REACT: (REhAbilitation Through Cognitive exercises)

REACT has been realized by a Rehabilitation Center with the advice of Grammelot and with the use of Quiddis.

Background
The need to use technological tools to monitor and continue home rehabilitation treatment. With the term Activities of Daily Life (ADL), we refer to the daily activities forpersonal care during one's life. The concept of ADL was proposed in the 50s by Dr. Sidney Katz and his team at theBenjamin Rose Hospital in Cleveland.

Materials and Methods
A team of professional figures, with multidisciplinary clinical skills and technical-IT skills, developed REACT activities. The group worked on matter of relevant interest for the rehabilitation of neurological patients and identified the most effective forms of communication starting from the available Quiddis solution (tests, tutorials and quiz). Nine activities were developed, divided into 3 macro-areas: motor activity tutor (e.g. fall prevention and sit to stand) , non-specific cognitive stimulation and activities of daily living (e.g. to get dressed; use of cell phone; shave the beard). All activities were proposed to patients in the exploratory study. Ten patients were recruited with functional disturbances of mild/medium degree in the upper limbs caused by neurological disease. Each patient underwent a cycle of 4 sessions of intervention (2 guided, 2 only supervision) with REACT support. Patients performed activities seated, equipped with tablet and earphones. Sessions have always been proposed in addition to physiotherapy and/or occupational therapy.
Outcomes focalized on the organizational impact of using this tool in a clinical neurorehabilitation context and considering the possibility of employment in the home environment (tele-rehabilitation). The questionnaires used
were the Motivational Index and an Approval Questionnaire developed by Casa di Cura del Policlinico, Milan (CCP).

Results
The analysis of satisfaction questionnaires showed a very good level of pleasantness, usability, satisfaction and sustainability. Furthermore, considerable involvement by patients in the administration of the Motivational Index is shown. The level of motivation during the treatment is high, enough to let some patients ask about the commercial
availability of the REACT platform. Moreover, a qualitative survey was submitted to the involved rehabilitators, which showed the interest in using the tool, that is potentially a valid support to the rehabilitation with the due technical improvement.

Conclusion
The operators believe that the instrument can be a valid means to support the continuation of the treatment once this kind of patients go back home after the regular rehabilitation in the clinic.Wider investigation with REACT support for specific neurological conditions should be studied.