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1st September 2021 Latest News

Cognitive Training In Parkinson’s


Co-design of the OrbIT ‘Serious Games’ system – you had your say and made our day!

By Associate Professor Lyndsey Collins-Praino and Dr David Hobbs (pictured)

Cognitive impairment is a common symptom of Parkinson’s disease, affecting approximately one-quarter of even newly diagnosed people.

These cognitive changes can make managing certain everyday activities, such as remembering to take medication on time or managing finances, difficult.

Cognitive training (CT), which involves repetitively training specific cognitive skills, may prove helpful. To date, however, evidence of benefit for Parkinson’s is mixed. This discrepancy may be the result of the methods traditionally used to deliver CT, including pen-and-paper or a traditional computer, which may be limited by motor impairment.

In support of this, previous studies report that about 80% of computer users with Parkinson’s have difficulty using the device, and almost half struggle to use a standard mouse. The apathy that affects up to 40% of people with Parkinson’s may also influence ability to fully engage with the CT program.

Working together, we can find a better way forward. Using the well-loved ‘Orby’ controller, coupled with an entertaining suite of video games, custom-designed to target the cognitive changes known to occur in Parkinson’s, we have developed a unique CT program called the OrbIT.

In order to ensure that the system was optimised for use with people with Parkinson’s, we conducted a co-design trial at the end of 2020.

As part of this process, 13 people generously gave their time to test the system. After three sessions, they provided extensive feedback that helped us to significantly improve both the controller and the games.

Improvements made include changing the controller setup and responsiveness, clearer instructions, optimising task difficulty, and redesigning certain games. After incorporating these changes, individuals were invited back to assess their thoughts. Excitingly, 100% of people reported their concerns had been addressed, with changes to the controller scored 7.64/10 and changes to the games scored 7.91/10. Overall, people indicated that they really enjoyed the system (8.18/10). These results were recently presented at the Australian Dementia Forum, and a paper is currently in preparation for publication.

Importantly, this process highlights the importance of co-design. When stakeholders and researchers work together, it leads to better outcomes for all. Had we simply conducted a trial, we may have mistakenly concluded that the OrbIT system lacked benefit, when really it just wasn’t optimised for people with Parkinson’s!

Now, we can move forward with confidence that we are testing the OrbIT’s full potential. Given the positive perception and enjoyment noted in the co-design, we hope that its interactive and targeted nature will lead to high levels of compliance and significant benefit for cognitive function in Parkinson’s.

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