprises of fout vetsions to accom-modate for different patterns of impairment. Theparameteitzation is based on clinical expert know-ledee.

Levels of diff icultyThe procedure consists of four versions for right-and left sided visual field defects. Versions 3 and4 differ from 1 and 2 by employing high-contrastfixation color changes and longer delay times forresponses. This is especially helpful for patientswith problems in attention and concentration ordeficits in color perception f catanct. Areas ofstimulation arc self-adaptive and adjust to the indi-vidual patient's tesults and ptogress.

EffectivenessClinical studies have shown that after subsequentperfotmance of several months of customizedVision Restoration Thetapy O'RT), 65oh of patientsachieved improvements in visual perception.

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F],riVisuo-motoric coord ination(wrso)

Brief descriptionThe object here is to train clients with disordersin visuo-motor coordination. A crrrsor and a rotor@oth abstract or concrete) are displayed on thescreen. The client moves the cursor into themiddle of the rotor and fties to keep it there fol-lowing the movements of the rotor.

Indicat ionsDamages of the motor cortex (frontal lobe) leadto deficits in the control of the minute motoractivity which can be observed most clearly incoordination disorders of the hand and fingermovement. In many cerebro-organic diseases anddamages, like cerebral insults, hemorrhage,extensive tumoufs, brain tfauma, etc., visuomotor functions are effected as well. The trainingis indicated for all disorders of the minute motoractivity.


In extreme visual disorders as well as in loss ofone visual field, the procedure is less suitable.Demands to the attention capabilities are alsomade. For vety serious apnxja the training isindicated only if the client is capable of handlingthe joystick.

TaskOn the screen a dot and a coloured circle (ab-stract mode) are presented, or e.g. a butterfly and aflower (concrete mode). The dot and the butrerflyare called "cufsor", the circle and the flower"rotor", The client moves the cursor into therotor by means of the joystick. Then the to-tor starts moving along a predictable track. Theclient tries to follow the movements with thejoystick (represented by the cusor). The RehaCompanel is requited to use this programme.

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Levels of diff icultyThe difficulty level is adapted to the currentperformance level of the client. The p^ra-metefs afe:t the size of the rotor,t the speed of the rotot, andt the type of movement (e.g. predictableor unpredictable, curves)

EffectivenessThe training'Visuo-motor coordin L 'jon" followsthe object persecution paradigm. Therefore onecan expect at least the same taining success asunder conventional training conditions.

Arrangementin groups

Procedures Levels Material used

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25 pictured objects


Friedl-Francesconi, H., Binder, H. (1996):Cognitive function training in the neurological re-habilitation of craniocerebral injuries. Zeitschiftfiir Experimentelle Psychologie, Vol. XLI[, fssue1,,1-21. In a study on36 patients with a seriousorganic psycho syndtome re sulting from cranioce-rebral injury, two forms of the computer-assistedcognitive function training were compared withone another: 1,2 panents were given attentiontraining on the Vienna Determination Device (20x 40 minute sessions over one month) in additionto their conventional neurological treatment, 1,2patients were trained instead with the RehaComprogrammes 'Topological Memory' and Visual-Spatial Operations', while the 1.2 patients in thecontrol group were treated only by conventionaimethods. Both before treatrnent started and af-ter it was completed, a battery of psychologicaltests comprising HA\XTE, TULUC, the AachenAphasia Test and the Benton Test were carriedout, as well as a special neuropsychological batteryof tests relating to hemispheric specialisation. Incomparison with the other two groups, the expe-rimental group using RehaCom achieved signifi-candy higher values in verbal IQ and performanceIQ itt the HArff{IE and Benton tests. Moreover,cognitive stimulation in the two right-hemispheredimensions 'Topological Memory' and Visual-Spatial Operations' proved superior to AttentionTraining with the Vienna Determination Device,.

Pfleger, U. (1996): Computer-assisted cognitivetraining programme with schizophrenic patients.Mtinster/New York: Waxmann - InternationaleHochschulschdften, YoL 204. The effectivenessof computer-assisted training in schizophreniawas investigated in a study using a sample groupof 28 patients with chronic schizophrenia. ft wasdesigned as a multi-level study examining not onlythe direcdy trained ateas of attention and memo-ry, but also psychosocial functions and psychopa-thological symptoms in apre/post comparison.

The'14 patients in the experimental gtoup weretrained with both RehaCom programmes (.At-tention and Concentration' and'Topological Me-mory) over 16 sessions. The L4 patients in thecontrol group received the clinict conventionalprogramme of therapy. The results were thatimprovements could be seen in cognitive per-fotmance in terms of attention, but not in termsof memory (multiple-choice vocabulary test,syndrome short test, d2 test and scales from theperformance testing system) ; psychopathologicalsymptoms and the level of psychosocial functionwere rated by the patients themselves and by thirdpanies on rating scales @rankfurt ComplaintQuestionnaire, Brief Psychiatdc Rating Scale,NOSIE and SANS). During self-assessment, pa-tients claimed to notice no effect, but third-partyassessments attested to the trained patients ex-hibiting changes in social adaptabthqr, social in-terest and their level of irritabiliw.

Puhr, U. (1997): Effectiveness of the Reha-Com programmes Attention and Concenrati-on','Divided Attention','Topological Memory','Memory of Words' and'Log1cal Reasoning, inneuropsychological rehabilitation. Thesis at theUniversity of Vienna, Institute of Psychology.Sixty-three stroke patients, 22 cratiocerebral inju-ry patients and 12 patients with viral encephalitiswere ftained using two out of five RehaCom pro-grammes (Attention, Divided Attention, LogicalReasoning, Topological Memory and Memory ofWords), depending on their most serious cogni-tive p erformance de fi cit. Training was sub dividedinto 1,2 x 15 minute sessions over the course ofa month. Before and after training, deductive re-asoning (coloured progressive matrices), genetalattention (Cognitrone), verbal and figural memo-ry (verbal and non-verbal learning test) and visu-al petception (Corsi) were examined. Pre/postcomparison showed first-order transfer effects(training effects), but no generalisation effects.

Preetz, N. (1992): Study to validate a compu-ter-assisted neuropsychological memory andconcentration training programme for patientswith cerebral damage at a chtic for neuro-logical and orthopaedic rehabilitation. Dis-settation ^t Magdebutg Medical Academy.

Thirty neurological patients with mainly vascularbrain damage who were undergoing out-patienttreatment at a neutological-orthopaedic rehabili-tation clinic took part in this study. The experi-mental group comprised 15 patients with cognitivedefects requiring treatment, and the control gfoup15 patients with no serious cognitive defects. Thepatients in the experimental group received 16training sessions at the PC lasting ca. 45 minuteseach, at which two of a possible four RehaComprogrammes wefe used on each occasion(Iopologrcal Memory, Memory of \Words,

Attention, Vigilance).

The effects of training were examined using abzttery of tests comprising perfotmance tests(d2test, Vienna Test System/work performanceseries, Colour-Word Interfetence Test, StandardVersion of Progre s sive Matrices, HA\ME / numb etrepetition, Vienna Test System/reaction timemeasurement, NTMS/pair association test,Diagnosticum for Cerebral Defects, BentonTest and LGT-3/objects) and questionnaires. Itwas observed that the experimental group, butnot, howevet, the control gfoupr demonsttatedsignificant improvements in performance in thetrained areas of attention and memory, as wellas genetalisation effects affecting cognitive func-tions not directly trained, such as intellectualcapacity and cognitive adaptability. The PC train-ing also improved the patients' subjective mood.

Wenzelbutger, K.T. (7996): The change in andtrainability of cognitive functions among alco-hol-dependent patients undergoing withdrawal

- a controlled study. Dissertation at the MedicalFaculty of Eberhard Kads University, Tiibingen.Two treatment pfogfammes v/efe compared withorre another during a thtee-week period ofcontrolled in-patient alcohol withdrawal. Anexperimental group of 18 patients wasgiven 4 training sessions lasting 45 minutes eachwith RehaCom's Attention' and 'Topological

Memory' progfammes. A second experimentalgroup of 18 patients took part in memorytraining (games) in the same timeframe. Theconttol group was treated as notmal in-patients.

Beckers (Diisseldorf Neurolo gical TteatmentCentre): In: Sfeber, P.; Regel, H. & Krau-Se, A. (1998). RehaCom computer-assi-sted programmes fot cognitive rehabilitati-on. (I\ewsletter 9/98). Modling: Schuhftied.

This study was conducted on six patients suffe-ring craniocerebral injuries, all. of whom exhi-bited serious deficits in attention and memory.SYAIS-R, WMS-R, RBMT, d2 and the ViennaDetermination Device were used to examine cog-nitive pedormance before and after training. Thetraining comptised 9 x 20 minute sessions withthe 'AUFM', ry'IGI' and 'MEMO' programmes.

A 'befote and aftef comparison showed signifi-cant imptovements in WMS-R subtests and withthe Vienna Determination Device. A single caseanalysis led to the following conclusions: theeffects of the specific computer-assisted cognitivetraining are most apparent in tests which relate tothe same function as the programme. Each typeof training improves only the intended dimension,and exhibits no global effect on other functions.With craniocetebtal injury patients, it improvesperformance in the functions being trained.


Giinthner, A., Jung, V. (Thesis, University ofTiibingen, 1997): Effectiveness of the RehaComprogfammes Attention and Concentration','Divi-ded Attention','Topological Memory','Memoryfor Words' and'Log1cal Reasoning' in neuropsy-chological rehabilitation. Giinthn er / Jung studied60 alcoholics during detoification using a three-group experimental design. The first group wastrained with RehaCom (AUFM and MEMO) infour sessions of 40 minutes each (20 minutes perdimension). The second group was given memo-ry training with (non-computer) memory games inthe same timeframe. The third group was used as acontrol, and received no training. All three groupswere tested before and after with a battery of pa-per/pencil tests (LPS [short form], revision test,trail-making test B and Benton Test). One impor-tant result was the significant intervention effectfound in the RehaCom and memory-g megroupsin the Benton Test. In a second study, Giinthnerexamined 20 schizophrenic patients using the samebattety of tests. In this case, however, he omittedthe 'games' comparison group. In this study too,memory training was found to have had an effect,because there were again significant imptovementsin the Benton Test. No effects on other test per-formances (LPS) could be proven in either study.

Fldschel, K., Uhlendodf, V., Biegel, K., Kune-rt, Weniger, G. & Ide, E. (7996\: Effectivenessof out-patient neuropsychological attention andmemory training in the late phase following cra-niocerebral injury. Zeitschrift fiir Neuropsycho-Iog1e, T,Issue 2, 69-82. Hcischel and colleaguesconducted a pilot study to examine how effec-tive neuropsychological attention and memorytraining might be in the case of craniocerebralinjury out-patients in late rehabilitation. Sevensuch patients were given individualised atten-tion and memory training over about 3 monthsusing a number of programmes, including Re-haCom (Attention, Vigilance, Reactivity, Figural

Memory, Topological Memory and Memory forWords). Pre/post comparison and a follow-upsix months later revealed cleat and enduring im-provements in attention functions GAP, dividedattention, set shifting) and a significant, butonly moderately stable improvement in memo-ry performance (selective reminding). Therewas no conclusive evidence of generalisation toother attention and memorv-related functions.

Jutblad & Erikson (Mdlndal): Schuhfried(2000). Newsletter. (I.I". 9). Modling: Schuhfried.In a Swedish study, eight patients aged between20 and 58, all with cognitive function impair-ments, were examined. Based on the test resultsflWAIS-R, TMT A and B, Gottschald test battery,Cronhol-Molanders memory test and the AMPS),thtee RehaCom programmes (AUFM, REA1,!fORT, MEMq RAUM or WISO) were selectedfor each patient. For a period of 10 weeks, eachof the patients trained with each programmetwice a week for a maximum of 30 minutes.Significant improvements in the'$7AIS-R, in theGottschald test battery and in the TMT A werefound in the follow-up diagnosis. The AMPS in-dicated a genenl improvement in motor tempoand planning abiJiry. A survey of the patients'families produced the following results: the re-Iatives of five patients stated that, even in eve-ryday situations, they had noticed improvementsin attention. In the case of four patients, theirrelatives observed improved memory perfor-mance when faced with everyday challenges.

Liewald, A. (1996): Computer-assisted cogni-tlve training with alcohol dependants during thedetoxification phase. Dissertation at the MedicalFaculty of Eberhard Katls Universiry Ttibingen.Four x 40 min. sessions at the PC were attendedover a period of two weeks by 20 alcohol-depen-dent men participating in a three-week course

of detoxification and motivational treatment, inwhich the patients v/ere trained using the 'At-

tention and Concentration' and 'Iopological

Memory' RehaCom programmes. The perfor-mance of patients was tecorded before and zftertraining in a number of neuropsychological tests.All in all, training and the tests revealed distinct im-provements in performance. The author concludesthatitis completelyfeasible andworthwhile to carryout cognitive training even during detoxification.

Mellfeldt Milchert, S. (2002)z Datorisetadkogntiv rehabilitering psykiatrisk oppenvird$/istra Stockholms psykiatriska sektor Spingapsykiatriska omride) Schuhfried (2000).Newsletter. QtIo. 9). Modling: Schuhfried.

Another Swedish study looked at computer-assisted cognitive rehabilitation in out-patientpsychiatric treatment. Eight psychiatric pati-ents suffering from problems of depression andcognitive dysfunction were trained using a selec-tion of RehaCom programmes. For each patient,training comprised 40 sessions (of no more than60 minutes each), split between the programmesAUFM, GEAU, \TGI, MEMO and BILD.

The following tests were used to analyse the ef-fectiveness of training: \7AIS-R, Benton Vi-sual Retention Test, Wisconsin Card SortingTest, TMT A and TMT B and Beck DepressionInventory. The final examination was evaluatedas a 'single case analysis'; all patients showedsignificant improvements in the WAIS-R, TMTA and B and the Beck Depression Inventory.

Regel, H. & Fritsch, A. (1997)z Evaluation stu-dy of computer-assisted training of basic mentalfunctions. Final repott on the funded reseatch pro-ject. Bonn: Kuratorium ZNS. One hundred andtwenty patients vrith cerebral damage (88 follow-

ing a stroke, 21 following ctaniocerebralrnjvy,llftom other causes) were treated with the logothe-rapeutic and ergotherapeutic convention al tteat-merits and computer-based training programmes(RehaCom programmes) fot at least four weeks.One hundred and eighty-two psychometric valueswere included in the evaluation. Pre/post compa-risons revealed 37 - 45 o/o confirmed differences.

Regel distinguishes three transfer effects: First-order transfer effect (training effect): trainingcognitive function results in improvements in theapproprratetests (e.g. training an attention functionleads to improved petformance in attention tests).

Second-order trans fer effect (generalisation effect) :training cognitive function results in improvementsin a cognitive atea which was not the subject ofthe training (attention training, testing memoryfunction). Third-order transfer effecc trainingcognitive functjon results in improvements whenresponding to everyday or ptofessional challenges.

A number of correlative connectionsbetween increased performance and trainingprogress using RehaCom programmes showthat computer-assisted cognitive training playsan important role in improving performance.Many indications wete found of a third-or-der transfet by questioning patients, conver-sing with them and obsetving their behaviour.


Diebel et al. (1998, Magdeburg Social Paedi-atric Centre):Diebel, A.; Feige, C.; Gedschold,J.;Goddemeier, A.; Schulze, F. & Weber, P. (1998).Computer-assisted attention and concentrationtraining for healthy children. In: Praxis der Kin-derpsychologie und Kinderpsychiatrie, 7998,Issue 9, pp.641-656.The aim of the study was to examine the Reha-Com AUFM programme for use in the treatmentof children. The programme was evaluated in thecase of children of normal health and from vad-ous age groups (nursery school children [15] andprimary school children from Classes 2 [1.2] and4 t15]). The nursery group trained twice a week,and the primary school children once a week.Each training session lasted about 15 minutes.According to the authors, neuropsychological di-agnosis was not possible for reasons of time andmoney. The results were therefore based on thedata recorded online from ttaining and on que-stionnaires, from observing behaviour and fromthe verbal comments of the children. The resultsachieved by the various age groups differed signi-ficantly in terms of the heightened perfotmanceparameters of training (evel of performanceachieved). Schoolchildren benefited more fromtraining than did nursery school children. Theimplications of changing the training programmefor use by children were also discussed.

Cochet, A.1 Saoud, M.; Gabriele, S.; Broallisl,V.; ElAsmar, C.; Dalery,J.; d'Amato, T. (2006):Impact of cognitive remediation on problemsolving skills and social autonomy in schizo-phtenia: application of the RehaCom@ software.L' Enc1phale; 32: 1 8 9 - 1 9 5. E A 309 2,',.uln6rabilit6i la psychose de la prediction i la prevention,UCBL Lyon1, IFR 19, Instirut F6d6ratif des Neu-rosciences de Lyon (IFNL), CH "Le Vinatier", 95boulevard Pinel, 69 677 BRON cedex, France.30 patients who were diagnosed with schizo-phrenia @SM f\D attended an explorative study.

It was a precondition for those patients to havebeen taking antipsychotica since at least threemonths. In seven sessions happening once a weekthe following RehaCom@ procedures for cog-nitive remediation were applied: Reha-AUFM,that trains the attention/concentration, Reha-ME-MO, which trains the topological memory, Reha-LODE with training of the executive functionsusing a procedure of logical reasoning, as wellas Reha-EINK, which also trains the execurivefunctions vta z virf:al shopping exercise. So farthere was no control group since this happenedto be a preliminary study. Alternatively results ofsimilar studies were consulted. Those patientsshowed a clear improvement of all trained skillsas well as their functional skills. Furthermoreclinical symptoms of schizophrenia were reducedwhich was e.g. reflected in a low termination rate.

Notes:

The company HASOM ED GmbH thanks al l partners who are and wereinvolved in the development of RehaCom. Without your col laborat ionthe development of such a sophisticated system for cognitive therapywouldn' t have been possible.

Prof. Hans Regel (f)Medical facuityUniversity of MagdeburgIdea, theoretical conceptRehaCom,Attention, memofy

Dr. Andreas KrauseMedical facultyUniversity of MagdeburgTheoretical concept RehaCom,Attention. memorv

Prof. Dr. Joachim FunkeP sychological instituteUnivetsiry of HeidelbergExecutive functions

Dr. Thomas KriigerCentre for evaluationand methodsUniversity of BonnExecutive functions

Prof. Dr. Josef Z*1,Clinical neuropsychologyDepartment psychologyUnivetsity of MunichVisual disotdets

Dr. Peter \X/eberHASOMED GmbHMagdeburgIdeas and concepts RehaCom

Dipl.- Ing. Frank SchulzeHASOMED GmbHMagdeburgProduct m n gerConceptual design anddevelopment softwate

PD Dr. Sandra Verena MrillerNeuropsychology Stroke UnitClinical centreBremen-Mitte gGmbHOccupational rehabilitation

n iohannes w-erres,.l t F'

Organisation of integrationt I -. Occupational rehabilitation^.',*) ceritre Sachsony-Anhaltt=r

The name RehaCom stands for a system that includes mote than 25 ptocedures for effective cognitive therapy of func-tional brain disorders. RehaCom contains procedures for specific and basal as vrell as fot complex and realistic training.

The use of RehaCom offers the following benefits:

Adaptive training - optimal operationAvailable in 14 languages - ttaining in the patient's own languageSpecial patient keyboard - raining possible even with restricted motor functionCentral patient administration - low administrative costsHome training on the internet - observed by a therapist if requiredStandardised operation and Help function - short inttoduction timeAutomatic record of past treatment - progress can be followed cleady

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Computer:

Monitor:

Printer:

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Prozessor zb 1GH4512 MB RAM (depending on the system)At least 1 GB free space on harddiskUSB po. for the Rehacom panel or a seierf parallel or uSB portfor a dongleDirectX compatible graphic cardMouse, Keyboard and CD/DVD optical drivesoundcard, speakers or headphones (for audio response)STindows 9 8 / \/IE / 2000/Xp/Vista

VGA colour monitor, L5,, otlatget (recommendation 1.7,, to 2,!.,)fot easier handling some of the procedures use a touch screen

any printer supported by Windows

Documents

RehaCom Catalogue